When preparing to start HRT, I was bombarded with information
about the potential risks and side effects that come from it as well as the
changes that I would most likely experience from the hormones. On top of that, because of the people in some
of the Facebook groups that I am in, there were other, less common side effects
that I learned about. This post is
mainly for the cisgender people out there that read this and are not familiar
with this subject. I will be giving some
of my personal experiences with HRT and its effects on me as examples.
I guess that I should first start with the scary stuff, the risks,
that come with being on HRT. Some of the
things in the Risks category are extremely dangerous but, after weighing the
potential of them against the known factor of suicide, I personally decided to
take my chances with the potentials as opposed to repeatedly attempting suicide
till it stuck.
One of the risks that is usually pointed out is the increased risk
of breast cancer. While it is true that
transwomen face an increased risk of breast cancer and other estrogen sensitive
cancers, recent studies have shown that those risks are largely influenced by
genetics and not necessarily the hormones themselves. Yes, they do have an increased risk over
other people who happen to hail from the more masculine sex but when compared
to cisgender women, the risks are roughly the same. This doesn’t mean that transwomen need to
ignore the risk factors when it comes to breast cancer. They need to have regular screenings just
like ciswomen to make sure that they haven’t developed it, especially if there
is a family history of it.
Another set of risks that tends to be pointed out is the risk of
liver disease, kidney disease, and other digestive system related diseases. These risks are largely on this list due to
the standard form of delivery for estrogen that was used for so many years and
is still used regularly today. I’m
talking about oral delivery in the form of pills. The reason for the increases risks if that your
body has to deliver the hormones through the digestive system which not only
causes extra strain on the parts involved, but it also lowers the effectiveness
of the hormones themselves. Because of
this, doctors are starting to move away from the pills in favor of patches,
gels, and injections. I am on injections
and I have to inject once every 7 days.
Tuesdays are my injection days and I inject into my glute which can be a
bit of a pain but, seeing as it is the safest method available, I’ll take it.
There is also an elevated risk of heart disease, blood clots, and
deep vein thrombosis but, once again, these risks are lessened by using a
non-oral method of delivery for the hormones.
In fact, the risk factors with oral delivery is the main reason my endocrinologist
only prescribes injections. She wants to
make sure that us girls have the smoothest and safest transitions that we can;
even if it means we have to get over our fear of needles and be inconvenienced
by regular testing she does in order to make sure everything is going smoothly. There are a few more risks that are there but
they are mostly influenced by genetics more than anything.
With those out of the way, let’s talk about the beneficial (in the
eyes of a transwoman) effects that female hormones have on the male body. Keep in mind that age does play a role when
it comes to what degree these effects have on the body, for example, a
transwoman in her early twenties is going to receive much more physical
benefits from hormones than someone in her early forties. The reason for this it that the body of the
younger woman is still maturing and by introducing hormones at a younger age,
it will finish maturing in a more feminine manner than the body of the older
woman whose body has finished maturing.
The most obvious effect of HRT is the development of breasts and
breast tissue. A transwoman is more than
likely going to experience less growth than her cisgender family members unless
she starts as a teen on HRT but, that said, most still do experience noticeable
growth and genetics really is the biggest factor in the development of the
breasts. The general rule of thumb is
that a transwoman should end up about one cup size smaller than their cisgender
relatives tend to average out to be, with more emphasis put on the sizes of
their mother, sisters, and aunts than cousins.
Some transwomen experience very rapid growth over a short period of time
while others take years to fully mature.
I happen to fall in the middle of those two. I had development start within the first two
weeks of HRT with rapid growth for a couple of months before my breasts stalled
out. Now at the six-month mark, they are
just starting to hit another growth spurt and there is no telling how long that
will last. They may stall out again or
they may grow to maturity, who knows.
Another effect that quickly becomes obvious to the outside
observer is the way the hormones affect the skin. Estrogen causes the skin to become softer,
thinner, and slightly lighter in color.
It also tends to make the skin less oily to where it dries out easier,
requiring the use of lotion to keep the skin hydrated. In addition to the effects on the skin, body
hair is affected as well. Body hair
tends to thin out and become lighter and less noticeable in color. There are exceptions to this, for example,
someone with extremely thick and dark body hair may see some lessening of it,
they may end up having to get laser or electrolysis to make it fully go
away. Now to be clear, it will not
affect facial hair. That needs to be
removed through laser or electrolysis in order to get rid of it permanently. Currently, I have had 16 hours of electrolysis
to remove my facial hair and, according to my wonderful torturer, I mean,
electrologist, it usually takes about a minimum of 100 hours to get rid of a
beard, depending on the thickness. It is
extremely painful and time consuming and leaves the skin irritated for days,
but in my opinion, if it makes I don’t ever have to shave this horrid rug off
my face again, then it is worth it.
Speaking of hair, HRT can slow down and even stop hair loss that
the transwoman has experienced. If they
are very lucky, they may even see some reversal of loss. I happen to be one of the lucky ones because
where my hairline had receded, it is very slowly starting to fill back in. That doesn’t mean that everything I have lost
will come back, but it does mean some of it will and is, and that makes me
quite happy.
Another effect that HRT has is the redistribution of fat within
the body. The hormones will, over time,
slowly shift the fat deposits in the body to more feminine areas such as the
breasts, buttocks, hips and thighs. It
also affects the fat deposits in the face which tends to give the face a
slightly more feminine appearance though, it won’t work miracles because the
bone structure that is there won’t change short of having plastic surgery.
One of the effects of HRT is sterility. The size of the male genitals shrinks and,
for most, loss of sexual function occurs.
To some transwomen, this is actually a relief due to the way they
experienced dysphoria when it comes to their genitals. For others, it turns out to be a non-issue
because what they had of a sex drive is usually killed off buy the
hormones. There are a few though, that
maintain both function and sex drive (with some it is even increased) even
though their testosterone production is at a minimum. I’m not going to say where I fall in this
category because there are somethings that nobody not involved with that part
of my life needs to know, but since I am talking about sex related things, I might
as well mention how HRT affect sexuality.
Honestly, it seems to be random how HRT affects the sexuality of
transwomen. Before HRT, if the
transwoman considered herself as a straight male, there is no guarantee that
she will be a lesbian when all is said and done. Her preference may shift from women to men or
both or neither. The same goes for
transwomen who previously identified as gay.
There is no telling exactly how HRT will affect your sexuality until it
starts to do so and there is no rhyme or reason as to why.
Ok, this post has gone on a bit longer than I intended so I will
pick up at this point in the next post.
- Arylin Michelle
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