I’m so fucking excited, but this is the first time I’m really feeling nervous about it. I wish I knew more of what the process is like? I’ve heard its dead simple, and everyone I’ve talked to at the clinic on the phone has been super lovely , but I can’t help but feel like somehow it’s all going to go wrong.
My doc was nice about it, we went over complications and he asked me to describe what dysphoria felt like to me (no wrong answers, but it did give me a bit of a panic attack describing it). It took a couple appointments before I started. It's not like it was 10 years ago where they made you have to live fully out for like a year or whatever, or if you don't fit exactly the gender stereotype they wouldn't prescribe. It's much better now.
They'll probably talk about route, cause E gets metabolized by the liver first pass you don't get as much of it by the usual oral route. They'll probably talk to you about T blockers, spiro is like the default one but it's a potassium sparing diuretic so you should be aware of the signs of hyperkalemia (rare side effect, but you should know about it). Spiro is also pretty cheap, dunno if it's cheap in the states though. You might get progesterone as well, my doctor recommended we wait a year or so with estrogen based on the clinical evidence, I'm happy to defer to his judgement but there is evidence that starting progesterone earlier can lead to better outcomes (e.g. breast growth for example).
E has side effects, cis women are at higher risk of embolisms and DVTs and hypertension and shit like that because of their endogenous estrogen. You will be at higher risk too - you should know the signs of a pulmonary embolism for yourself. They'll also talk about irreversible effects, regret over transitioning is VERY VERY small compared to like every other medical procedure but it is a thing and you should know what may be irreversible (fertility and breast growth basically) so you can give informed consent about taking HRT.
They'll screen you. They ought to know your baseline hormone levels so you'll do some blood work and probably urine work too. After starting for a while, you'll have to be screened again so they know if the prescribed HRT is working as intended or if the dose/route/med needs to be changed.
Also, the number one users for HRT are actually cis people, lol. Tons of cis women take E, some take t blockers too. It's not just a trans thing and it is fairly well known and studied and the meds are all very safe.
Thank you. I’ve tried to read up on side effects as best I can, but reading it from another person is way better then in kind of fear mongery articles.
The side affects and risks are also significantly lower than they used to be. A lot of the data on the rate of severe side affects often comes from trials with other populations that are not trans because there has historically not been very much research into our healthcare needs.
This can result in inflated perceived health risks because you can sometimes see a number that looks severe, but when you look up the population the study came from its 60 year old+ cis men with pancreatic cancer or whatever the fuck.
Other times, the risks won’t get updated even though HRT is improved. Good example is that the type of estrogen now used in HRT is bio-identical instead of synthetic and has waaaaay lower health risks.
There’s also the issue of the medical community fixating on increased rates of medical conditions that while higher for a cis man, are close to or identical to the risk of those conditions in a cis woman. Example: breast cancer.
Obviously doctor’s are going to be risk-averse, but they can sometimes over do it. Important to be mindful either way so you can stay safe. I’m nervous about starting too!