How fast should I go up?

[Guest Briannapan]

Hey guys. I am a 17 (ugh, that sounds so old. I just turned 17 this month, but definitely don't feel like it) year old MtF and I was put on a 3 month Lupron shot to destroy all that pesky T in my system. 4 months ago, so my T level are still low from that. Anyway, I have been on very low dose estrodiol for a a little over a month and a half now and the only changes I have seen are increased happiness , a MUCH clearer mind, and some small breast buds, which kinda rocks. But I do have a decision to make. You see, my doctor (who is one of the most amazing men on this planet) is basically giving me a choice on how quickly to increase my dose (I hope it is okay to talk about doses on here when you aren't specifying an actual number). Tentatively, we have decided to increase it every four months (taken down from an original 6) by a certain dose, but he said I can change that to however quickly I think would be best. There are two conflicting sides to this. One is the fact that I am still kind of a child, and never really progressed through male puberty to that great of an extent (voice dropped a little, but not fully, and I was never fertile, believe me, I tried to store sperm. That was a waste of an extremely dysphoric moment. They counted 1 sperm cell. Literally. One.). My doctor thinks that, because of this, replicating a female puberty by having a delayed increase in estrogen dosage over a longer period of time could have better feminizing results in the long run. He bases this on his work with Turner Syndrome girls, where they had better feminizing effects and breast development with a more delayed increase in estrogen, to replicate a regular female puberty. He thinks it might be similar with me, but he also said that I am not a cis girl with turner syndrome, so he can't really say. It is just and idea he had. Just for some more info, my endo does work with trans kids a lot, but most are a bit younger than me, and in those cases, he usually does increase estrogen slowly to replicate a female puberty. But because I am on the cusp of "adulthood", he is leaving it up to me because he honestly doesn't know if going too slowly would have me miss those benefits of starting estrogen while young.

The other half of this is that I am 17, and I know that once you pass the age of around 18, you kind of begin to loose some of those bonus effects of estrogen that younger trans girls get. Things like possible hip widening, better breast growth, facial stuff, I don't know, i've just heard that the younger you are when you take estrogen, the better the outcome. Another kickback of going faster would be: going faster. I am planning on being totally out in school by the end of the year, so I can go back to school next year as a girl for my senior year (don't worry, my high school is ridiculously liberal, luckily for me), and showing up at a family wedding in a dress for the first time this June, so being physically further along would certainly help out in some social aspects there. Although, I really wouldn't want that to dictate this decision much, because it will effect me for the rest of my life. Wow, pressure. I know I will be happy with either one I choose, because honestly, I am finally doing something I have wanted to do ever since I can remember. And nothing can take that away.

Right now, my gut is telling me to go faster than what I am right now. How much faster, I just don't know. I know none (or most?) of you guys are not doctors, and probably don't feel comfortable in answering this, but I really just need opinions on this, because I have no idea what to do. I just would love recommendations on what you think I should do, what you would do if you were in my situation, or, even better, what you did in your past experiences and if you were happy with the results. I would especially appreciate regimen (not specific doses, obviously, just the speed in which said doses were increased) information about people who started HRT around my age and the results you saw. But all comments would be appreciated. Thank you so much guys.

[JJ]

One thing to remember is that chronological age is just a guideline-a measure from one day to another that says roughly what your biological age might be. But we are all individuals and our actual biological age can vary a lot. It sounds like yours may be younger than others your age. Meaning that you are not under as much of a time crunch as you fear. Also much of what will happen in regards to breast and hip development will be related to genetics more than the age you start or go on full dose HRT from what I have read.

It's something you may want to to research and discuss with your Dr but it is my understanding that the outstanding effects that you see in girls who started HRT very young is not due to the age they started E but to not going through male puberty with the growth, skin coarsening, facial and body hair development etc. In fact many Drs. still refuse to prescribe E before age 18 but will administer medication to delay puberty till that age and that when puberty is allowed to resume and the hormones given it still occurs as it would have even though the person is over 18. In other words, as long as the T is blocked I don't think you have to worry about that time pressure. That need to address the issue young has already been met by blocking male puberty.

My advise would be to take it at the pace that you can best adjust to-both physically and mentally. Puberty is a big change in your life and has a lot of effects. Especially emotional ones for many, many girls. It is a time of pressure from within in a way -when you add changing gender presentation and appearance to that you have a lot of stress and a lot to adjust to. You have a long life living as an adult and a woman but being a child, that is short and soon over. If you want to enjoy it a little longer then my vote would be to do so.

