Hormone Replacement Therapy (How to Obtain it, What to Expect, The Road Ahead)

(I'm sorry! This post became a little long, but I hope it helps with any questions!)

Warning:

This post contains discussion and photo of HRT injections. Needles are mentioned and shown at the end.

Hey everyone! I'm back with another, hopefully helpful, blog about HRT or Hormone Replacement Therapy. I plan on touching certain topics on how to obtain HRT, what you should expect from it, and how it will make its way into your life.

HRT:

Now, I assume most people know about HRT, but I will go over a little bit about it. HRT are hormones that transgender individuals may take to help them transition into the gender they truly are. They can be injections, creams, or patches. Injections are the faster way for transitioning; however, patches and creams are made for individuals who may struggle with needles. I will be focusing on the injections in this blog. HRT is not a requirement for any transgender person to take. It is a treatment that an individual may take if they do wish. There are people who choose to not take HRT and that is fine. They are no less transgender than anyone who chooses to take this treatment.

A FTM (female to male) person such as myself would be given Testosterone, a common hormone that males typically produce more than females. A MTF (male to female) person would be given Estrogen. A common hormone females produce more than males. Hormone levels do not effect if you are transgender or not. A cis-male or female can have opposite hormone levels and not be transgender. Hormones are the chemicals in our body that tell our brain how our body forms, how we act, and other various things throughout our chemical makeup.

Obtaining HRT can go a couple of ways. The most common way to start HRT is by going to a therapist so that they may evaluate your mental health to see if you are ready for treatment. This can be anywhere from a couple of months to years given your health. A therapist's job is to make sure your mental health is prepared for hormones along with educating you on transgender topics. Though hormones are a great treatment, if not careful, an individual can experience a variety of things from depression to anxiety. Another way to obtain HRT is by providing written consent from a healthcare provider that you are ready for treatment. This is a less path traveled on, but it requires a medical expert as well.

I can not stress this enough, please do not try to find loopholes to obtain HRT. The written permission can be very annoying to wait for. I had to wait a whole year till I was able to have permission. Though it was hard and it hurt to be told I can't start many times, I am glad my therapist worked with me and made me wait. I was young, in high school still living with my parents with no job. She made me wait till I could myself and had me focus on graduating. She put my future in front of what I desperately wanted, but she knew it would make things more stressful for myself. Be kind to yourself physically and mentally. Have patience and trust your therapist.

After obtaining permission to start HRT is where the real excitement begins. Before starting, usually a doctor will want you to bring your written letter of approval from your therapist and at least one other person with you. Here they will show you how to inject your prescribed hormones into certain locations on your body. Some doctors have different ways of injecting and will tell you upon arrival. Mine showed me four. Two points on either front side of my thighs and two points on either back side of my lower hips. She gave me four locations to circulate my injections so that I would not build scar tissue in the areas of injecting making it more difficult for the needle to go in. My best friend was who I brought with me so that he could learn how to inject hormones into me in the back if I needed help or couldn't do them myself.

Before the doctor writes your prescription you will have blood work done. It is to test your hormone levels and to make sure you are healthy enough to proceed. After your test results are back your doctor will write you a prescription and how much you will take. It could be every week or every other week depending on what's best for you. How much hormones you take will be determined by your test results. Many start with 1ml every two weeks or .5ml if every week. This can change throughout your life depending on how your body responds to the hormones. After you have received your prescription you will go to a pharmacy and turn in your prescription to start treatment.

Questions:

Now, this is where a lot of questions come and I will try to answer them as much as I can.

Q: What are the side effects and what should I expect from HRT treatment?

A: With any medication there are risks and side effects, HRT included. Your doctor will tell you that some side effects do include small things such as: acne, weight gain, and temperament swings. Other more sever side effects can be: depression, heart attack, and cancer. Now, this isn't meant to scare you, but educate you. The more sever side effects typically are never seen besides depression and anxiety. Typically in a situation that your mental health is effected they will lower your dosage as most of the time you are just taking to many hormones for your body. This is why communicating with your doctor over every change will be crucial. Let your doctor know if you are having problems so that they may help you.

