Dear Amy...

I write in this blog mostly for myself. It's the comments that keep me at it, though. Just knowing that people are reading this crap makes it all worthwhile. Every once in awhile, someone tells me that I've helped them in some way. I love that. I love helping people. That's definitely a bonus, and one that never fails to pleasantly surprise me. I had the opportunity to exchange a few emails with someone wanting to start transitioning. I'm presenting these messages here, in the hopes of helping others. Perhaps some are afraid to reach out. Did I give the right advice or not? You be the judge.


Hi Amy,

I have been following your blog for some time, and I thank you for giving hope to people like myself who are wanting to emulate you.

I do have a question I hope you may be able to help me with?

I wish to start the process of becoming a woman, and gender re-assignment.

I would like to start by taking the estrogen pills, what did you need to do to start the hormone pills? What did you say to the doctor? Did you doctor easily prescribe you the estrogen pills? Did you need to do anything first to be able to have the pills?

How quickly after start taking the pills did you notice your body changing? I am aware it it not reversal, is that correct? That is ok with me, I just wish to start this process.

Hope you can help
 
XXX

Hi XXX,

First of all, thank you so much for reading. I'm glad that I can be of help to people who need it. :)

In my opinion, you should first be in therapy before starting on any hormone medication, particularly one that specializes in Gender Identity Disorder. My therapist gave me a letter to give to an endocrinologist after three months. Many people see a regular doctor to get their medication, and that's what I actually do now, for insurance reasons. You would just tell your doctor that you are transsexual and wish to start on hormone replacement therapy (HRT), and here is the letter from the therapist. If your doctor won't agree to start you on the meds, you'll have to shop around for one that will.

There are many who purchase their hormone medication via the internet, and don't see a doctor at all. Many times they can't afford the doctor visits since they have no insurance. I would NOT recommend doing this at all. There are some that have to do it this way, but if you can see a doctor at all, do that by any means possible.

Your blood levels should be tested regularly, every three to six months. They look at your estrogen and testosterone levels, and also your liver enzymes. You should take at least a 81 mg aspirin a day. Estrogen tends to thicken the blood, and the aspirin will help thin it out a bit. Some doctors order blood thinning medication instead, if the patient needs more thinning than an aspirin can provide. These are all things to consider, but if your doctor knows what she or he is doing, they'll have it all handled.

Besides estrogen pills, you should also use a testosterone blocker. They work together to help your body transition into being more like a female's. I use spironolactone, but there are other blockers out there.

As far as changes, let's see if I get this all right. It's been awhile. After a week or two, I noticed my skin was softer and my hair was less greasy. I also felt much more calm, and I could feel my emotions a LOT more. The aggressive/horny state that testosterone can bring out in a person was mostly gone. After about a month, I noticed my body hair had drastically decreased (softer, grew slower, and there wasn't as much of it as before). This is when the breast growth started as well. I began to lose muscle mass, and my hips and butt gathered quite a bit of fat.

That's correct, some of these changes aren't reversible. The body hair, grease in head hair, and skin softness (or lack of) should come right back. The testosterone will reduce the emotionality, and the aggressive kind of feelings will come back. But the breast growth is not reversible (you'd have to have a breast reduction in order to get a flat chest again), and after about three months, you'll be sterile for life. If you plan on having any kids with your genetic characteristics, you would have to bank your sperm (very expensive!).

A great resource is Transsexual Road Map. They've been around for years and have lots of great information, as well as links to other good sites.

http://www.tsroadmap.com/

I hope my answers were of some help to you. Let me know if you have any other questions.

Would you mind if I made your question and my reply into a blog entry? It may be able to help others. I'd remove your name, of course. Let me know. :)

Take care,

Amy




Hi Amy,

Thank you for taking the time to send me a detailed email, I really do appreciate it, and yes of course you are welcome to include our email in your blog.

I do have couple questions, I hope I do not come across ignorant? I just wish to know what the process is for starting things to become a woman.

