HRT and not seeing much change - wonder if should change docs

[next_level_mom]

Hi, this post is in regards to my AMAB daughter.

 

She came out to us not quite two years ago. I'm not sure exactly when HRT started but I think we moved fairly quickly, since she was already 18.

For quite a while it was just estrogen patches in increasing doses and then another med was added about 6 months ago... I forget what it's called, an

anti-androgen?

 

But other than some weight redistribution, it doesn't seem to really be making much change and I think she's disappointed and frustrated. It doesn't

help that COVID makes things like getting hair removed much more difficult.

 

The transition doctor she's seeing is a pediatrician, because my daughter is autistic and her own pediatrician kept her on as a patient so she wouldn't

have to make a change, and referred us to the pediatric specialist. I'm wondering if maybe that could be affecting the treatment and a doctor for adults

would be more proactive. Or does it just take a long time for some people?  I see before and after pics of other trans women and they're so strikingly different.

[Carolyn Marie]

It's hard for us to judge, especially since your description of the changes your daughter is seeing is not very specific.  Suffice to say that people do vary greatly in their response to HRT, and getting put on a blocker (another term for anti-androgen) just six months ago might explain it.  I would give it another 6-8 months, and in the meantime she can express her concerns to the doctor and see whether that results in more adjustments.

 

For many trans women, 4-6 months from starting HRT is when noticeable changes start happening.  During that same period of time she should notice body hair diminish in amount and thickness.  Full breast development usually doesn't occur until 2+ years.

 

Carolyn Marie

[next_level_mom]

I don't think there's been significant hair reduction, which is probably the biggest issue for her. Having to shave all the time depresses her.

 

 

[Jackie C.]

1 hour ago, next_level_mom said:

I don't think there's been significant hair reduction, which is probably the biggest issue for her. Having to shave all the time depresses her.

 

 

 

I get that, it used to depress me too.

 

Hair you don't want is tricky though. Results vary wildly from girl to girl. Some get greatly reduced growth, and thinning body hair, others don't see a change and have to look to other solutions (like electrolysis). I wish your daughter all the luck in the world, but @Carolyn Marie is right, she's just into the phase where results start showing up and that's assuming that her hormone levels are in the target zone already. As an example, my hormone levels hit the target zone immediately. First try. A friend of mine just got hers in the target zone after seven months. It can be disheartening because we all want out changes NOW, but the process is kind of a long and twisty road. We don't always get everything we want (just like cis-girls so we have that in common already) and changes can take a while to show up. In a lot of ways it's just like puberty the first time around. That wasn't over in six months either, right?

 

Hugs!

[Nora]

1 hour ago, next_level_mom said:

I don't think there's been significant hair reduction, which is probably the biggest issue for her. Having to shave all the time depresses her.

 

 

Totally get that. Could be helpful to remind her that LOTS of girls have hairy arms and legs (those are my two trouble areas that I dread; shaving my whole body gets pretty exhausting lol. I noticed a few of my cisgender female friends though have super hairy arms, and that really helped me with that particular area of dysphoria. Now I mostly just focus on my face and legs unless my arms start looking a little too much like a chia pet lmao....they still make those? XD

[Kelly2509]

I haven't seen significant changes and I've been on HRT for 9 months with decent Estrogen and testosterone levels since May.  If patches were used, my guess is the doc started with very low doses which means much slower results.  My doc advised me against patches because they are generally low dose and for most transwomen he's dealt with who've gone that way they had to use multiple patches at a time to get the dosage needed.  Also my doctor said changes in body hair is approximately a 2 year process, assuming good hormone levels in the blood, so a few months to see results seems optimistic at best.  And of course facial hair isn't affected by HRT so there's that.

 

my advice would be if you haven't already to get her estrogen and testosterone levels checked and consult with the doc to see if she's in or near the target range.  I've been told by many that you can expect the entire first year to mostly just be the doc dialing in the proper dosage, so get the blood tests and work with the doc to make sure the proper adjustments are made.  Then I would advise patience, which is probably the hardest part of transition in my opinion.

[Carolyn Marie]

2 hours ago, Kelly2509 said:

  Then I would advise patience, which is probably the hardest part of transition in my opinion.

 

This  ^^^^^^

[next_level_mom]

Hi all, so sorry I haven't replied sooner. Just got busy and forgot to check back. @Kelly2509, she was started on a very low patch dose, though it has been increased. I'm still wondering if we should maybe find a more proactive doctor, though of course the present circumstances make everything more complicated.

 

I didn't know facial hair wasn't affected by HRT!  I'm not sure she knows either. Would it make sense to take her for electrolysis? (Ironically, I think she got hairiness from me, my husband didn't have any real facial hair til he was in his thirties, lol.)

[Jackie C.]

Your doctor's approach is fine. They start low, do blood tests and repeat until your daughter's bloodwork shows estrogen and testosterone levels in the proper range. This is very much a slow and steady sort of thing. Think of it like having puberty again. That wasn't over in a day and your doctor doesn't want to accidentally hurt her with too high of a dose. The basic pattern is two months. Test. Adjust dose. Repeat until she hits her targets. There's no one-size-fits-all dosage so your daughter's doctor has to be careful to feel out what's right for her.

 

As for electrolysis. If she wants it, I'd say go for it. You need to have hairs of a certain length which might cause her dysphoria while she's letting it grow out, but in the long run it's the only truly permanent solution.

 

Hugs!

[next_level_mom]

Thanks Jackie C. I'll do a little research and check in with her about whether she can handle it.