I'm not a Dr but from my observation very little is gained from rushing anything to do with transition. Enjoy your journey. Savor it. And if it starts chaffing that it is slow or dragging and you really feel ready then you can always speed it up.

Johnny

[Guest Sarah Michelle]

I started out with the full dosage of estrogen, spiro and progesterone. My doctor didn't even suggest to take it slow. That doesn't mean it would be best for you. I don't really know if increasing your dossage faster is going to help that much. It will still depend on how your body reacts to it. As they say YMMV on what results you will get.

Good Luck

[Sally]

OK, here comes another opinion from someone who started transitioning much later in life, going slow was never discussed because I did not start until I was 58 years old.

My opinion is that there is only a difference of 4 months before you increase but I would really need to know how many steps there are before I could decide - 3 steps means a full dose in 1 year, 6 steps is 2 years - is this program intended to mock female puberty and work over a course of several years or simple to start slower?

You have already started on estrogen so I would just bump it up to full strength from the beginning - even in cis-girls everyone's puberty is different.

As to being too late for the full effects - I don't really believe that it is possible for a 17 year old to have started too late, I;m doing pretty well at 60 and I live with two others each older than me and they are doing very well too.

Love ya,

Sally

[Guest Briannapan]

Thanks so much for the speedy replies! I really do appreciate it.

Johnny- Yeah, I have figured that my biological age is somewhat lower than my chronological one. When I was 12 or 13, I had a hand x-ray to see my bone age, which they determined was similar to an 8 year old. I actually got that done when my parents wanted me to take the growth hormone. Thank goodness I got out of that one. And I do realize that some of those better effects do come from having less of the damaging effects of puberty. But what I was referring to was the decrease in effectiveness of estrogen after a certain age (chronologically, around 18). I have read that after around 18, a kind of switch goes off in the body that stops some of the potential effectiveness of estrogen. I believe the reason for this is because thats usually when the average female puberty begins to die down. I was kind of amazed when reading about this, but apparently it does exist. I honestly haven't even thought about how slowing it down would, in a way, increase the length of my childhood.. now that really is something to think about. This would be good in some aspects, but then again, I am a a junior in high school, and I don't know if delaying adulthood is the best idea. But it definitely seems like something I would do .

Sarah- I figured I would get a YMMV response, hah. But you reminded me to mention, I am soon starting Spiro, additionally, to make sure T doesn't climb back up, and once I get to a higher dose in estrogen, he will put me on progesterone, too.

Sally- I would get to half of the lower side of the recommended estrogen dose for transgender people in 4 steps. So a little over a year. He says, since I only weigh 92 pounds, I probably wouldn't need a full dose to have my estrogen at a female level, but we would obviously go closer to the recommended dose if my blood tests show that I would need it to get to a mature female level. But we would probably still go up slowly, as we have been doing, by a certain small dose every 4 months. So yeah, I can make this go as slow are as fast as I want, but I'm just not certain on what to do yet. And yes, I know it's never too late to start, but I am just trying to increase the effectiveness in my current situation, and am trying to figure out the best way to do this.

Thanks again everyone. Some interesting things to consider were brought to my attention.

Brie

[Guest auxo]

If I were in your shoes I'd take into account the fact that estrogen inhibits skeletal growth -- a welcome change for most mtfs, but possibly not so for some who are slim but want to be slightly taller. Most natal females stop growing around 14-16 while boys can grow until their mid-twenties because of such estrogenic effects. Height is an important sexual cue, and for reference I'm 5'6-7" and still find myself taller than most of my girlfriends.

[Guest Svenna]

Brie,

The folks that answered before me have covered most of what I was going to say, so I'll just add a few points...

1) It is impossible to predict what your blood levels for Estradiol, Progesterone or testosterone will be for any given dosage. Everybody metabolizes HRT drugs at differing rates and only through the close monitoring of your blood serum levels can one accurately (and safely) assess the need for dosage increases...

2) Your physical characteristics suggest to me, and remember I'm not a doctor, that you may have an intersex condition as well as be trans. Just a hunch, don't hit me with a stick if you find the notion troubling, lol...

3) You are an exceptionally fortunate MTF to be living in such a tolerant set of circumstances. Embrace your good fortune!

