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Transfem
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Some helpful links:
- The Gender Dysphoria Bible // In depth explanation of the different types of gender dysphoria.
- Trans Voice Help // A community here on blahaj.zone for voice training.
- LGBTQ+ Healthcare Directory // A directory of LGBTQ+ accepting Healthcare providers.
- Trans Resistance Network // A US-based mutual aid organization to help trans people facing state violence and legal discrimination.
- TLDEF's Trans Health Project // Advice about insurance claims for gender affirming healthcare and procedures.
- TransLifeLine's ID change Library // A comprehensive guide to changing your name on any US legal document.
- Gender Spectrum // Resources for youth, parents and family, educators, mental health professionals and faith leaders.
Support Hotlines:
- The Trevor Project // Web chat, phone call, and text message LGBTQ+ support hotline.
- TransLifeLine // A US/Canada LGBTQ+ phone support hotline service. The US line has Spanish support.
- LGBT Youthline.ca // A Canadian LGBT hotline support service with phone call and web chat support. (4pm - 9:30pm EST)
- 988lifeline // A US only Crisis hotline with phone call, text and web chat support. Dedicated staff for LGBTQIA+ youth 24/7 on phone service, 3pm to 2am EST for text and web chat.
You've been on HRT for a decade? If you don't mind me asking, what ester & dose and what route of administration? Do you get blood tests and if so what are your levels like?
IRL I met some trans elders who had been on HRT for a while and didn't see any effects from it (almost no breast growth or much change to their face beyond skin softening some, etc.). I think they were taking the estrogen orally, and they weren't sure exactly about their blood levels, but they thought they were fine.
When taken orally, I think around 80% of the estrogen is filtered out by the liver, so it can be hard to get enough estrogen that way and there are peaks and troughs multiple times a day (it is ideal when taking oral to dose 3 - 5 times a day to ensure even and adequate estrogen through the day). Patches & gel are all better than oral, but injections seem the best in terms of getting a consistently high enough level of estrogen.
As of my lab work done on Sunday, my levels are 140pg/ml estrogen, and ❤️ testosterone. (How feminine is that?)
This is all oral, cause I’m a giant wuss.
So your testosterone is really low !! But I would personally consider estrogen too low, though you know your own body best. When did you get the blood work done compared to the last dose you took?
I think the common conservative recommendation is to have between 100 - 200 pg/mL so your blood work looks good on paper, but I personally found below 300 at trough was mentally difficult for me. I use estrogen as my anti-androgen ("monotherapy"), so I take a larger dose than most.
You might consider aiming for higher blood levels of E and with a better & safer route of administration.
I am a wuss too, it was extremely difficult for me to overcome my needle phobia (I mean, literally breaking down crying after some injections, taking a long time to overcome the mental block to actually push the needle in, just so so so hard for me). But you do get used to it, and it's not bad after you get some practice.
Also, I inject subcutaneously, so I use really small needles that don't hurt at all (literally, I sometimes can't feel the needle). That was crucial for me in overcoming needle phobia, I think it would be much harder to inject intramuscularly (IM).
Even if you still can't do injections, I would encourage doing something to avoid oral, even sublingual troches which have their own problems might still help with absorption, and even better would be patches or gel.
If you haven't already read it, I highly recommend reading this: https://transfemscience.org/articles/transfem-intro/
It's a bit long and technical, but it might help (it certainly helped me).
My blood work was done a week ago and I think it looks pretty alright. Next I talk to my general practitioner, I’m gonna ask her to bump my E to 8mg from 6mg per day.
Usually the blood work will vary heavily depending on when you last took a dose. When I get blood work, I do it right before I am going to inject so that the blood levels are at the lowest they could be (the "trough"). With oral I would imagine your E blood levels will fluctuate significantly, so when you last took a pill will make a big difference in terms of what your blood labs show.
The problem with taking larger and larger oral doses is that it doesn't absorb better and you are just potentially taxing your liver. At the very least I would try out sublingual route and see if that helps 🤷♀️
I wish you luck dear, it's not easy figuring this stuff out (esp. with clueless doctors).
Oh! I should have said that I am taking it under my tongue. I’m not just swallowing the tablets.
(See, this is what I mean when I say my English is terrible.)