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Two Years of HRT

TwoYears

If you ask a medical professional about feminising hormone therapy, the most helpful response you get seems to be a furrowed brow followed by, "Look, we generally consider it to be a two year process."

A two year process.

That's a rather relative concept, of course. Hormones change you constantly over time. Whatever hormones are in your system will affect how your body grows and changes as you age.

Of course, you don't stop taking hormones after two years, either. Medically transitioning means that your body's hormone generation gets blocked at least partly, and is replaced with different hormones which you must take artificially for the rest of your life.

I'd be lying if I said the idea of 'taking pills the rest of my life' didn't scare me a bit earlier on, but... almost everyone I know does. Be it anti-anxiety meds, anti-depressants, blood-thinners or something else... at some point in our lives, we are likely to end up medicated for our own health.

But nonetheless, "two years" is a measurement that I kept reading; kept hearing. So it's hard not to focus on it.

It makes a degree of sense. Around two years on a decent dosage of hormones, depending on various factors like your existing hormone levels, genetics, etc, certainly seems to see the most major changes.

I've done a lot of self-reflection as I blog over the last two years, but as this is specifically two years of hormone therapy, I thought I would talk about physical changes and, more important, how they affected my life and sense of self.

I am going to attempt to skip a lot of details I've gone into before (links at the bottom of this article of that detail is of interest to you), and focus on things that spring to mind now I can look back on this with a few years of time to settle down and consider how it affected my life.

Beginning

preHRT

Before I accepted I was trans, I over-compensated for how uncomfortable I felt 'being male'. I tried desperately to assuage my constant sense that I didn't belong by over-performing masculinity in many ways. I mimicked very macho behaviour when I was uncomfortable, I lived under a beard, perpetually alternating between full and more of a goatee depending on how self-conscious I felt.

I never used to understand what I was feeling almost constantly - what it was that made being out in public or even out amongst friends so very tough sometimes. I wondered if it was some kind of social anxiety, but it wasn't until I realised I was trans that I recognised it for what it was - debilitating gender dysphoria.

I did anything I could to hide my face, which I used to, ironically, get teased about as I looked "too girly". I had a weak jaw, no adam's apple, and numerous other physical traits which, when I was trying to pass as male, plagued me. I'd learn later on these were amazing gifts for a trans woman.

After I figured it out, I saw a GP as soon as I could for referrals to a psychologist and a specialist for HRT, sure it'd take me a long time to get access to hormone therapy.

A lot of my experiences didn't fit with the 'transitioning' narrative I'd read, or heard from people I spoke to. On a lot of levels.

This was partly because I had read a lot about hormone therapy in other countries (Australia is in some ways and in some places quite progressive and helpful for transgender support, if you know who to talk to) but also partly just blind luck on my part.

My endocrinologist gave me choices: did I want to transition fast, or slow? A good specialist will help tailor your dosage levels to fit what you want from hormone therapy.

For me, it felt like ripping off a band-aid. I had an uncomfortable fear of spending too long at what I think I internally perceived as a kind of 'half way' stage... so I asked for the higher dosages. I hated my body, I wanted to to change, and I didn't much care how. As I remember thinking to myself: "I don't care what kind of body I have. I just don't want a masculine one."

Stealth

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I began hormone therapy on the 31st of December, 2015. For various reasons I told nobody I was spending time with, but as I was on 2mg of oestrogen every 8 hours, several times throughout the day I snuck into the bathroom to take the pill.

It felt very strange ringing in the new year, knowing I'd begun, but with no-one else around me know at the time.

The first few weeks were hell. Going from zero to being carpet-bombed with oestrogen resulted in hot flashes, heart palpitations stopping me from sleeping for quite a few days, nausea (literally morning sickness) and more. Each time I felt awful, and yet was still trying to seem 'normal' to many people around me, I'd stare at the list of "okay symptoms", but everything i felt was on the "to be expected" list.

I was still 'presenting male', at least by traditional definitions. Although this meant just as androgynous as I ever was, I wore baggy t-shirts, cargo pants and work boots.

When I went out, for a while my usual dysphoria-related anxieties subsided. I knew what was going on, so I could go into men's rooms and feel, instead of discomfort, a sense of knowing fully who I was, and that being gendered incorrectly and people assuming I belonged in there was just an accident of aesthetics.

I began to think of myself as a weird kind of journalist. I started paying attention to behaviours in men's room. Observing behaviours when I was around men with no (other) women present.

I asked my female friends, "If you were a guy for a day, or a week, what would you do that you can't do now?"

From the varied answers, I made a tiny bucket list of things I took for granted.

Going for a walk on my own late at night wherever I wanted.

Sitting alone in a bar without anyone trying to talk to me.

Going jogging without support.

Swimming topless in a public pool.

It was a strange few months, knowing I had a big secret, being excited, but also terrified.

