Tuesday, February 11, 2014

Hormones, Part 1

First a brief introduction for those that don't know what's the deal with hormones: Basically, hormones are what differentiate males from females physically. I mean there's the brain stuff (relevant in mine and other transgender people's case) and the genitals which develop at different times, but once a baby is born the genitals produce hormones, which is what causes the actual physical changes.

First, puberty is just the time hormones' effects really kick into gear. Before then males and females are mostly the same (besides sex organs and the brain), which is why it's argued that it's ideal for transgender people to transition before the onset of puberty: if HRT (hormone replacement therapy) starts then, transgender adolescents will simply go through the puberty of their identified gender, and externally look pretty much no different than any other female in the case of MtF, and male in the case of FtM.

Specifically, in general males have a little bit of estrogen, and a lot of androgens (AKA testosterone). Androgens cause muscle growth, more male-like fat patterns, and a more blocky "maleish" face. They also can cause a more greasy face (where acne comes from) voice deepening, facial and body hair growth, and an increased male sex-drive (exactly what the difference is in sex drives honestly I'm not sure).

For females, they generally have a little bit of androgens, and a lot of estrogen, which varies according to the menstrual cycle. Estrogen causes more female like fat patterns (breasts, hips, etc.), a softer more "feminine" face, and softer, more fragile and clear skin. Acne can also be caused from changes here as well I think. Then there's the emotional (where PMS comes from) and sexual side effects.

Both hormones also help promote bone growth (I think), and obviously there's variation in everyone for how much hormones they have, and how these changes affect them. For example, I went through male puberty and had higher than average androgen levels (and normal estrogen levels for a male), but at 19 my voice is about as high as most younger teenagers - to the point people either think I'm much younger than I am or even refer to me as ma'm or think I'm my mom every time I answer the phone. Yet I also have rather thick body hair, and could probably grow a full beard if I wanted to.

To be clear I'm not an expert on any of this either, please consult your doctor if you have any medical concerns.

But so the idea is that with MtF transgender people (where I'm at), they take Anti Androgens (AAs) and Estrogen (E) to get their hormones to normal female levels. With time (a month to 2 or 3 years depending on the person) this can have rather good effects on helping pass-ability as the desired gender.

For those that don't desire to transition (because of being married or other things), simply the brain receiving hormones that it's expecting has very relieving effects. It doesn't completely eliminate the feelings, but those I've heard from that have done MtF HRT (on low doses to limit the physical changes) have expressed that it helps them feel more at peace with their female self. So they feel more comfortable expressing that part of them, but transition type-things also don't seem as pertinent because there's not as much emotional distress. In other words it helps them function better while still presenting as male, which seems to be the best treatment option for those that transition isn't an option but are still really struggling with Gender Dysphoria.

For those that transition isn't really an option but also can't be on hormones because of medical circumstances my heart goes out to though - it's a very difficult situation to be in.

For those that some level of transition is possible and desired, generally higher doses of E are sought out that maximize the feminizing effects. As far as I understand it male hormones are very effective for FtM people, and besides top surgery (to undo irreversible breast growth) are the main aspect of transition. For MtF people hormones are nice because of the changing of body fat distribution (so breast start growing, faces get softer, etc.), but they don't generally have as significant of an effect, because many of the irreversible male changes have already taken place. Personally I'd say the emotional effects are very nice though, even just with AA's I've been more moody, but I don't mind that. It finally feels like what I'm supposed to feel. Besides those effects unfortunately facial hair growth requires laser hair removal or Electrolisis (it doesn't go away with HRT) and voice deepening is irreversible.

Anyway, with that out of the way, my goal is to eventually start on HRT, as part of my desire to socially transition.

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