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A Year On

It’s been a little over a year since I started hormone replacement therapy (HRT). I almost missed the anniversary of it. Several fires in my personal and professional life have been dominating my attention. I’m glad I caught it though, because it feels like a big deal to me, and I want to celebrate it.

If you’re not immersed in trans culture, first of all welcome! Second, I assume you’ve got some questions. Why go on HRT? Why pay attention to the date? Why does this feel like something to celebrate? I have some answers, from my perspective. Remember trans people aren’t a monolith and I can’t speak for all of us.

Why Did You Do It?

Well, part of it was to address a problem. Here’s how my endocrinologist described the issue:

Encounter Diagnosis

Gender dysphoria in adult (Discharge Diagnosis) –

Transsexualism (Discharge Diagnosis) –

It’s weird, incidentally, to have your identity medicalized. That’s a topic for better, more informed authors, or at least another time. To the point, it isn’t how I thought of the problem.

At the time, I thought my sweat smelled weird, and it caused me to shower 2 or 3 times a day. I was shaving my face about as often. Both were irritating my skin, making it feel raw. I couldn’t ‘just get over it’, as many people in my youth had suggested.

I also struggled to dress myself in the mornings. I’d put on half a dozen outfits trying to find something I felt at home in. The lines were all wrong. Nothing fit on my body the way it was supposed to. Turns out, I just wasn’t shaped like other women.

Like many women with body issues, I spent some time in therapy trying to work through them. I, too, thought for a time that with enough therapy and personal growth I could ‘just get over’ these feelings.

At some point though, I realized I didn’t have to. It was my body, and there was no shame in changing it if I wanted to. Tons of people go to aestheticians and have plastic surgery. I could do what I wanted with myself, and I had lots of different options, including HRT.

Why Do You Mark the Date?

So I can celebrate it, sure. Also, for medical reasons related to my transition. Time since starting HRT gates a number of other types of gender affirming care. More frequently though, it’s to measure my progress.

Perhaps the worst kept secret in medical care is that you have to advocate for yourself. This is doubly or triply true of trans health care. Most providers don’t have personal experience with it. There aren’t a ton of trans people, so most medical professionals don’t have a lot of experience with us. There aren’t as many studies as one might like.

You can find dozens of these with a simple search, and they all roughly, but not perfectly align.

There are general timelines, of course, like the one above. I compare my progress to charts like that before I meet with my endo. I talk with other trans women to learn what their transitions have been like. Both help me advocate for myself when I talk to my endo. If it looks like things aren’t progressing as they should, it’s largely me that has to advocate for a change in medication or dosage.

Why Celebrate it?

It was a huge thing for me. Given the current discourse, you’d think it was trivial to get exogenous hormones. I spent over a year in therapy before I felt comfortable pursuing it. Finding an endocrinologist who had space to take on a new patient, and one who was willing to take on a patient like me, took months. The intake appointment was over six months out from the point where she said she’d see me.

Beyond the time investment, it was a huge thing for me. It was a big step in taking ownership of my body. It was a big step in admitting who I was to others. I could only do it because of all of the steps I’d taken in accepting myself. I’m not just celebrating the day I started taking hormones. I’m celebrating being able to love myself, and all of the work it took to get there.

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