#trans progress

So, lots of interesting HRT stuff. At my last levels check, I was on 4mg injectable EV a week. And… my E actually went down, even though that’s an effectively higher dose than my previous regimen (6mg sublingual/day). Because of this, I talked with my provider, and essentially she told me to fuck around. I probably was way looser with it than she wanted me to be, but she told me to go to 8mg/week maximum, and try and settle on 6mg/week minimum. So….. here’s what I did.

1 week of 8mg.

2 weeks at 7mg.

2 weeks 6mg, during which my levels were checked at mid.

I… can’t really advocate for this. Basically, my logic was that I wanted to see what it felt like to max things out, but have my actual levels check reflect what I’m like at 6mg to know if increasing or maximizing the dose beyond that is necessary at all. Ultimately, I’ve concluded that 8mg feels too high- I start getting a bit of headache and nausea at peak. 7mg feels very comfortable. 6mg, I felt fucking miserable at trough. When I was on 4mg/week, I used a couple of sublingual pills to try and get through that, but I tried to see if I could stop doing that. It went okay for the higher doses, but on 6mg… ugh. Felt like complete shit. I’ll def be using a couple this week to get through that, probably just 4-6mg sublingual on wed/thurs to make sure I’m feeling okay.

Oh. Also. I ditched Spironolactone, against the advice of my provider. 

I was getting really, REALLY irritated by the diuretic effects, so I quit it when I tried to 8mg dose just to see what would happen. I figured that 8mg would be more than enough to suppress T on its own (likely true), and so I thought it would be the best time to try that. And… when I stopped spiro, a depressive haze that had been in my head lifted very quickly. I thought it was just depression based on a rough past couple of months, and that’s probably true, but it also felt physical. The diuretic effects have also stopped, and I genuinely can’t imagine going back on spiro.

I’ve heard a lot of theoretical stuff about spiro potentially being able to inhibit growth and development. It's possibly a growth hormone inhibitor, but should be a more potent antiandrogen than anyone else. It’s…. Really hard to say whether spiro actually inhibits growth. As with a lot of transfemme physical developments, there’s never been a comprehensive, conclusive study on it, which is why its relegated to miscellaneous anecdotes that everyone will swear one way or the other on. I’ll have some opinions on this later.

So what improvement to my levels did I get out of all of this?

Well…. Good, but nothing radical. My midcycle estrogen is 159 pg/mL, which is about my target for trough. It’s a good step up from the 4mg dose, but I’m probably going to increase to 7mg/week- that felt fine to me, and I’m pretty confident that that’ll be the dose that nails it. I’m pretty deadset on going forward with that, I would just need a levels check to verify we’re all good there. (Side note, I’m a bit frustrated that my body literally seems allergic to just… stuff. Idk if I have an overactive liver or what, but my T crashed super easily, adderall consistently lasts shorter than it should, and my E is really struggling to go up.)

And did this result in any physical improvement? 

I actually think that this last month has been the single fastest month of physical development I’ve ever had. Here’s some things I’ve noticed:

My breasts have become much larger and more developed in relation to my chest, with a much better shape. Comparison pictures to even just the end of January show a wild difference (sorry, not posting that publicly). To be fair, though, I’m still pretty clearly in tanner 2, and I maybe want to wait for just a bit more development before I start progesterone. 

Waist measurement is still going down, and hip measurement is still holding steady. This means that, in effect, my hips are getting wider.

And this is one of the most exciting ones- my upper body seems like its getting smaller. I’m floored by this. My underbust is less, my chest looks noticeably less barrel-y, and my ribcage kind of “flows” into my waist better. I wrote a bit about this on reddit just now, but I think I know what’s happening here. Not only is fat burning from the sides of my chest as it builds on the front of my chest, I actually think my costal cartilage might be getting “tighter”, effectively pulling my ribs a bit closer in to my sternum

I have…. No way to confirm the hunches of that last one, other than the images I can show. So for educational purposes (and y’know. Making the funny women in my phone type funny syllables) Here’s a quick timeline where I think you can see the “barrellness” of my chest decreasing:

From left to right, we have September (0-1mo), December (3-4mo), March (6-7mo)

Don't worry, my shoulders are just as wide and athletic dyke-y.

Am I delusional? Is this anything? Maybe. Pictures are hard to make consistent with changes this small. But I do feel like its noticeable, and it seems like women’s cut shirts and tanks have fit me in a way that’s a lot more consistent with a cis woman’s body. Again, there’s also nsfw images, and I think they show a lot of progress, and I think I can pretty definitively say that this has been the single month with the most physical changes since, well, my first month back in September. 

Why did this happen? Well, I’m working with a sample size of one here, and multiple variables have changed at the same time. There’s really three things that could be happening: increased injection dosage, ditching spiro, or the general come and go of physical changes. It’s impossible to completely know what’s going on because of this, unfortunately- I’d need way more data. That said…. This is the first new “wave” of development I’ve had since I started, and my actual blood levels didn’t increase that much. I really, really don’t want to conclude anything, but I’m kinda thinking that spiro had something to do with it. It has broad effects on physiology which aren’t entirely characterized, that could easily theoretically be inhibiting generic growth and development. That said, I think starting with a strong antiandrogen is basically necessary for HRT. It’s extremely difficult to get E levels up without robustly inhibiting T first. Obviously don’t take this as medical advice, or even a scientific opinion. This is nothing more than a hunch.