that’s a good idea, and also take it with a grain of salt - not the most accurate

thank you, I was so curious - here’s a gold star: 🌟

sleep tracking through devices like Apple watches are basically a scam:

https://www.neuroscience.ox.ac.uk/news/are-sleep-trackers-accurate-here2019s-what-researchers-currently-know

https://edition.cnn.com/2025/03/10/health/orthosomnia-sleep-tracker-wellness/index.html

hm, if it’s not too much to ask, maybe a visual would help? Like, an example where Excel or some other program shows correct layout, and LibreOffice has incorrect?

I haven’t had much discomfort with LibreOffice and I tend to be pretty OCD and I do UI work, so … maybe I’ve just ignored it - would like to learn, though!

what is recovery like after the implant?

I ask because I have a relative who got pellet implants but it took a while for them to be able to sit right and engage in aerobic exercise (can’t remember if it was a week?), and they had to get the implant once every few months so it wasn’t reasonable for them.

Just so you know, spiro does not meaningfully change blood T levels, it is a weak androgen receptor antagonist, so it (rather poorly / partially) blocks androgen receptors in your body from using the T in your blood.

The main thing that would be stopping your body from producing T is having enough estrogen in your body, which tells your brain you have enough sex hormones and it can stop producing T.

Lupron basically does this more directly: it tells the brain to stop sex hormone production.

Lupron is really great, it should be covered for all pre-op trans people, even adults. It’s a safer and more direct medicine, and the only reason it isn’t used for adults is because insurance companies don’t want to pay for it.

So Lupron would definitely tank your T levels, but I suspect the injectable estrogen was much better at keeping your blood E levels elevated, which is probably why your T levels haven’t come back.

Patches are better than oral in terms of increasing blood E levels, but you still don’t absorb a lot of it, and it can be uneven especially compared to injections.

So thank goodness you got Lupron and switched to injections!

does sound like a bad (or malicious) doctor, they shouldn’t be starting someone at the max dose … especially since spiro can cause serious side effects.

oof, your T suppression should not have taken a year and a half to occur. With sufficient estrogen levels it should happen rather rapidly. My testosterone and estrogen were both in cis-female levels by the time I did my next blood work two months later.

I wonder what your E levels were as your T failed to reduce (I’m going to guess they were too low) 🤔 Were you on spiro?

this is the way

I prefer Google Sheets to Excel, but I still use LibreOffice Calc for everything anyway

it doesn’t feel that different than Word and Excel, tbh - I don’t know what you’re talking about

still better than oral, and if you’re on an anti-androgen or post-op it could work really well.

Not as effective as injections at getting your estrogen blood levels up consistently though, so it’s not practical for monotherapy, for example.

queer and gay are both common umbrella terms, e.g. a “gay bar” basically means a bar for LGBT+ folks

that said, with my partner I jokingly call us the “lgbt”, pronounced like all the consonants are shoved together, the way it’s pronounced in this tiktok:

https://old.reddit.com/r/TikTokCringe/comments/125jlqw/exposing_our_woke_teacher/

ugh, I wish EEn was available through Rx, it’s so much better than EV - I suspect I wouldn’t have had such severe trough dysphoria that year if I had been on EEn.

I haven’t done them personally, but my endo offered. I am too much of a control freak about my levels to rely on a pellet, at least pre-op. I should re-consider them now that I’m post-orchi 🤔

The risk aversion is deviation from their standard plan and from possible mortality as a side effect of bica. Yes, I 'm aware that it’s an exceedingly low chance. They are still stuck in the early 2000’s for treatment plans.

Spiro also carries mortality risk, a greater but similar risk AFAIK as bica. My liver enzyme levels were elevated on bica, but my endo was not concerned about it, he said they often just stabilize and it’s not a reason to stop. I only stopped bica because it didn’t act on the CNS and help with my biochemical dysphoria - I was just as miserable from the T in my body with it vs without. (So I did monotherapy instead.)

The risk of heart issues is actually the spiro, which appears to be happening but they still aren’t responding to the request.

Your doctors are not sufficiently educated and are putting your life at risk as a result. That’s unfortunate, but at least it sounds like you know what to do.

My doctor happens to be a trans woman. Howewver, she transitioned more than a decade ago and is comparing everything to her experience. I’m not sure if she’s bothered keeping up with things. I’m not here to judge, just to get myself in order.

tbh, I don’t know that being trans makes a difference, Caitlyn Jenner is trans and that doesn’t stop her from being an anti-trans menace on Fox News. You would hope being trans would help, but it sounds like it’s actually hurting your care, since she is not educating herself.

Try as I have, this part has been exceedingly difficult. The only meetups are youth oriented or singles mingles at bars.

I’m in a conservative southern city, but even we have a local pride organization that runs the annual pride event - they had a trans support group that I went to and that’s how I got connected. Sometimes it’s just a matter of finding the right person to let you in the door, so to speak. Maybe reaching out to the local pride org and asking around to see if any other events you don’t know about are happening, or even suggesting hosting a trans event if you ever feel like it.

