TRANS WOMEN: HERE'S SOME SHIT YOUR DOCTOR WONT TELL YOU ABOUT HRT

1. Progesterone: not for everyone, but for many people it may increase sex drive and WILL make your boobs bigger. Also effects mood in ways that many find positive (but some find negative). Most doctors won’t prescribe this to you unless you ask. Most trans girls I know swear by it.

2. Injectible estrogen: is more effective than pill or patch form. Get on it if you can bear needles bc you will see more effects more quickly.

3. Estradiol Cypionate: There is currently a shortage of injectible estradiol valerate. There is no shortage of estradiol cypionate. Functionally they do the same shit.

4. Bicalutamide: This is an anti-androgen that has almost none of the side-effects of spironolactone or finasteride. The girls I know who are on it are evangelical about it.

@euryale-dreams

Are there HRT medications that don’t increase blood clot risk? I’m already at risk because of my blood pressure, and my doctor won’t prescribe HRT that increases clot risk while I’m on the medication - and I may never not be on the medication.

Absolutely.

The concerns surrounding venous thromboembolic events as a side-effect of hormone replacement therapy can mostly be traced back to one particular study known as the Women’s Health Initiative. This study was an enormous undertaking which, unfortunately, demonstrated significant adverse effects of the hormone therapies studied. As a result of this the use of hormone replacement therapy in postmenopausal cis women was dramatically reduced as the medical community began to question whether or not the therapy caused more harm than good.

Naturally, trans women have been suffering from this fall-out ever since.

What physicians seem to fail to recognize is that the study examined a very specific hormone regimen which was, arguably, outmoded at the time the study was conducted: It examined the use of conjugated equine estrogen (Premarin) with or without the use of medroxyprogesterone acetate. Neither of these drugs is regularly used for the treatment of transgender women.

The estrogen most commonly used to treat transgender women nowadays is 17β-estradiol either in pill form or in the form of a sticky patch that you apply to your skin. Esters of estrogen (e.g. estradiol valerate) are also sometimes used either in a pill form or as an intramuscular injection.

Transdermal estradiol patches are the gold standard when it comes to treating women who are at high risk of a venous thromboembolic event. It simply does not increase the risk of developing a venous thromboembolism. The only thing you should keep in mind is that patches are not always well tolerated because of the lifestyle changes required to keep them from falling off and the fact that they tend to irritate the skin.

Fortunately, oral 17β-estradiol appears to be safe, regardless of the increased risk. At least one large study has shown that the use of oral estradiol in trans women is not associated with venous thromboembolic events. An individual woman’s risk would need to be substantial in order to contraindicate the use of oral estradiol.

For those who have significant risk of venous thromboembolism because they have had a previous thromboembolic event, because they are paralyzed, or because of some other factor it is good to know the relative risk between oral and transdermal estrogen. The latest research indicates that the use of transdermal estrogen lowers your risk of a thromboembolism to 80% of what your risk would be using oral estrogens.

It’s difficult to find hard numbers regarding the relative risk of venous thromboembolic events with regards to hypertension. The best I could find after an hour or so of searching was this study regarding VTE in lung cancer patients. Hypertension increased the risk by a factor of 1.8.

However, to put that into perspective being of African descent increases your relative risk for deep vein thrombosis by a factor of 1.3 when compared to Europeans. Europeans are, themselves, at increased risk when compared to Asians and Pacific Islanders by a considerable margin: a four-fold increase.

I should point out that being ‘male’ is also a risk factor for developing a thromboembolism and hormones are likely to be a contributing factor. Also, menopause is another serious risk factor. Given this information it is likely that the use of transdermal estradiol will lower your risk of thromboembolic events significantly.

As far as the anti-androgen is concerned: The primary use for spironolactone for cisgender people is as an antihypertensive.

Even if the risk of thromboembolism was truly significant with modern hormone replacement therapy it wouldn’t justify what your doctor is doing to you. The fact is that mortality in the transgender community from suicide–caused in part due to the lack of access to hormone therapy–is substantial. The quality of life lost when a trans woman is denied hormone therapy is substantial. The fact that your doctor does not appear to be taking this into consideration when they weigh the risk of thromboembolism against not receiving necessary medical care is deeply concerning.

