Ask Amanita

Dear Amanita,

I have come out as trans three years ago and I have fully socially transitioned. I am known for who I am amongst friends and family, colleagues and strangers. Occasionally, I still get misgendered, but in general people know me as the woman that I am. I have thought about hormones frequently and deeply. I long for the positive effects that they’d hopefully bring: smooth skin, reduced body and facial hair, another emotional layer to access, but I dread some other effects like a reduced sex drive, weight gain or sadness.

I am torn and I don’t really know where to get proper information from. I’m also worried that other trans women will think that I’m not valid, if I tell them that I’m a bit afraid of hormones too. What do you think?

Michelle

Dear Michelle,

Estrogen Pill

First, let me say that you are not alone: Many women struggle with this question and all paths are perfectly normal. Many women who are trans do not have access to hormones. For many it is a long time to wait. In these situations the wish to be on hormones is often very strong and it is important to make access to hormones easier in many places. As soon as a woman has legal and financial access to hormone therapy she can make informed decisions with her — hopefully well-trained — endocrinologist. 

To get the best possible treatment it is important that you can tell your doctor about your fears and wishes. For some trans women a reduced sex drive is desired, for some it is not. Some cannot wait to experience reduced activity in their genitals, for others this is a source of fear. Some are ready to embrace the expected frequent tearing up, some dread they will be melancholic.

I have worked with many women who feel fantastic on hormones and others who struggled with side effects like significant depression. Whether you are comfortable on hormones or not, whether you try or not, whether you stop taking hormones … none of this makes you any less of a woman! I have told many of my clients: Not all cis women agree with hormone treatments. Some will have severe side affects when being on hormone replacement or contraception. Some will therefore decide to stop the treatment. Some will enjoy and thrive. But all of us are women.

If you’d like to stay on hormones but your side effects plague you, try to find the best possible endocrinologist. There are several medications that block testosterone and several ways to take estradiol. Maybe your body doesn’t feel good on Spiro, but it is fine on Cyproterone, maybe daily oral estradiol doesn’t feel as good as an estradiol gel, you might have to try some options. 

For some of my clients it turned out that they liked going back to not taking hormones. It didn’t feel great for them to try. Yes, reduced facial hair was great, but they felt low. Many said they felt invalid because they thought they weren’t trans enough, if they experienced side effects. But it is biologically not surprising to feel low: Testosterone binds serotonin, and with less testosterone your body might find it more difficult to be happy. Many women who I have worked with then realized that they liked the amount of testosterone that their body made and that it is okay that they do. They realized testosterone as a genderless hormone, all humans have it, it’s not a “male” hormone) and understood they have a strong feminine sex drive. They discovered it as a super power of the sex goddess that they are. For many this was a journey of self-acceptance.

Others swear by the estrogen high that they experience and wouldn’t want to ever be without it anymore. We are all different. I notice with most people I work with that the highest high and the most beautiful gender euphoria comes from self-acceptance. From knowing that you are valid and from finding peace in your path. Allowing yourself to do whatever is good for you and allowing the same for others. The greatest gift that we can give each other as a community with unique challenges and many obstacles in the outside world, is to embrace each other’s paths and be supportive. Not everyone in the community has the same path to inner peace and embraced femininity. Together, we’ll help each other get access to medical treatment and accept each other and ourselves as valid and wonderful whether we want to (or need to) make use of it or not.

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Tags: featured, hormones, Transgender

Category: Transgender Body & Soul