You've made a great start already, keep up the fine work and womanhood will be yours for the living..

Love and good tidings, Svenna

[Guest Briannapan]

First off, thanks for your input.

Auxo, thanks for bringing that up; I actually have considered that, too, as my doctor did mention that. It's not a huge problem though, as I am 5'1"-5'2", about the size of my mother and sister. My dad is 5'7". Growing up, my doctors told me not to expect to be taller than 5'5". Which is why they wanted to get me on growth hormones when I was around 13, and I weaseled my way out of that because I really always knew I was trans, or at least that I wanted to be as feminine as possible. But now, ironically, it wouldn't hurt to be taller as I have a huge interest in fashion and modeling, and being taller in fashion always helps. But either way, it won't make that much of a difference, and if I stay the height I am now, I wouldn't mind, because thats probably how tall I would've been anyway, if I were cis.

Svenna, I'll answer your questions as numbered.

1. I do understand that, but I do know that what I am on now is *probably* not equal to a cis female, as it is basically the lowest dose usually sold. But yeah, thats why I have my doctor and we can check how I react to whatever dosages we decide on, and adjust accordingly. I actually have noticed some signs that make me think my T level is rising back up a bit, so I will probably ask for a higher spiro dosage (he didn't put me on too high of one, as he didn't think I'd need it), or the next step up of estrogen, which is still small, but double what I have now. I actually noticed that my T level is probably going back up around when I started spiro.. which is odd. Unless there is an initial spike in T level on spiro, which he didn't tell me about.

2. Hah, thanks? I mean, I wouldn't find that troubling, because I would actually have a physical, concrete reason for feeling this way my whole life, which would be nice. But I don't think that is the case. I mean, I've looked like a cis female, although a very young, possibly prepubescent cis girl, ever since I grew my hair out, and get called a girl wherever I go (except in school, where I confuse everyone XD), and it is true that I made it until late my 16th year without developing many distinct secondary male characteristics. But I don't think I am intersex because we got a karyotype done by this insane doctor who wanted to do all types of tests on me to find out why I felt this way (he was a stereotypical conservative jew, no offense to anyone), and he mostly just wasted our time. Thankfully we left him to look for someone.. better. And we found him. But anyway, the karyotype clearly showed that I had XY chromosomes, which kind of sucked to actually see on paper. It was a kind of a "Haha, your a boy" type of thing. I guess its possible that I have some mild mosaic of XY and XXY, but it's not really safe to assume these things. And to find out, I'd probably have to have some expensive test, which, if I want to see in the future, I may, but it's not important to me right now. Plus, none of my doctors have ever even spoke of the possibility, so if they don't have a hunch, I don't. I think it is much more likely that I am just a late bloomer.

3. I know. I am really thankful for everything, because I've had relatively few issues in this whole thing. Which I know is SO rare and I feel blessed. I'm going to be killed for this here, but looks really are important to me, whether it is a character flaw or not, I am just so glad that I am okay with how I look. I actually LIKE how I look for the most part, although I HATED where I felt it was going pre-hrt. I dislike my feet (size 8, which I know isn't even that bad) and the obvious other "part". I think I am pretty. And HRT can only help that. I actually feel bad that I feel bad about my feet, because I know your average mtf faces a lot more adversity than I ever will. And here I am, worrying about my feet. I guess it's kind of a privileged persons' guilt kind of thing. I don't understand what I did to be so lucky. Sorry if this sounds like bragging in any way, I am just trying to convey how thankful I am for everything that presented itself around me, and all the acceptance I've gotten. Of course I wish I told people sooner, as it only would've helped, but I wouldn't trade my life for anything. For the first time in my life, I am actually happy where my life is going, even though school is more stressful than ever.

Ahh sorry about that.

It's the low-dose estrogen talking, I swear.

[Guest Svenna]

Brianna,

Ah, good! I'm glad you've been looking into these issues for a while and are obviously informed about many of the possibilities...

I would add one more statement, and then I will let the intersex angle go. I've no vested interest in any given diagnosis, so please don't read anything into this additional tidbit...BUT...

In the case of suspected intersexualism: The absence of evidence is not evidence of absence...

I had to run that concept around my brain for a long time before I realized the implications...

But, it is what it is, regardless, since physical intersexuality can occur with or without a Y chromosome. But there will be time to ponder such notions later down the line, I'm sure..

Love, Svenna