Coming Out

2-months

I had spoken to quite a few other trans women over the internet at this point, and I'd understood that hormone therapy takes quite a while to be visible. I suppose partly because of the pessimism I felt at that point, I assumed I'd be able to hide the effects of HRT for some time, as the idea of coming out scared the hell out of me. I had originally intended to put it off for a good six months or so.

But by just under two months, the changes were extremely obvious to people who knew me.

I lost a huge amount of weight. My skin softened. Laser hair removal had begun to remove most all the evidence I'd once sported a lumberjack-grade beard.

Friends who didn't know sometimes paused when they saw me and said, "You look different."

I met one friend I hadn't seen for ages and was told, "You look amazing! So much younger."

Then there was my breasts.

Most of the trans femme people I knew had little to no breast development, many eventually having implants. It turns out the reasons for this are many, but include that standard practice for years was (and sometimes still is) going on testosterone blockers for a while first before going on oestrogen - evidence is that this closes off androgen receptors in your chest, which can limit breast development, often to tanner stage 4.

But between my genetics and the nature of my hormone therapy, that wasn't the case for me. Helped no doubt by, as my endocrinologist put it bluntly, "evidence of early breast development" (Between this and my low natural T levels I'm still unconvinced I'm not intersex, but I've had no real reason to be karotyped except idle curiosity.)

I began to wear a-size-too-small sports crops under my baggy, black t-shirts to flatten my growing breasts.

At around this point, between the incredible discomfort of growing breasts, and added discomfort of trying to hide them, and various life reasons, I decided to come out earlier than I'd intended.

Fear of Change

After I came out, there were a lot more changes. I was put on progesterone, started on testosterone blockers (although I was told that from oestrogen alone my T levels had dropped to "safe cis woman levels" entirely on their own), and went through another round of fun side-effects.

I moved to a more queer-friendly part of Sydney, meeting new friends at a sharehouse who were the first people to ever know me only as Elissa.

Before I transitioned, I was largely attracted to women, but sometimes developed baaaaad crushes on men. I didn't openly identify as bi, but in retrospect it's quite clear I was, although for a lot of reasons (mostly being in a monogamous long-term relationship with a woman) I never acted on those feelings.

In retrospect I wish I did, for reasons I'll talk about later.

There are a lot of things about this brief period of my life that were interesting in retrospect. Thing I can identify as internalised transphobia, ignorance of my own privilege and even some super-fun internalised sexism.

Around 3 months something quite surprising happened, too - I was gendered correctly by a complete strange.

I was at a bar, waiting to be served with another girl, and the guy behind the counter said, "What can I get you ladies?"

It shocked and delighted me so much I changed my order to sparkling wine, to celebrate.

(It also showed me an interesting fact of subconscious gendering - on my own, I would largely still be gendered male despite increasingly-visible breasts, but when hanging out with groups of women, I'd be gendered correctly every time.)

5months

I was convinced that beyond my body shifting, I wouldn't "be a different person". But I suppose, on some level I knew this wasn't the case. Despite this, I simply feminised my existing appearance a bit - I often wore eyeliner, and switched to babydoll tees to better suit the changing shape of my chest, but otherwise I still wore cargo pants and boots, only trying dresses briefly at home. Dresses felt a bit strange to me, as they simply made me aware of how slight my hips were, and they were a major point of insecurity at the time.

Also? I had heard of many instances of trans women 'over-performing' traditional femininity, perhaps as a way of compensating, before dropping it and becoming just as varied as cis women are.

Out of some fucked up, kinda transphobic desire to avoid that myself, I convinced myself that nope, I was kind of a tomboy.

It made sense, right? I liked lots of boy things like coding and video games. Boy, did I have a lot of crappy internalised sexism, too. I'm shocked and embarrassed in retrospect that I managed to at least partly absorb crappy gendered ideas of conflating personal style with interests.

Meanwhile, my oestrogen levels were bumped up again. As I was told the body can't easily absorb more than 2mg every 8 hours, an additional 2mg a day was put on using gel. Between that and my vitamin D deficiency, I was taking androgen blockers, oestrogen pills, vitamin pills AND smearing a gross gel all over my arms every morning.

Followed by more oestrogen at midday, then yet more plus more gel before bed.

It was a time mostly defined for me by constant alarms saying "time for your pills".

Femme

Around half a year, I moved house again, to a different suburb, and at this point my legal name change and new photo ID came through.

That was important beyond the obvious. Oestrogen softens your skin, so even if I was getting misgendered as male, I was also usually clocked as much, MUCH younger than I am. This meant getting carded.

A lot.

There is very little as embarrassing as realising, as you present an old photo ID with a bearded, dour looking dude, that you have no idea what gender the bottle shop attendant thought you were.