Q: What is the timeline with physical and mental changes I will experience?

A: To be honest there has never been a set in stone timeline with physical and mental changes. HRT treatment can vary for everyone yet have similarities. One of the first things you might notice is temperament changes. Temperament changes are more about your temper. Some experience shorter tempers and can lash out at other people. This tends to last 2-3 months. If it lasts longer or gets worse it's best to talk to your doctor about a possible dosage change. Voice changes happen around 2-4 months. You will be going into what the doctor calls a second puberty so be ready for voice cracking! Acne can also occur at this stage. Weight gain happens typically within 3-5 months as your body starts adjusting to the hormones provided. Other things such as facial and body hair happen at random. Mine occurred at 2 months where is my best friend who started at the same time as me has very little body and facial hair at 3 years. These are in no way an exact time line of changes that may or may not occur. Even now I am still going through changes at 3 years.

Q: Is it better to do every two weeks or every week?

A: Two weeks or every week have little to no difference in your transition. I do every two weeks because, I am busy with work and life and it works better with my schedule. Some may take every week as it works better for them. The only difference is that, if you take it every week side effects such as acne can decrease as opposed to every other week. Because you are taking small amounts of hormones every week your body can adjust better. Where is if you take every two weeks acne can be a small problem as you are taking twice as much hormones for two weeks. All in all, you will receive the same amount of hormones no matter what. It is just what works best for you.

Q: What if I want to do injections, but can't inject myself?

A: This is why you bring a second person with you to the doctor. That way if you are not able to do your own injections another person can. You can even go to a doctor close by and ask if a nurse may assist you with injections. Most of the time they will say yes and do it for free. Others may charge depending on the doctor.

Q: Does it hurt?

A: Any needle has the potential to hurt. From my experience, the part that hurts is the initial breaching with the needle. After the needle is inserted there is no pain unless you go too deep into the muscle tissue. Sometimes after an injection the pain you may feel under the skin is a slight knot that has built up with the hormones. Hormones are a thicker liquid and can feel like a tiny ball under your skin. Simply rubbing over the spot gently will take care of this problem. Another pain can be if you penetrate the muscle tissue too deep. This is nothing to worry about unless bleeding profusely occurs. This pain can be helped with over the counter medication along with rubbing the area. It will heal on its own. If pain continues or gets worse over the course of 4-5 days is when you might want to call your doctor to make sure everything is okay.

Q: Is HRT worth it?

A: For those wanting to undergo HRT, personally I believe it is worth my money and time. I felt happier and like I was getting closer to being who I really saw myself as. Some days of course there is dysphoria or other things that hormones can't help me feel confident with. HRT will not take away all problems or leave you always happy, but they do help a lot in my opinion. Truly it is up to you if they are worth the time.

Q: How long do I have to take HRT?

A: For those who don't know HRT is a lifelong treatment. Once you start there is no time you will stop after "reaching" a certain point of transition. Of course you can stop whenever you would like or if finances don't allow you to continue. The only downside would be none of your changes while on HRT will revert back.

Q: What if my parents don't me and/or don't want to pay for HRT?

A: Unfortunately I have experienced this my whole transition. I live with my parents still and they do not my decisions to transition. As a rule in the house I have made, is that I will pay for my own doctor visits and treatment. My parents honor this as I am a legal adult and paying for everything myself. Before I made rules with them my father wouldn't let me use hormones. Going unwisely behind his back I paid and took them anyway which led to many more problems within our relationship. My best advice is to wait and get a job to pay for them yourselves. If your parents are not ive yet want to pay for your treatment you can. I only caution that at any time they can stop your treatment as they are paying for it. Again my best advice is to wait till you have moved out and/or can pay for them yourself

I know this post is long and I appreciate anyone who made it this far. I hope the information I provided for you can help you with your decisions or what to expect. As always you can ask any questions you want me to answer if I haven't answered what you were looking for :)