I strongly recommend that you seek a doctor who is more sensitive to your medical needs as a transgender woman.

Edit: Fixed a minor, but embarrassing, error.

oh wow this is so helpful & good info

Everyone who cares about transfem people please reblog this

this was really fucking helpful

I know a lot of trans women dont have acess to information like this and its very helpful.

Here’s some stuff I could have used being told when I started HRT:

If you do HRT, you are seizing control of and reconfiguring an aspect of your own metabolism, which is fucking cool and amazing, but despite what medical literature and community knowledge exists, you must always be your own advocate in the process (even if you think you have good doctors). As someone who deals with hypervigilance, I’m not going to tell anyone to be more vigilant, but HRT has myriad and subtle impacts on your body and mind (duh). Some of these you probably want, some of these you probably don’t, but telling the difference can be more tricky than you think.

Really watch yourself for side effects. I don’t mean relatively rare side effects like liver damage or blood clots, but simpler stuff that’s much easier to dismiss as just being transient or bearable, like nausea or mood swings. Such side effects are likely to be be small and easy to deal with in the beginning, easily borne, but if they become more serious over time they can do so so slowly that you don’t realize your quality of life is being reduced, especially if you’re loving many of the effects of HRT at the same time. Don’t accept any side effects of your meds as unavoidable, or akin to a price you have to pay for HRT’s benefits. Just adjusting the dosage of your meds, the times you take them, how you take them, and what you take them with can have a huge impact, but doctors can leave out that this is a process of experimentation, and that finding the right combinations of meds and dosages can take time.

Evangelical is not a word I ever thought I’d use for myself, and I’ve only been on bicalutamide for a week, but wow. If you are using spiro and experience any nausea or stomach pain while on HRT, even if you think it has other causes, or if you’re someone like me who carries their anxiety or fear in their stomach, I’d highly suggest at least trialing bicalutamide in place of spiro, just to make sure you know what’s causing that pain and/or nausea. I took 300 mg/day of spiro for about a year, and was waking up in pain and nausea every day without connecting the dots. Now that I’ve switched anti-androgens and tapered off spiro, in just a week I have twice the appetite and almost no stomach pain. What pain I do have dimishes every morning. So far, bica has been literally life-changing for me.

But I only found out about bica from another trans woman, here on tumblr ( @social-justice-cleric ) . My doctor insists he mentioned it as an alternative, more than a year ago, but frankly he stood by as my stomach pain became worse and worse, and only switched me to bica when I did my own research and asked him to. Don’t underestimate the importance of community and its accumulated knowledge- make sure you find other trans people you can talk about your transition without fear of judgment, especially including talking about any and all biomedical components of it. This is especially important for trans women who tend to socially isolate ourselves in response to stress or uncertainty (aka, me).

And as someone who really wanted results from HRT as quickly as possible, it’s ok if you end up wanting to step back your dosages, or if a medication doesn’t work out. This should seem obvious, but it doesn’t make you less of a woman to slow down or even stop doing HRT. Additionally, don’t assume that the speed at which your appearance changes is necessarily correlated to the amount of meds you take- there is for everyone a threshold of dosage past which there is no benefit (and instead just increased risk). For instance, I just finished a two month trial of progesterone- maybe my breasts developed a little more than they otherwise would have, but mostly I just had slight mood swings that trended slightly more to the negatives than the positive, so I’m not going to keep taking the stuff. And if spiro was the only anti-androgen out there, I might have stopped taking one entirely rather than stay on it. But decisions like these are hard, and intensely personal- your doctor can’t, or at least shouldn’t, make them for you.

Ultimately, all the biomedical means of transitioning are for is getting the changes you want to your body and/or mind. And despite the legal-functionary and regulatory components of biomedical transistion, these means do not make you into a woman. Regardless of whether or not you apply these biomedical technologies to your own transition, you are a woman. Some of us trans women come to accept increased medical risks, or endure physical discomfort, in pursuit of the self and life we want. In this, we are hardly alone among women. And, as is the case for any patient heading into a doctor’s office, what medical experts tell us must always be judged against our own embodied expertise.

