Reflections on 1 year of hormone replacement

15 Aug 2024

Recently I hit my 1-year mark of hormone replacement therapy (HRT). Many trans folks consider the year markers to be like the anniversaries of their rebirth. I’m not sure I hold hormones alone in such high regard. However, they have been a welcome and important part of my growth both physical and mentally in the last 12 months.

I wanted to take a little time to write about the decision making process to starting, the experience so far and the other factors in life that have helped me transition.

October 2022 - A decision to wait

Two years ago I faced myself with a couple of options. Either 1. Focus on transition, or 2. Focus on career and work community. In my work sphere I’ve been involved in community events for a number of years. When the pandemic came, it brought a lot of in-person events to a halt for years. As a result I felt like I had some unfinished boy-business (ie something I felt I wanted closure on before focusing on trans stuff). So I concluded that it was better to focus on work community first, get my closure then move on. I’d be lying if I said I didn’t want success in career to pull me away and distract me from gender identity issues as well. A part of me still felt like a trans imposter. I needed something else in my life to pull my attention away from gender identity struggles for a while. I hoped it would help me know how certain I felt about it. So I dove head first into a very ambitious conference project that consumed the next 10 months of my life.

July 2023 - A new beginning

A month before the conference I was utterly miserable. The event had been an absolute hellscape to put together. Every moment I wasn’t spending worrying about planning the conference I felt paralyzed with depressed feelings. Feelings about my life, my measures of success, and the poor focus I felt I had on the things that really mattered to me. The inevitable march of time loomed over me. I’d buried myself yet another year in work and made little progress to happiness. It also had absolutely zero effect on distracting me from my gender identity problems. In fact it might have made them worse. I felt more distant from my femininity, like it wasn’t something I carried with me all the time. It was something I buried in my closet and put on like a hat. I hated that.

I realized I couldn’t wait any longer and I needed to try hormone therapy to see if it was for me. I was tired of putting my life aside for career so long. So with the help of an affirming care clinic, I started the process to get a prescription and began at the end of July 2023. Every day thereafter I’ve had the choice to stop. To not take pills. Every day since then I’ve wanted to, though. I opt in to staying on HRT every single day.

Feelings

I noticed after starting only anti-androgens (testosterone suppressors) that my connection to my emotional side felt stronger. In fact, only a few days into my new regimen I saw the movie Ladybird and bawled so hard, the emotions stayed with me for days. It was a foreign feeling. Since then my capacity for getting emotional has remained, and it’s taken experience and practice to manage those feelings. I’ve found it to be a very welcome change overall. Something about masculine identity and testosterone seems to bury/overcome feelings. Sometimes in a way that is unhealthy. I am happy about having more access to emotionality. It makes me feel alive.

Physical changes

In the last year I’ve gained about 20-25 lbs. this is a combination of it being harder to burn fat and grow muscle, as well as the fact I’m letting it happen. Hormones can only do their work to distribute fat in the human body if you have fat in the first place. Trying to remain a stick figure has no real gains for me. I won’t let myself balloon out without limits but as long as I’m looking and feeling healthy I don’t over-fixate on the scale.

Changes in my face have been subtle, a general softening of features. Changes to my body, however, have been more obvious. I’ve been developing breasts at a reasonable rate and the curvature of my body is developing strongly too. Body hair has also diminished significantly in its rate of growth and strength.

Mental wellness

While it’s hard for me to put a finger on whether HRT has changed my mental wellness directly via chemical differences, I do think it’s greatly put me at ease. Access to femininity feels a lot more like it comes from within and not just due to the clothes or makeup I put on. That alone is a huge peace of mind and it’s helped me be more and more comfortable in casual clothing. Having completed many sessions of laser hair removal also contributed a lot. It helped me feel like I could reduce makeup and the hormonal body hair changes compounded that.

Outside factors

There have been some other major factors to wellness that have occurred this year. In a lot of ways I think their importance overshadows that of hormones.

I’m speaking about the implications of social acceptance from family and friends. I came out to my parents as trans in late April 2024 and my old friends and family on Facebook just a month later. Prior to coming out like this I used to feel like I was already out of the closet….mostly. Yet still I would cry at night, overwhelmed by emotions. Weighed down by the thought of telling people. Feeling almost sorry for being me, like my gender identity was an unwelcome burden.

On the other side of PROPERLY coming out, I don’t even know what to call the limbo I was in before for so long. In any case the clouds really parted once I felt like I wasn’t hiding from anyone any longer. While I haven’t officially come out at work, I don’t think the queer femboy in light makeup, earrings and manicure is fooling anyone. I feel welcome at work as I am so there is peace and balance in all my regular spaces.

Conclusions

There’s still so much unsaid about this journey, but maybe I’ll leave more reflection for the 2 year marker. I anticipate that the next year will bring on more changes in personal growth.

If you ask me straight up am I happy on hormones right now, YES absolutely. I’m still exploring the right regimen for me (ie finding the right balance of estrogen and testosterone for me). It’s a process that takes time, and blood tests, and talks with medical experts.

If you ask me if HRT is the MOST important thing for a trans woman to be doing, I’m uncertain. I don’t think medical transition or surgical transition can ever replace the power of social acceptance. Feeling accepted as we are also throws into question how much change we really feel we need. Social acceptance is the path to feeling like we are enough a lot faster/cheaper. So, for all the cisgender folks out there reading this, I think it’s worth reflecting just how much of an impact you can have on someone’s transition. Simply accepting someone as they are, calling them by their preferred name and pronouns is a small step in making someone feel at ease. And, when everyone takes those steps it moves things forward in big ways for trans folks.