Either way, it’s probably just a matter of persistence and continuing to network - there are trans people where you are, and someone is probably organizing something. If not, you could always try to get a directory going, make a group chat, etc. and start to get people connected. That’s more effort, but it’s quite valuable to have your local trans community’s experiences available to you - it tells you a lot, what places to go to, what places to avoid. Which hair dresser is safe and good, which dentist is safe, etc. - there are so many reasons that network is so important.

Mine is usually around 25 now, I don’t really have thoughts about it - I actually wish I had more atrophy than I do, erections are not as firm but otherwise it is about the same as before. I would prefer significant atrophy, tbh.

Though you’re right, that isn’t good for surgery, so that’s a thing.

But yeah, I’ve heard plenty of people notice some kind of dysphoria at trough. I remember feeling very clearly off if I was late by an hour or two when I was taking gel. Got worse when I was on higher dosages actually, so I suspect it’s the spikiness that does it.z

oh, interesting - that does sound similar to what I experienced … and it has gone away now post-orchi, so … I just assume I was right about it being the T.

It’s so freeing to be able to be late on a dose and not be impacted meaningfully. It was surreal cutting my dose and frequency in half, and watching the window pass for when I would have normally injected again. I had so much suspense built-up around it, and I felt completely fine for the first time. There was no building desperation for my next injection, no onset of crippling depression and worsening mood, as if the world is flat and nothing is enjoyable, no more 24/7 obsessive anxious rumination, and so on.

Now I just feel “normal” - it’s bizarre. Estrogen actually feels sorta optional now, where before I clung to it for my life - I was very sensitive to its absence before, but now I feel fine when my E is lower even if I still enjoy when my levels are higher, too.

I highly recommend for anyone like me to get an orchi ASAP. It’s more affordable, it’s an easier and less painful recovery, it’s a faster surgery, and it means you can get of anti-androgens and feel confident knowing your HRT supply isn’t the only thing preventing you from sliding into hell again.

I begged my doctor to put me on bica and injections, but they are all too cautious about adverse effects

Aaaand that’s when you get a different doctor - the adverse effects would be from taking oral, which at least plausibly taxes the liver, while injections are practically risk-free by comparison. My current endo actually tries to get her patients off oral and suggests injections instead.

I already had an episode of incredibly high heart rates this weekend that impacted activities, but that’s apparently not enough to go to injections until month 3 for them

What’s the reasoning here? There is no evidence injected bioidentical estrogen carries any heart risks, the closest thing would be that synthetic estrogen pills might increase risk because of those studies on Premarin, but that’s a reason to do injections rather than oral (though the pills you take should be bioidentical now).

but I’m considering finding a new doctor.

please, please do!

Even somewhere like Planned Parenthood that offers informed consent would be better. Your current doctor sounds transphobic and misinformed, they should let you be in control of your care especially with a decision like oral vs injections.

I recommend meeting and talking to the local trans community and finding out who other people see and which doctors the community recommends, that can be a good way to find a doctor who actually knows something about trans care or at least will allow you to have more autonomy in your care (though … don’t expect even the good ones to know enough, unfortunately we’re still at a place where trans people really have to educate themselves and take their care into their own hands).

I couldn’t get T levels that low even post-orchi 🫠 …

Though, my blood work showed my T levels were suppressed to cis fem levels the whole time, I swear I still had biochemical dysphoria where my body seemed to produce a little T once a week in the trough, which then would have me feeling off.

It could have been something else, maybe it’s just side effects of really high estrogen, but even when I tried lower doses I would have worse mental health symptoms …

Either way, that stopped post-orchi, I just no longer felt biochemical dysphoria a couple days after trough and it didn’t seem to matter what my estrogen levels were anymore (I mean, the high E levels made me very sensitive and more moody / emotional, so I lowered my dose, first by half and then later by half again).

That said, I was injecting EV, which is so spiky - I suspect my E levels were dropping so suddenly on trough day that my brain triggered the testes to produce T, and it didn’t show up in blood work because I always tested right before injecting again and not the day after injection when it seemed like my T levels had risen.

Either way, it’s not an issue for me anymore, I just think it was cruel and unnecessary to force me to go through that entire year without an orchi, I was very firm about wanting it when I socially transitioned, then I had to wait three months to get HRT, then an entire year after that to get the orchi. They wouldn’t force me to wait that long if I wanted the testes removed as a cis person, like the post-vasectomy pain I experienced. It’s just transphobic, tbh - and it works, I suffered that whole year as a result.

that’s surreal to me that you hear a female voice - and hey, that’s not a roast!

One problem I’ve run into is that I can analyze someone else’s voice pretty well, but my dysphoria brain worms distort my perception of my own voice - it’s hard for me to hear it accurately or know how it sounds to other people, the same as it is hard for me to see a woman in the mirror or know what others are seeing.

It makes it hard to get a sense of when I’m overshooting or overcompensating, or when I’m not compensating enough - that finesse is difficult when your perception is constantly distorted.