So I took to avoiding bars (and I do love the atmosphere of bars), getting housemates to buy booze for me, or at least wearing a done-up leather jacket to hide my breasts and hope to hell they could accept that the extremely feminine-looking person in front of them was, indeed, just what that bearded dude looked like after shaving.

A few times I was refused service. "That's not you."

But with new local shops, ID that actually looked like me, and with the help of some awesome friends who liked playing with makeup, I did something I'd begun try try something different: wearing makeup and dresses.

I was absolutely shocked what a difference it made. Not just to what I looked like, but to how I felt. I'd spent so long sure that being kinda butch, or at least a liiiiitle androgynous was 'safer' and 'easier', that discovering how flattering certain kinds of dresses were blew me away.

I dyed my hair (and, oh wow - being a redhead feels so right I now have trouble picturing myself as a blonde). I bought makeup. I began to learn how to use it.

10monthsa

I'd seen a "kinda feminine" person in the mirror for maybe six months at this point, but when I saw myself the mirror for the first time and saw a genuinely quite striking woman looking back at me, I cried in delight.

My breasts initially developed shockingly fast - from flat chested to a B cup in mere months. From there things slowed down, but not by much. I was somewhere between a C and D cup by the end of the first year, which was amazing, but also a shade uncomfortable (the first time I had to run for a train was a rude shock). It also meant that clothes I thought I looked okay in before suddenly made me insecure about looking immensely top-heavy.

So, with a change in body shape (actual curves! By two years I'd settle somewhere around the generous end of a D cup) came yet more shopping as I outgrew things I'd previously fitted in. I even began to like my hips, once I learned how to dress around them a bit, or at least appreciate having slim hips.

I tried an enormous variety of clothes and dresses over the following months, and various makeup styles, until I began to find styles that made me feel the most comfortable; the most 'me'.

Around this point, my endocrinologist also did something enormously helpful: he moved me from a frustrating combination of gels and pills to an oestrogen implant. As uncomfortable as getting an over-sized big sister to a subdermal contraceptive put in every 6 months or so, and as uncomfortable as the week or so of further morning sickness every time got... life is much easier when you aren't micro-timing oestrogen pills several times a day.

This was my (for now) final dosage change. An oestrogen implant, 100mg of spironolactone and 400mb of progesterone every day. With my hormones settling down a bit, and finally finding a personal style that I felt worked for me, and also the enormous privilege of almost always being gendered correctly in public, life went from complicated to... comfortable.

Sexuality

As I mentioned above, before transition I tended to crush on a guy or two for every half-dozen women I'd swoon over.

When I initially got hammered with oestrogen, a fascinating thing happened: I lost my sex drive. Entirely.

I'd see people I knew I should be attracted to, as I had been in the past, and just feel nothing. No sexual desire. Nothing more than a platonic, aesthetic attraction at best.

It was... nice. Genuinely nice. It felt like my brain was clear of an addiction, in a way. I could focus on work, on reading, on movies, without what used to be an annoyingly strong sex drive getting in the way.

That didn't last long. After a few months, my sex dive came back... with a vengeance.

But also not the same.

Where-as before oestrogen my sexual desires to almost animalistic in quality, now they were usually focused on specific people, rather than abstract imagery of sexually attractive bodies. I'd fall more for humans, rather than just bodies.

I had always had issues with intimacy. I felt uncomfortable receiving compliments, as they were almost always masc-gendered. "Handsome" made me grind my teeth.

As my body shifted and I got female-gendered compliments from partners, for the first time in my life I could actually accept the compliments and feel better for having received them.

To add to these shift, there came something else: almost all attraction to men vanished. I'd run into men I had feelings for in the past, and even if I felt some degree of romantic attraction, I found myself feeling nothing else. At best, I'd feel ambivalent about them, and at worst I found myself uncomfortably and clearly repulsed by male bodies.

I had been told sexuality shifts aren't THAT common with medical transitioning, but they did happen. I'd been told that most often people became more bisexual.

But not me, seemingly.

17months

At first I avoided using the term 'lesbian' (for reasons of internalised transphobia yet again) but after people began to call me that, it began to feel somewhat right, and I slowly began to accept it.

It wasn't until I was walking, late at night, along a main road with a female partner, holding hands, that things changed.

Two fuckwits in cars drove past, and bellowed as they did so, "Dyke bitches!"

As depressing as it is, that gross homophobia validated my sexual identity in a way I hadn't really been able to manage before.

Life As A Dyke Bitch

Over the course of an incredibly short time, I went from the seemingly having the royal flush of social privilege (white, cisgender, heterosexual, male) to losing three of those.

Getting used to losing privilege is strange. Getting used to random homophobic abuse, sexist and transphobic abuse took a while, and it still hurts so in a sense I'm still not "used to it". It doesn't wash off my back. It stings, it invalidates, and it sticks in my head for a long time after it happens.