Biomedically transitioning shouldn’t be seen as a necessary stage of one’s gender transition- it should be an opportunity available to all of us, but not one we all must take, or need to take, to be happy. Since we live in such a cissexist and transphobic society, biomedically transitioning is for many of us a desperately needed means of survival. And at the same time, and in equal measure, it is also for many of us a source of incredible joy. Listen to your doctor, listen to the community, listen especially to your body and to your own heart, and see what works for you.

Also, as a trans woman who has a chronic liver disease, bicalutamide can be hepatotoxic (damaging to the liver) and so far Spiro is the safest antiandrogen if you are a trans woman or AMAB nb in a similar situation as me. However, bicalutimide has not been tested in hrt doses, which are much smaller than the doses bicalutimide was originally for. Feminization begins as low as 12.5mg and the doses tested were 150mg.

estradiol depot is good replacement for valerate as well. 2nding the injections over pills. you can get so much more estrogen into your system SAFELY when it doesn’t have to be processed by your liver (which is what pills have to do).

Article 13 has been approved by EU. It’s worse than Net Neutrality has ever been. I don’t even know if we will have any access to Tumblr, Pinterest, Ao3 or even Instagram. Memes are probably dead, just like reactions, fanfictions and gifsets. Everyone in EU is in danger that they will not have access to their favorite sites. But I haven’t seen a SINGLE post about it on my dash because Americans doesn’t give a damn.

Also, I’m in Europe and ngl, had no idea this was even an article up for debate let alone it being fucking passed.

Don’t panic! This was expected at this stage and it is only the beginning. If you are a European and feel passionate about this, please keep on reading and help!

So what has happened so far … the Commission has drafted up a long overdue copyright reform. https://eur-lex.europa.eu/procedure/EN/2016_280 It contains a lot of good, and some bad: mainly Article 11 and 13.

This was put forward as a whole to the European Parlament, where it was voted down on the 5th of July 2018

This meant, this will not go through the fast way, and will be subject to scrutiny and change. 

The Commission made some alterations https://eur-lex.europa.eu/procedure/EN/2016_280 and put it forward again. If Parlament would have voted it down again, it probably would have meant back to the drawing board, but most people (including me) agree that Europe does need copyright reform, so on the second vote it passed the first step:

So what happens now? 

This will now go into what is called the Trilogue, where Commission, Parlament and representatives of all national governments will sit together to make alterations until everybody is happy implementing the regulation.

This means we can now influence this via our MEPs and our National Government!

In countries that are red your government is likely to support Article 13.

What to do now?

There are a lot of organisations that organise actions against article 13. Check out their websites and get in touch with your MEP or local government and let them know you are unhappy about this.

… and many many more, just google to find one in your country.

Also, as @asthesea-breezehitsmylungs pointed out, a lot of people are not aware of this going on. So make them aware! Share the memes and point them to the petitions. And don’t just complain how shit this is, get in touch with your politicians!

Oh good.

Yo, everyone, EU or not, please at least signal boost this shit. I’ve said it before and I will say it again: those two articles will suck majorly for all of us.

Like dude, how much time do you spend enjoying various things that relate to, Idk, your favourite show or book series. It’ll probs be gone. Funny memes and shit? Nah our generation doesn’t fucking need to laugh, it’s not like half of us are already depressed or anything. And so many other things that are cool about the internet, I’m not even gonna mention how some big, cool places like YouTube and Tumblr will be fucked by this.

So seriously, there’s only so much a small bunch of people can do. We need some noise on this. As much as I hate to admit it, some things require some fat numbres to be paid attention to. So even if you’re not planning on taking any action yourself, the best thing to do would be to spread this to everyone you trust to either get involved or pay it forward like you did.

And seriously, every little thing helps, ok? We should have a say in how the laws that deeply affect us are made.

SIGNAL BOOST

what a convenient date 🤔🤔🤔

–

Submitted by @goshgay.

