Unlike the Other

I think for most of us the most difficult part during the early phases of Transition is simply telling someone what we are going through. The first person I revealed myself to was my therapist during our first session. I didn’t exactly tell her I was trans, but I provided her with enough information to get her pointed in the right direction. Months later I told my mother and that was a hard birth if there ever was one.

I have told many people since then, so many I have lost count. I must be nearing triple digits by now. In a way, it does get easier with practice, but finding the right words still alludes me. It always feels awkward, sometimes more than others, but it’s almost always an uncomfortable place to be for all parties involved. Having a sense of humor about all this helps, but I am not always that funny.

The common response I keep getting from people is “congrats”. People don’t know how to respond, and I get that. But for me this response feels a lot like someone randomly thanking me for my service in a public place – I don’t know what to do with that.

A young woman tried to explain this response to me recently. She said she was congratulating me on having the courage to be myself. I guess I hadn’t thought of it that way, but then again I don’t see me as being courageous. I don’t feel as if I have much of a choice in the matter at all.

For me coming out to people has become a bit of a selfish exercise. Part of me feels as though telling the world will set me free to be myself. I want nothing more than people to recognize me for who I am.

Most MTF trans-folk seem to be hung up on the physical element of passing. I’d be lying if I claimed to not want to peel back some of the effects of testosterone-induced puberty, but at the end of the day, it is less important to me that I pass, and more important to me that people see me for who I am, accept me for who I am, respect me for who I am. I think someone can recognize me as being trans, and still treat me with respect and dignity. What more can I ask for?

I have found that I can sometimes be a bit too eager to tell people who barely know me. After some thought, I believe I am being selfish and that it isn’t fair to the person I am talking to, to just unload that on them without warning. Not everyone needs to know, and not everyone wants to know. It’s been a learning experience.

I’m a work in progress in more than one way.

So it’s been three months since I started HRT, and much has happened during this time. As much as I wish things would move at a more speedy pace, I am truly amazed at how quickly things have changed. That might sound like a bit of an oxymoron, but it isn’t.

On a day to day basis, changes are very minimal, and often not apparent to the naked eye. However, looking at the changes over the course of a month or more, they quickly become undeniable.

Physically

The biggest changes for me have been: Boobs, Butt, and the thinning of body hair.

My rear has rounded out a lot. It’s really noticeable when I wear my old jeans, as they are much tighter than they once were.

I wrote a month and half ago that I was as flat chester as ever, this is no longer the case. I am happy to report, that I officially have little A-cups. Nothing crazy, but I love them regardless. The goal is a B-cup. Being as skinny as I am, anything more might look a bit silly.

I have also been noticing that the hair on my arms has gotten much lighter, and is growing slower. I think my leg hair is also growing slower, though it isn’t as apparent.

I have also been told that my skin is much softer – I can’t really tell. I can say, that my skin has cleared up a fair bit though.

Emotionally

I have change a fair bit emotionally. I feel I experience things much more intensely. I think part of it is just allowing myself to experience emotions, rather than trying to bury them.

I am told that I am more loving, and will admit that I am much more likely to cry when I see, or read something sad.

Psychologically

Psychologically I feel much better than I did this time a year ago. For one, I am happy to report that I haven’t had a panic attack since the middle of June. That’s roughly seven months. Of course I can’t contribute that all to HRT, but it certainly plays a part.

I still have my struggles with anxiety, but it is nowhere near as bad as it once was.

What’s next?

I am in the process of coming-out at work. I first approached our HR manager before the holidays, and I was informed yesterday that the big boss has been briefed on my intent to transition on the job. So, I should find myself in a meeting with local management very soon to discuss the details of how we will proceed.

The company holiday party is next week, so all of the players will be in town, including my HR contact, and the big boss. So next week should be very interesting.

Medically, I have my next doctor’s appointment in two weeks, and a follow up two weeks after that. I am really curious to see where my levels are at.

