My body is strange. I am routinely pegged for being 29, when I’m almost 20 years older. The doctors believe my genetics is responsible, but who really knows? Lots of people look younger, or older, than they are.
Excellent question. In the old days, transsexual women took very different hormones - hormones which were not nearly the same as real female hormones, and which very often were combined with large amounts of progesterone. Reports for decades showed that deep vein thrombosis (DVT) was a big risk for transsexual women, especially those over age 40, and other blood clots could form which could be fatal. Progesterone, as we saw from the hormone replacement therapy (HRT) studies of the late 2000’s, was responsible for serious increases in breast cancer risk.
Nowadays most transwomen take 17B-estradiol, which is much closer to what human women actually would produce in their bodies. It’s not 100% the same, but it’s closer. Also, progesterone is now not recommended, and not commonly taken. The studies I’ve reviewed show that nowadays DVT is rare, and limited mainly to transwomen who are heavy smokers. Breast cancer is thankfully rare as well, although we definitely need mammograms (I was having them before hormones, as I had breasts from my natural hormones).
The anti-androgens we take, spironolactone or finasteride or others, seem thankfully to have limited side effects. Spiro can cause potassium issues with the body, and can be a diuretic in larger doses. Finasteride can cause impotence, but that’s pretty much inevitable given the enormous amounts of estradiol we take anyhow.
There are some other miscellaneous problems which can pop up from the hormones. Sometimes you can have liver disorders from oral estrogens, and have to go to a patch, for example.
Some other things are problems, some are benefits with some problems.
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Our skin becomes very soft, and weaker than it was as “men.” I cannot count the number of times even other women at work have sat there stroking my arm or face, saying “OMG, she’s softer than silk.” Men and cisgender women like to touch me, which is actually sort of as odd to me as it must sound to you. Because it’s soft, it tears easily, however, and I wear thin leather “fashion gloves” almost any time the temperature is less than 60, just to protect my hands from cuts.
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We bruise MUCH easier, and the bruises take a longer time to fade.
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Our nails are so brittle on some of us that we never grow them, clipping them as short as possible because otherwise they just crack (that’s me).
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I had a difficult time building any muscle when I was young, just on my natural hormones. Even after I was forced to go on a weight training program to “toughen me up,” I was always dead last in the class, by a large margin. After 18 months on hormones, it’s safe to say I’ve lost 50% of my strength. I now need big, strong men to open jars for me, or lift my roller bag into the overhead bins on planes. Last weekend I dumped my motorcycle on the drive, and despite all my lifting, I could not even budge it an inch. Up walks a utility worker who saw me fall, about 5 inches taller and maybe 50 pounds heavier, an average man, yes? And he says “here little lady, let me help you”, grabs the handlebars and wrenches the bike upright with modest effort. That incident filled me with a mix of pleasure and shame. I was happy a man came riding to my rescue, but unhappy I couldn’t lift it myself.
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My smell changed. Before, I had very little body odor. I loved not being able to wear any deodorant as I gave off no scent unless I was really hot and really sweaty for a long time. Hormones made me smell almost within the week, and I could detect it because I wasn’t used to it. It wasn’t BO, it was a scent of…I don’t know how to describe it, I just know that even after a fresh shower, without an hour I could tell I was no longer scentless? About that time, even though I was still in stealth at work (there was an overlap where I was taking hormones before I came out 100%), I started to receive compliments from the men on my “cologne.”
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My depth perception and spatial awareness changed. This was profound and a little scary. I adjusted to it after a about a year, but at first it was really not cool. Two examples - I fence, and one of my best tricks is “pulling distance”, where I retreat from an attack just barely enough so their sword misses me by about an inch, then I can riposte and score. Within a month after hormones, I started getting hit all the time when pulling distance, as suddenly everyone seemed about 3-4 inches closer than I thought. Second example - the garage I park my car in is tight, there is only about 4 inches of clearance on either side of the door (once inside it has plenty of room). In nearly 13 years living here, I never once touched the sides of the garage - not once, and that’s even coasting on in quickly. In the first two months after hormones, I scraped the car so many times I forgot to count; more than a dozen?
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For the first time in my life, I became prone to yeast infections. Enough said.
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My sense of taste and smell changed, profoundly in some cases. My sense of touch did slightly. These were some of the more troublesome side effects.
Many, many other changes have happened. As a scientist, I logged and documented them, and it’s been fascinating to observe these things first-hand, like being an explorer in an uncharted land on a one-way journey. Hormones are very powerful, and I take huge amounts of them. I almost feel like, well this will sound odd, like my brain has been slowly re-wired over time. In a good way, mostly. The literature supports proof of long-term hormone use leading to permanent cognitive differences, but the root cause is not understood. I know I’m absolutely not the same person I was 18 months ago, and it’s possible I may be a different person still in another 18 months. I don’t know. It’s a little scary, you know?