Q1. When I go to my doctor for the first time and tell my doctor I have a gender dis-order and want to be a woman. Forgive me if this is a silly question, but do I need to dress as a woman when I say this in order to convince her?

Q2. What happens at therapy? Again during therapy do you have to dress as a woman, in order to add some weight to your case when starting the process of wanting to be a woman?

Q3. Once I have a referral from my therapist for hormone treatment, with so many different forms of medication which one worked best for you? What was the name of the hormone medication which saw your breasts grow, and your body change into a more feminine appearance?

Q4. Once I start the medication, what are the next stages of the transition into becoming a woman? Obviously therapy is on going, but what happens next?

Thank you again for everything, you have bee so helpful to me, I admire you for what you have done, and I want to emulate your success in becoming a woman

Thanks
XXX


Hiya XXX!

I'm sorry for the delay. I was very busy yesterday and then again today. Thanks for allowing me to post our messages in my blog. I assume I can do the same for these latest messages as well? :)

First of all, the way you say, "becoming a woman." Well, I'm a stickler for saying things correctly. This may feel right for you to say it this way, but if you feel that you are a transsexual, then you already are a woman, inside, where it counts. I was born as a woman, but in the body of a male. So if I were you, I would say, "becoming physically a woman," or better yet, "aligning my body to match my gender identity." That might make a better impression on any doctor you go to see.

Don't feel bad about asking questions. Asking questions is one of the ways we learn about things. I don't think you're ignorant at all. You just have some learning to do. I would recommend reading all you can on websites like tsroadmap.com, and possibly picking up a book like "True Selves." That one in particular is great to loan out to friends and family. It explains the transsexual dilemma to others quite well.

Q1. You can dress however you want to dress. The doctor will know that you're just starting out. I dressed in female clothes at the time because I did so every chance I could. Others may not feel the need to do so.

Q2. Ditto. I went to a few group therapy sessions at my therapist's office. (It was purely optional, but I found it to be interesting and fun.) Me and someone else were dressed as female, another was dressed as a man, and another presented herself as androgynous. It's all up to you and your comfort level. The therapist should be interested in your thoughts and feelings, not your outer presentation.

Q3. I've only used estradiol (a form of estrogen), spironolactone (a testosterone blocker), and finasteride (DHT blocker, to help prevent male pattern baldness). Last year, I added provera (progesterone) to help "round out" my breasts. That really helped with that, but it gave me crazy mood swings. I stopped after about six months. I would just start with estrogen and a testosterone blocker first, and worry about the other things later on. The doctor will probably start you on a low dose and increase it over time. I've never tried different brands of medication, as far as estradiol and spironolactone, so I don't have anything to compare them to. Many transwomen use estrogen patches or injections, and I've heard that the results pass along more quickly (plus it bypasses the liver). I hate shots, and the patch wasn't covered by my insurance, so it's been pills for me, from day one to present day.

Q4. Big question here. The details are all up to you, but I think it's best to let the medication do it's job for awhile. You'll be going through a lot (mentally and physically), and it may take some time to get acclimated. In the meantime, you'll need to get rid of facial hair, since hormones will not have much of an effect there. Laser hair removal can help a lot, but the only proven method to get rid of the hair forever is electrolysis. This can be quite costly and time consuming. Once you're ready to take the next big leap (with most or all of the facial hair gone), you can come out to family, friends and coworkers; get a name change (along with changing your social security card, driver license, and passport if need be); and live as a woman full time. Then it's time to save up for GRS (gender reassignment surgery), FFS (facial feminization surgery), or whatever surgery you might need or want.

Don't just follow my advice. This is a monumental change in your life, and you need to do all the research you can. Read, read, read. Take notes. And take your time. That's the best advice I can give you. You will want to rush through all this as fast as you can, but this should take you years to accomplish. It's not all about rushing to the end. Enjoy the journey.

You're welcome, and thank you for the kind words. I view my journey as a quest towards finding myself. Most people start out life with a body and gender identity that match. Transsexuals have to fight just to be treated as the gender they are. I wish you the best of luck with your journey.

- Amy 


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