I really need to figure out what I am going to do about my voice. I think it’s my biggest tell, not that I am trying to hide who I am, but being able to fly under the radar provides a sense of security. Voice training is an option, though I don’t feel I have had much success with this thus far. I am not sure a surgical solution is an option, as it is rather cost prohibitive.

Speaking of surgery, I do plan to have a surgery this year. Something called a “trachea shave.” In layman’s terms, this is the reduction in size of the Adam’s Apple. The Adam’s Apple is cartilage on the outside of the voice box. This is done via a small incision under the chin. They go in through this incision and shave the cartilage down in size. Results depend on the size of the Adam’s Apple, and how much material they can safely remove.

I feel having this surgery would help me further reduce my anxiety level, as this is a major visual source of dysphoria for me.

 

I got home late this evening. It’s a rainy day in Vegas, and things seem to slow down here on days like this. Overall the day was pretty average, went to work, ran some errands, just another day.

After dinner I proceeded into my bathroom, still wearing my work clothes, slightly damp disheveled hair, and as I stepped in front of the mirror – I froze. I just stood there staring into the abyss.

I think most trans people take frequent inventory of their lives, the decisions they’ve made, and how far they’ve come, as we ask ourselves, “am I doing the right thing.” It would almost certainly be easier to cave, to conform, right?

As I stood in front of that mirror, I saw something in my eyes I hadn’t seen in some time. Something I am not sure I can describe. A feeling, a past, an empty-ness I had hoped to never experience again. What seemed like an hour was surely not much more than a brief moment, but in that moment I had my answer.

I quickly changed into the PJ’s my mother got me, and a fluffy pink robe I received from my sister, and I couldn’t help but smile as Emma re-appeared in front of the mirror. It’s hard to believe what a difference clothes can make.

The truth is, I couldn’t go back to the way things were.

It’s been a day. Sunny in the morning, cloudy in the evening. From dancing in my underwear, to sobbing silently in the back seat of my parents car. It’s been a rollercoaster. Let me explain…

I woke up this morning to another sunny day in southern Nevada, perhaps a bit earlier than I would have liked, but I was in a good mood. Signing in the shower, and dancing in my underwear to some of my childhoods greatest hits, good!

As I got ready I examined myself in the mirror and decided I looked cute in my girly shirt, and new ear rings.

The days agenda was one of shopping at the outlet mall downtown Las Vegas. I was excited to spend some quality time with my family, while possibly finding some cute outfits at a bargain.

I grabbed some Dunkin’ on my way to my sister’s house. Gotta have my coffee. All seemed well, my spirits were up.

The first store we walked into was Adidas, where I was promptly sir’d by a young man asking, if he could assist us. Not that I expected him to greet me any other way, but in a way this set the tone for the rest of the day.

As we wandered from store to store, I found myself admiring the droves of shoppers and how they moved about, seemingly without a worry in the world. Never having to question their gender, never worried about being put into question for the way they move, dress, talk, sound… for showing interest in the wrong item.

As I watched silently, I realized that I did not know what that felt like. I have always felt watched, judged, unable to comfortably move about in a store just minding my own business. Even when I was presenting male, shopping for boy things, I always felt this way, for as long as I can remember.

Wondering, if I would ever get to a point where I felt this comfortable, to just be myself, unapologetically – this made me sad. This sadness loomed over me for the remainder of the day, with my hormones rearing their ugly head. I couldn’t shake the feeling of needing to just cry.

I realize that feeling this way is completely irrational. I have been on HRT for less than 3 months. I lived as a man for more than 3 decades. I don’t know what I was expecting as I walked out the door this morning.

I am typically the person who everyone expects to have their shit together, but sometimes I just need to be a little irrational. To cry… to throw a tantrum… to spill my heart out… to have someone take pity on me, and tell me that everything will be alright.

I know that tomorrow will be a new day, with a new outlook. I understand that not all is lost, and that I have every reason to be hopeful for the future. I can’t tell you how blessed I am to have a loving, supportive family, and amazing friends to boot. But for now, I just need a good cry.

