ETA: I’ve received so many incredibly helpful responses and so quickly! Thank you all!!! 🥰🙏 I no longer have the doubts I had that led to these questions. I am grateful that I was able to address many less-positive concerns here. Now, I get to focus more on trans joy and preparing to start this incredible journey with you all 🥰
-Long-time lurker, first-time poster

Content warnings: Brief mention of transphobic reactions, a couple questions about de-transitioning

Context

I’m in my late 30s, amab. I’m considering transitioning. I’m considering HRT and hair removal only, no surgery. I plan to identify/express as a binary woman when HRT has taken effect. But if I don’t get the results that I’m looking for, I could see a world where identifying as an enby (and staying on HRT, etc) might make sense. (I’m a frontline healthcare worker who’s concerned about negative reactions from patients when transitioning and/or when my pronouns don’t match my appearance in some people’s eyes.)

HRT trials

At this point (I’ve questioned for years), I don’t think I’m ever going to be 100% sure about whether or not I want to transition. I think that preparing to transition and starting HRT might help me reach greater certainty about whether I want to continue. Does that sound reasonable? Do you think a doctor in an informed consent context would have concerns with starting me on HRT if I said that? Also, is it fair to say that I can probably look androgynous or plausibly cisgender (especially with effort - if I had a need to) for a year or two after starting HRT?

Older adulthood

I’m not sure what to expect in my late 60s, 70s, etc. Do people who’ve transitioned for decades at that point feel that their gender doesn’t seem as relevant any more, question the benefits of staying on HRT, and stop? In that case, is there any sort of detox/withdrawal, pain, or significant health-related complications associated with stopping HRT?

Reversibility

Hypothetically, let’s say I wanted to stop transitioning or de-transition - closer to my current age - and wanted to identify/express as a man. The only real issue to me seems to be that I might have breasts - and ‘only’ an A or B cup (re: concealability). Skin, body fat distribution, hair, and muscle mass changes seem inconsequential to me (and are all considered reversible, with BF being reversible/ variable). Loss of fertility is not important to me. And medically salvaging a functional penis (i.e., libido and erections with testosterone and blue pills), if necessary, seems medically doable and acceptable to me provided I prevent penile atrophy. How’s my understanding of that?

I’m not seeking medical advice, just community perspectives, anecdotes, and/or pointers to resources. Thanks for reading and also for any responses. Comments on other things I’ve mentioned are also welcome :)

  • Jorunn (she/her)@piefed.blahaj.zoneEnglish
    7·
    16 days ago

    I think that preparing to transition and starting HRT might help me reach greater certainty about whether I want to continue.

    Very reasonable. I started HRT specifically to see if it was right for me. It very much was!

    Do you think a doctor in an informed consent context would have concerns with starting me on HRT if I said that?

    Some will have a problem with this and some will understand perfectly. It’s always best to lie to your doctor, which sounds like a terrible thing to say but this is the truth when you’re trans. Always lie unless you for sure know they are fully supportive of the trans experience. Don’t lie about everything ofc :P lie away uncertainty and the like. Some doctors in some places don’t recognize non-binary people so it’s unfortunately best to present as binary, unless you know they accept enbies. In some cases hamming things up is also necessary. If you only care about HRT you can also fully bypass doctors and do HRT on your own. I do this. I only go to doctors to get regular blood tests.

    Also, is it fair to say that I can probably look androgynous or plausibly cisgender (especially with effort - if I had a need to) for a year or two after starting HRT?

    Maybe. I started around 30 and I think I could pass with great effort now after two years on HRT. A big part of it is actually hair removal as well. You should also start looking into voice training if your goal is to pass. It requires a lot of effort and takes a lot of time, so start looking at it now. Maybe find a voice therapist.

    Edit: Results vary a lot. It depends mostly on genetics, and then there’s stuff like make-up and clothes and all that. Exercise can help you as well.

    In that case, is there any sort of detox/withdrawal, pain, or significant health-related complications associated with stopping HRT?

    • Your testicles will atrophy somewhat on estrogen, but tmk they always start up testosterone production again when not suppressed.
    • You will suffer from some very temporary menopause like symptoms when you stop taking HRT.
    • A lot of people experience dysphoria from being on the wrong hormone, and once they go back to testosterone they start feeling that dysphoria again.
    • If you don’t have enough sex hormones over a long time there can be negative effects such as osteoporosis. You won’t suffer this if you still have your testicles.
    • The effects of testosterone will return once you’re back on testosterone. This means masculine fat distribution, more body hair, masculine smell and sweat, etc etc
    • Estrogens and androgens have different risk profiles, which means while on female sex hormones you will be more predisposed to the things cis women tend to be predisposed to and visa versa. Not really a complication, but something to be aware of.

    Reversibility

    You have a lot of questions about HRT. I very much suggest you read this: https://genderdysphoria.fyi/en
    It’s a great guide and explanation for a lot of stuff, including what hormones do to you.

    As for the penis. Testosterone maintains the penis via random erections which you will no longer have, or at least, way less random erections. This means if you wish to stop atrophy you must induce them yourself. You can also use topical testosterone gel or cream, but be aware that this will likely increase your blood testosterone levels in general. But it’s an option.

    I hope this answers some of your questions! <3

    • streetfestival@lemmy.caOPEnglish
      5·
      16 days ago

      Thank you so much, Jorunn! I’m glad to hear that string HRT to see if it was right for you was right for you. I think I’ll follow your encouragement to start vocal training sooner vs later. Thanks! <3