However, the strangest thing to adapt to wasn't copping the abuse myself, but seeing it as a near-constant in media.

Newspaper headlines containing transphobic garbage "in the name of balance". Watching media and seeing women as sex objects; as prizes for the menfolk who are almost always the central characters.

Understanding conceptually that this was a bad thing is very different to coming out of a movie and finding your male friends obsessing over it while you sit there quietly and stew over the fact that the women in the film had almost nothing to do, were barely developed, and existed solely the further the male characters' character development.

23months

Despite the negatives, nothing beat the absolute delight I felt seeing lesbian couples in a film or TV show and for the first time feeling like someone was on-screen whose relationship I could identify with.

I sometimes feel a slight estrangement from queer culture. Perhaps because I spent so much of my life outside it, never knowing I might fit in there. Perhaps because it's hard not to shake that quiet fear that someone you run into might be a transphobic horror-show of a human, even though that's almost never happened in my two years out.

It was near the end of my second year since beginning to transition that my country's government decided to level an astounding fuck-you to the queer community here by insisting upon a "postal survey", a non-binding census not performed as such, which resulted in months of constant media sledging LGBT rights. It was one of the few times in my life I felt myself too scared to read the latest news.

Everywhere I went was homophobic and transphobic propaganda by disgusting conservative groups. Homophobic abuse was worse than at any previous point since I transitioned. When I wasn't trying to cope myself, I was talking to my LGBT friends, trying to provide emotional support for them.

Regardless of the outcome, it was a spectacularly horrible experience, and one of the few up-sides was that I came out the other side feeling more solidarity with my city (and even my country's) queer community.

I sat with friends and hundred of other queer people at a huge picnic in the middle of the city when the "yes to same sex marriage" result was announced. Most of us weren't crying because we were being granted the right the marry our partners; we were just crying because it was over. We'd gotten through it.

Life As A Woman

Catcalling. Mansplaining. Working at an expo and having people assume I'm a booth-babe rather than one of the actual developers. Having gross, drunk dudes hit on me in situations where there's absolutely no polite way to do so.

Being extra careful to plan my nights out so that I'm not alone, drunk walking around the place or on public transport late at night.

Avoiding eye contact with men, or being too polite to them, lest they view it, inexplicably, as a come-on. Keeping an eye out, even in the middle of the day in a safe suburb I know well, for drunk groups of men who are more likely than usual to have a go at me.

Having fuckwits pull up besides me in their car and proposition me.

Sometimes, being a woman fucking sucks.

I am at my most comfortable in nice dresses, made up as well as I can manage. But as I've spent chunks of time presenting and looking like a bearded dude in his 30s to a youthful, skinny blonde girl in a flowery dress and most everything inbetween, it'd be ignorant of me to ignore how differently you get treated based on what you look like.

Making the decision not to alter my personal style just to appease or dissuade gross men feels like a form of defiance now.

I am a feminine-looking woman who enjoys her life and owes you absolutely nothing.

Conversely, I have the closest and warmest friendships I've ever had now I am not hiding from myself. The wonderful experience of warm, emotional and supportive relationships with other women is something I never imagined would feel so good.

My friends are my life now, and all that's changed is me.

Now What?

Early on, I had little idea of the privilege I had when it came to transitioning. I didn't recognise how lucky I've been with the sheer effectiveness of hormone therapy for me. Of the fact that I almost never get clocked as trans by strangers out in public; just by people who already know some trans women and might know what some of the giveaways are.

Over time I've come to recognise that I am enormously lucky.

I've had almost exclusively supportive friends and family, accepting me and being excited for me through this whole crazy time of my life.

The constant dysphoria I felt that limited so much of my ability to function in life is all but gone; all that remains is dysphoria which can, unfortunately, be triggered by intimate situations - something which means surgery is probably in my future, unfortunately.

But even if that remains, or I am unable to afford surgery, it's a small price to pay in the short term for a life which no longer pushes me toward anger, bitterness and even suicidal ideation.

Hormone Therapy has been an almost universally positive experience, even if was a bit uncomfortable at times, and the strangeness of the almost top-to-bottom nature of body changes (face -> chest & body hair -> hips) did give me very odd feelings of insecurity early on.

I smile more broadly. I am confident approaching shop attendants, bartenders or other people I don't really know. My relationships, which before felt a bit 'off' no matter how deeply I loved my partner, feel more real - more functional. I love my body. I care about my health. I no longer feel the the need to be trashed almost every night of the week. I no longer feel I'm undeserving of my friends and lovers.

Transitioning is the best thing I've ever done with my life.

2yearsofhrt

If you're interested in some more detailed notes on my earlier hormone therapy, I did some month-by-month breakdowns here:
Before HRT
Month 1
Month 2
Month 3