Dysphoria is something everyone experiences differently. For me it was something I could neatly lock in a box with Emma, for months, sometimes years at a time, and not think about. But it would never really go away. It was something which would come and go in waves, each wave being taller, and harder to ignore than the one before it.

Each time a wave hit, I would try to explain it away. Clinging on to excuses. I am a very analytical thinker, an engineer by trade, and these feelings simply weren’t logical.

Then about two years ago, after being hit by a tsunami sized wave, I was at place in my life where I was genuinely unhappy with myself. I simple wasn’t the person I felt I should have been, and it was at this time that I found myself at a junction. I had to decide whether or not I could go on living like this.

Suicide wasn’t an option. Not that I haven’t ever thought about it, but I didn’t want to die. I just didn’t want to be who I was. This really only left me with one option, it was time to address my misery and start researching what I was experiencing.

I went on Amazon where I purchased at least ten books including biographies like “She’s not there” by Jennifer Boylan, and more general educational books like “Transgender 101” by Nicolas Teich.

I also searched the inter-webs for all, and any information which seemed relevant in my quest for knowledge. This included many hours of articles on various blogs and forums, as well as 100’s of hours worth of YouTube videos. Some of my favorite YouTuber’s being:

A Girl for All Seasons
Claire Michelle
Jamie Mackenzie
minorqback
Stef Sanjati
Gage
AJ Clementine

While I didn’t always agree with what these people had to say, I appreciated their honesty, and I found it helpful to see others like me living fulfilling lives, post-transition. Something I didn’t think possible for much of my life.

In addition to my research, I also knew I needed to talk to someone. To seek professional help. It took me close to a year to finally work up the courage to contact a therapist. It takes a lot of trust to open up to someone, and I hadn’t trusted anyone with this secret for more than three decades.

Once I finally started contacting therapists in my area via the Psychology Today web site, it didn’t take long to narrow down my options, and make my first appointment.

I was super nervous at my first appointment with Rochely. She was warm and welcoming, but I was a mess never-the-less. I tried to tell her why I was there, but remained rather reserved for the first few visits with her. I realize that this probably didn’t work in my favor, but I needed time to warm up to the idea of sharing this with another human being. Not to mention I needed time to truly come to terms with who I am.

Rochely believed in me from the onset, and accepted me as I was, without judgement. She challenge me, forcing me to ask myself questions I may not have otherwise considered asking. My time with Rochely was something I grew to look forward to. I was antsy to tell her about any new milestones I had crossed, big or small.

I am thankful for the time I was able to spend with her, as I feel it helped me gain confidence in myself and who I am. My time with her wasn’t helpful because she gave me the answers, or told me what to do, it was helpful because she challenged me to look for answers within myself.

Here I am, two months older and seriously overdue for an update. So without further ado lets dive right in.

I had my follow up appointment on October 6th. Aside from a vitamin D deficiency (go figure), my blood results looked pretty good. My doctor also noted that my testosterone levels weren’t good for a natal male. She didn’t really delve into the details of that though, and simply stated that it wouldn’t be a problem for me since I would be taking testosterone blockers.

I left the office that day with four prescriptions, each with 5 refills. I promptly filled my prescriptions for Estradiol, Spironolactone, and Finasteride at my local Walmart. I also received a prescription for Progesterone, which I took to a compounding pharmacy on the south side of Las Vegas. This one took a little longer to fill, and was significantly more expensive than the equivalent I could have gotten at Walmart, but I wanted to ensure I received a bio-identical progestogen, rather than the more common synthetic progestin.

I took my first regimen of the hormones I picked up on Tuesday October 10th, and started taking Progesterone two days later.

I have been on HRT for nearly 7 weeks now. It’s weird how on the one hand it feels like time couldn’t be passing more slowly, but looking back it’s hard to believe it has been a month and a half already.

I haven’t really noticed to many changes yet, though there certainly have been some.

The most apparent change has been a drop in libido. The drop is drastic. While it isn’t gone, the ever omnipresent male libido is merely an annoyance of the past now. I’ll spare you the details… haha.

