One month into HRT. I continue to be torn between desperately wanting to move faster and thinking that keeping it slow is still bringing about things awfully fast. I don’t really know how to reconcile those two things, other than to say I recognize them both and I’ve talked about them and felt them for some time now, and I think that’s just my existence right now. I think slowing down because I’m afraid is unrealistic because I’ll end up hating myself for not taking action. Speeding up because the excited part of me wants to get deeper into a transition of sorts is going to speed up alienation and hasten a crisis of sorts. There’s a sweet spot in between the two time scales, and I think that finding it and sticking with it is really the only reasonable thing to do right now.

I’m taking 100 mg. spironolactone split in the morning and evening and I really can’t tell if it has cut out my testosterone. My erections are fewer, so I know it’s working, but I don’t know how effectively. I’ve sort of set a goal of 90 days HRT to ask Dr. F for a blood test to see what my serum testosterone levels are — that ought to be ample time for the drugs to be effective — it’s actually probably too conservative, but I think that’s just fine. So my plan is if, in 60 more days, we find I need to double the dose in order to knock T down to normal female levels, then that would be warranted. Then we can test again in 90 more days.

Another test of whether spiro is working is whether estrogen seems to be working unopposed, since Spiro blocks T from hormone receptors, allowing E to attach, instead. It certainly seems to me that the 1 month of estrodiol, low dose of 1 mg, has worked pretty effectively, so maybe Spiro is doing a great job. In any case, I read online that 4-6 weeks into HRT, breasts become tender and there will be a nodule forming behind the nipple. I started getting this feeling at about 2 weeks, mostly tenderness, but the past 2 weeks have been a steady acceleration of that feeling to the point where, this last 5 days or so, I’m quite sensitive and would really hate to get bumped into.

Nodules: I feel the nodules pretty clearly — they form a painful (or sensitive, more properly) area directly behind the nipples, and if you push on them, it hurts. I think heat makes it feel better, but I haven’t really done a good test yet.
Nipples: I had also read that the nipples (the skin itself) can be sore or sensitive, and that also describes me right now. I don’t think it’s anything even moderately noteworthy yet, but I’ve been putting lotion on them in case they get more sensitive.
Fat: it seems to me that fat has begun redistributing around the breasts, but the tape doesn’t back me up. And even if it has begun, it’s only 30 days and unless I pull my t-shirt really tight, there’s absolutely no sign that breasts are forming. Unofficially, however, I don’t think there’s any doubt that the boobs are fatter than they were a month ago, especially the left one.

So it seems like, even though I mentally complain about going too slow, a lot has happened in 30 short days. I’m going to stick to my 90-day evaluation and do nothing until then, but I am sort of anticipating doing two things at that point: upping spiro if the bloodwork says I’m not in female levels and doubling estrogen from 1 mg. to 2 mg, perhaps twice a day, as well.

Why? I feel that this is really the right direction to take. I don’t feel desperate and out of control of my life, like I did in the fall. And while it’s too early to do a serious evaluation of the HRT, I’m mindful of the various websites that all say something like this:

Do a trial test of hormones for 3-6 months. Changes won’t be permanent (i.e. you can stop spiro and get your erections back, etc) until 6-9 months, so while you’re flirting with going too long, this window gives you a pretty firm glimpse of what a possible future as a hormonally female body is like. If you love how you feel, think, and are, then this is the right course for you. If you are uncomfortable with how you feel, think, and are, then you have learned that this is probably not going to solve your gender issues.

Right now I feel great. I don’t think I’m feeling (mentally, emotionally) any different, but I really need to check with others on that because it’s probably not something I’m going to feel that intensely (although others report feeling different emotions rather quickly — I’m wondering if that’s not either placebo or the release from a lifetime of repressing things). Physically, I’m comfortable in my skin. And it’s hard for me to imagine that in 6 months I’m going to feel any different — I anticipate deciding one of two courses in 6 months: speed up and decide to transition or stay the course, making steady changes, and eventually decide to transition later.

In other words, while it’s not a burning desire in me, when I visualize the second half of my life, and especially what I am likely to have to do in the next 3 years, I picture transitioning. Maybe that won’t happen. Maybe I’ll assume a very happy middle, androgyne existence where I’m kind of half man half woman who presents as male (sort of), thereby avoiding the formal, legal, and social shift that comes with telling everyone you’re having a sex change, adopting a new name, bringing on massive change in your family, etc.