First Consultation

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: