I began on low-dose HRT (estradiol patch and spironolactone pill) in mid-July, 2019. My doctor described it as “one sixth” of the amount she would prescribe to someone in full transition. Since then, I have had two increases, and am currently at approximately 1/3 the full dose. I am posting updates every few months, or when things are interesting.
Mid June, 2021 (1yr, 11 mos) – I had my 2-year check-up in early May. It was actually a 96-week checkup because the estrogen is prescribed in packs of 12 weeks, rather than 13, meaning the appointment will move about a month forward with each passing year.
I told my doctor that the hormones are controlling the dysphoria well, but that I remain somewhat disappointed to not be getting much in the way of emotional changes. She was totally open to going up on the estrogen, and bordered on encouraging it, but I declined. In addition to not seeing much in the way of emotional changes, I have seen essentially no physical changes (beyond slight weight gain, which could be related to the pandemic), and I’d prefer to keep it that way — mostly. I know that my body is now fully primed, and even a small increase could trigger rapid developments. Or not. I’m 57, and the chance of significant bodily feminization has always been rather low.
The doctor said that she goes with what each patient feels is right, as long as it’s safe, and that most of her patients know when to go up. I asked her how they know, and she said that they typically get to a point where they “just can’t take it anymore.” I am not there . . . yet.
In talking with my spouse afterward, she also encouraged me to consider going up if the results aren’t satisfying, and questioned why the doctor would trust patients to make that decision if the potential benefits are well-established and not dangerous. While that’s certainly a welcome response, I’m not sure she entirely appreciates the potential degree of physical changes, and that she would likely not be comfortable with them.
But as I have processed these conversations, and my own desire to experience more psychological benefits, I am becoming more willing to risk the physical in service to the emotional. With another follow-up appointment already scheduled for November, my doctor made it clear that I could contact her before that to request an increase and she would grant it without hesitation. That would likely take me up to something approaching 1/2 of a full dose.
If I’m honest with myself, I realize that I really would like to be at a full dose someday, say, by the time I turn 60 in the summer of 2023. If I plot that out, it looks something like this:
Actual
July 2019: 16%
Dec 2019: 25%
July 2020: 33%
Goal(?)
July 2021: 50%
July 2022: 66%
July 2023: 100%
I may have to live with physical changes — which I very much don’t want, but also very much do still dream of. Perhaps I am actually nearing a point where I just “can’t take it” — the ambiguity, the waiting, the hoping, the anticipating, the need to shirk off one gender and reveal the other. I may very well need/want to take the next baby step.