As for physical changes there hasn’t been anything drastic. I do feel as though the hair on my arms is lighter and growing in slower. Not sure I can say the same about the hair on my legs though.

I have also been noticing changes regarding my nipples. While I remain as flat chested as ever, I do believe my areolas have gotten slightly larger and perhaps a shade or two darker. Also the nipples themselve are larger and feel more rigid, with a firm ball forming underneath.

They are more sensitive and can hurt when touched. I would describe it almost as if they were bruised.

It also seems there has been some minor fat redistribution around my hips and butt. Nothing major, but my hips have a little cushion on them for the first time ever. I am seriously skinny, so my hips have always been quite bony.

Other than that I haven’t really noticed much. I am under the delusion that my male pattern baldness is reversing itself, but I think that is probably just in my head.

My doctor did explain to me that in terms of HRT, I am quite old. So I am unlikely to see the same sort of results as someone 10 or 15 years younger than me. So we will see how things go over the coming months, and years. Keeping my fingers crossed.

I have my next lab and doctor visit scheduled for March, though I might move those dates up a bit, if I can.

Yesterday was a pretty big day for me. I had my first consultation for hormone replacement therapy (HRT). This marks the first step towards medical transition. Something I have been dreaming of for most of my life, though in my dreams it was more of a magical over night transformation.

In any case, I think I went into the appointment fairly well informed, and I knew about much of what the doctor was telling me. But she did have some insights from years of direct experience that you can’t really get from reading a book, a blog, or watching a YouTube video.

She talked about some of my options. There are four substances that we talked about. Two are pretty typical for most male to female (MtF) trans-folk in the United States. Spironolactone and Estradiol.

Spironolactone is an anti-androgen, also known as a Testosterone blocker in layman’s terms. The goal here isn’t to block Testosterone entirely, as it is important for things such as bone health. Both men and women naturally produce Testosterone, and I would take an anti-androgen to lower my levels closer to that of a natal female.

Estradiol is exactly what it sounds like, a form of Estrogen, the female sex hormone. Estrogen would be gradually introduced to my body, and gradually raised to female levels. The introduction of Estrogen into my body will induce what is essentially female puberty.

Then we also talked about Progesterone and Finasteride. I was familiar with Progesterone, but had never heard of the other.

Progesterone is quite heavily debated among clinician’s and the trans* community as a whole. It is believed that Progesterone has a number of benefits during transition, namely most trans-women care about it’s claimed benefits in the development of breast tissue. There are a number of studies that aim to disprove this theory, but most rely on synthetic Progesterone which does not appear to share the same benefits as bio-identical Progesterone.

Finasteride is one I had to do some research on after I got home. It is most famously known and marketed as Propecia. A hair loss drug that I have in fact heard of. Finasteride like Spironolactone, is an anti-androgen. It was developed for the treatment of enlarged prostate’s in men. It has also been noted in the treatment of prostate cancer in large dosages. Finasteride blocks Dihydrotestosterone, also known as DHT. DHT is one of the main culprits in the cause of male pattern baldness.

I will share some links below with further information on each of these drugs.

The doctor I saw was Doctor Haydee Docasar in Las Vegas. She seemed very knowledgeable and friendly. I picked her over others in the area not just for her wealth of experience, but reading reviews of each of the clinicians I got the impression that she would ensure that things would be done right. Hormones can be very dangerous, if not properly monitored.

Hormones are powerful, but changes can be slow to appear, so it is important to be patient and not over medicate. Taking to much to fast can not only cause lasting organ damage, but it can also lessen breast development among other things. For someone my age it will typically take about 18-24 months for the majority of changes to take hold.

I have a follow up appointment in two weeks to discuss my lab results. If everything checks out I should receive my first prescription at that time. Wish me luck. 🙂

Further information:

• Hormone Replacement Therapy (MtF)
• Spironolactone
• Estradiol
• Progesterone
• Finasteride