August 8, 2009 1:05 AM BST
I kind of agree with Marsha.
Though I know exactly what she means, I wouldn’t describe feminisation from female hormones as a “side-effect”. Of course, achieving feminisation is not why natal females usually take hormone “supplements” but it is the primary effect that nature intended.
Anyhoo…
Blood tests for measuring hormone levels are wholly unreliable. They are basically a snapshot of one’s levels at any one time. The resulting level will be hugely affected by when you took your last pill/gel/shot, the time of day, when you last ate, how much you ate, how much you ate the day before, how much water you’ve had to drink, and so on.
The big mistake, in my opinion, is to base oestrogen dosage on test results. Unfortunately far too many GP’s do exactly this, perhaps because that’s the way the endo at Charing Cross, and probably other gender clinics thinks is somehow a foolproof method. To suggest a certain level of oestrogen in the blood will achieve feminisation is totally arbitrary, has no scientific basis, and no studies have been done to demonstrate the effectiveness of such a “philosophy”. In short, the level that any endo says you should be aiming for is totally made up. Natal female hormone levels vary wildly, hugely wildly. Our “ideal” level is picked out seemingly at random, not an average of anything, usually at the lower end of where female levels might be, and so what…? Who is to say that this level is what we need to achieve feminisation? Female levels do not remain at this constant, why should we achieve good results on a steady, low-ish level which is virtually impossible to measure accurately anyway. I could go on, but you get the point, yeah?
It’s a nonsensical way of doing things. I went for an appointment at CX regarding referral for a trach shave, they said, “You might as well have a blood test while you’re here…”
I wasn’t expecting it, I’d had one recently which was “fine” (according to them). I’d arrived in London the night before, my train was extremely late getting in so I’d checked into my hotel and gone straight out for dinner. I ended up staying out later than I’d expected (a nice man bought me dinner), I got back and realised I’d missed putting my gel on as I’d been on the train all day, so I slapped it on in the early hours. I also took my evening pill, much later than usual. Then I had to get up early for my appointment, quick shower and applied more gel, didn’t want to leave it until late as I’d be on the train all day again, and took my morning pill. 2 pills, and 2 lots of gel within the space of a few hours. Had my test done that morning. Unsurprisingly, estradiol level was pretty high (yet still well within “female levels”).
So their endo sent a letter to my GP a couple of weeks later saying my estradiol level was “enormously raised…” and I should lower my dose. I’ve never met the endo at CX, I never got the chance to tell him I’d taken a “catch-up” dose late at night followed by most of my quota for the day in the morning. He never asked, of course.
I explained to my GP why the level was higher than before, but he was still reluctant not to follow the word of the gods from Charing Cross. Such is their influence, and ignorance.
“Don’t self-medicate, go see an expert” is advice you will see littered about TS forums everywhere. My advice – become an expert yourself. It’s your life, your transition, your body. You are more important than random numbers on a screen; not everyone sees you that way. They crunch your numbers, and get paid lots. That keeps them happy. Blind faith in such gods is not for me.
You’ll get the hang of hormones when you take them, you will know how they are affecting you; it’s difficult to explain to someone who doesn’t take them. Some people seem to need higher doses than others. As I always say, give it time. Don’t increase your dosage every month just because your breasts don’t seem to be growing. Ignore the “guidelines” you have read on the internet, like it takes two years to achieve full breast growth – that is utter nonsense. Try seven, or ten, or somewhere more realistic around there. Once again, it varies. And also, a higher dose will probably not mean they will grow any quicker.
A sufficient dose is what you are aiming for, and breast growth is not the only factor you should go by to determine this.
But estradiol level is certainly not a factor.
xx
August 8, 2009 3:13 AM BST
Marsha:
I absolutely am not advocating self-medication. Like you, I have a doctor who supervises my med’s and we work together, well, things are pretty settled now it seems, so there isn’t much “work” to be done.
Regular blood tests are essential to monitor your health, just ignore estradiol levels, they are virtually meaningless.
I’m not giving anyone any credit, I don’t often do that (worra bitch), dunno why you suggest I do! Nor am I suggesting that people should do what I say, just offering my opinion, as always. But if was suggesting that people should do as I say, and they didn’t, they wouldn’t be deserving of any credit from me would they. No, I really don’t give some people too much credit.
Your “almost sense” was not quite accurate; there is no surprise that I was agreeing with you. You often say your opinions differ from others here, but that’s not really the case. I often agree with you, so do others. I just put it differently, or add bits, or be pedantic about some bits, (pedanticism, a bit of a hobby of mine). We all have opinions Marsha, you are not unique in that respect, and you are not always alone in your opinion.
You’re absolutely right in your first paragraph, I just wanted to make the point about oestrogen.
We are advised to stop hormones before surgery as a precaution, but since I think that was a rhetorical question and you know the answer I won’t go there.
Just to clarify for others’ benefit, Vaniqa is not a pill, it’s a cream. It does not remove hair. It’s very expensive yes, but pretty cheap on NHS prescription!
Indeed, Spiro will NOT remove facial hair. Spiro in fact can be extremely dangerous if used in ignorance. Which is why you should be an expert, and discuss your med’s with your doctor. I expect I feel much the same as you, Marsha about non-transitioners who think they can take one pill to remove hair, or one to grow breasts (perhaps just a little bit), or one that will allow them to breast feed, or one to make their bald head sprout beautiful new hair...
As I say, I do not advocate self-medding, but nor should you take stuff without knowing anything about it even under supervision, if you value your body that is.
The “expert’s” advice (like the CX endo for example) should be taken with a pinch of salt; if they had their way, that’s all they’d prescribe for you.
xx
August 8, 2009 10:29 AM BST
I'm inclined to think that the experience of the www.transgendercare.com people is as good a guideline as we are likely to have as they have the experience of seeing hundreds of ts through transition and are kept in check by the US legal vultures so as they say aim for high estro and low testo numbers then that sounds good to me.
It would be interesting to know what the preferred hormone regime is for the different gender clinics in the state funded countreis of the EU are but I've never seen any details published...and that makes me wonder if in fact they might respond to a request to be posted on here as a warning and guideline...I'll try that and see if they respond.
and I bet it’s even better than many GGs.