For everyone who doesn’t know there’s a strike against McDonald’s on that date. Don’t fall for this. Support striking workers.

Just unquietly.

The largest storm ‘since records began’ is currently building in south east Asia/ the Pacific - its looks like it’ll be skirting the Phillipines and hitting the area around Hong Kong and Macau around Monday the 17th.

This is Typhoon Mangkhut

Those little green lines are islands and countries.

It is LARGER/STRONGER THAN FLORENCE

It’s currently typhoon 10. The highest cataorgoy and equivalent to a category 5 for American hurricanes.

Jfc, pray for South East Asia

Here are some statistics that show how powerful Mangkhut is:

30 million people.  That’s a lot of fucking people. 

A major update for the fangame has just been released! I know I don’t post much lately, but I do hope you all enjoy what we’ve been working hard on so far! ; v;

Happy ③ anniversary！(❀ฺ´∀`❀ฺ)ﾉ

IT IS SOCIALLY ACCEPTABLE NOW. 

IF ANYONE GIVES YOU SHIT FOR IT? WELL,

WOW

I’m pretty sure you’ve reached Legendary Status when the God of Skating, Tony Hawk looses his shit

That’s literally the move Christ Air from the first tony hawk pro skater game

HE REALLY DID IT

holy

FUCKING SHIT

so wait

someone literally had the balls of vibranium it takes to attempt christ air

in front of Tony Hawk

AND STUCK IT

jfc

Fucking

SICK

Shout out to Akbar Cook for being there and caring for our kids in your school. Thank you so much.

If cat and otter videos can get 200k, this should be able to too.

@deadcatwithaflamethrower

*reblogging for extra shout-out*

You guys are just in denial of the Truth.

COME ON.

i admit youre right, but please

please

life tip whatever dumb ass name you get siri to call you is what your iphone automatically signs your emails as. i have been applying to jobs for 2 months as queef.

#OH MY GOD OH GMY GOD OH MY GOD NO N ONO NO NO NO NO NO NOOOOOOOOO #HOLY SHIT #I HAVE BEEN APPLYING TO JOBS AS ANAL DESTROYER

FUCK

This post actually deserves a “reblog to save a life”

So I posted this on Twitter:

And then when I refreshed the page:

and yes, I had to give them my phone number to get my account back.

i’m on a different computer and too lazy to get the mega guillotine image can someone get it for me

“Keeping the internet open is critical for us. It powers social movements, and provides a global platform for people of color, LGBTQ folks and the most marginalized communities to tell their own stories, run their own businesses and route around powerful gatekeepers.”—Candace Clement, Free Press Action Fund Campaign Director via @fight4future​

Starting today, June 11, U.S. internet providers will be legally allowed to censor and block websites and apps, and force you to pay extra fees to to access your favorite places online. Your internet sanctuaries, the communities you are part of, the ones you have help build up, could be decimated.

Will it happen today? No. Next week? Probably not. The changes will not be swift. They will come piece by piece. A slow, tempered death to the free and open internet we love.

It doesn’t have to be this way. You can still make a difference, Tumblr. We need the House of Representatives to sign a discharge petition in support of the Congressional Review Act that would force a vote on the floor.

Contact your reps—let them know you support net neutrality.

It’s so easy. Just go to BattleForTheNet.com, fill out the form, and follow their directions from there.

They have an updated widget for you to throw on your websites to urge others to make a difference. You can put it on your Tumblr. Let your followers know what you stand for, encourage them to do the same. It’s so easy to do. Just copy and paste their small line of code right into the customize theme page on the web.

Go, go, go, go. We know you have that passion in you. We’re fighting right alongside you.

A lot of adulthood is shouting “AUGH MY LAUNDRY” hours after you put it in the washer/dryer and running to go fetch it

oh shit my laundry

reblog to save someone’s laundry

this is a companion post to the “don’t forget your made tea and its getting cold” one

Augh, my tea!

@heatherwitch Did you get your tea?

I did, almost four hours late but it’s all good cause I was reusing a teabag so it’s actually still really yummy and faintly tastes of peaches and spices <3

This is when Homestuck peaked it could have only went downhill from here and it did