Feminizing Drug Regimens: Pre-SRS Transsexual Medications

Hello Girls,

I don’t know if any of you are serious about really becoming girls, but if you are, my advice would be to seek medical advice in the first instance. If you do choose to self-medicate, which can be risky, below is a ‘typical’ transsexual MtoF feminizing medication regimen from: http://www.transgendercare.com/medical/resources/tmf_program/tmf_program_regimens.asp.

This is a U.S. site and some people have suggested (see comments) that the doses recommended here are far too high. It is best not to self-medicate at all if you can get hormones through a Gender Identity Clinic or from your GP. If you must self-medicate, start off with a relatively low dosage, like 2 mg of Estrofem or similar a day, and see how you go.

This is how I started, and together with the 5mg Finasteride which I was taking anyway for prostate problems (BHP), was sufficient to cause breast growth.

The following full transsexual regimen, which I have been taking more recently (minus the Spironolactone), certainly promotes full feminisation fairly rapidly:

Feminising Medication Regimen

1.  4 mg Estradiol (Estrofem) (sublingually – under the tongue) daily – one in morning, one in evening
2.  Two 50ug (mcg) Estradiol (Estrodot) patches applied weekly Saturday morning and Tuesday evening, or any other two days in the week, three and a half days apart – but stick to the same days each week.  Alternatively you can use transdermal gel rather than patches – see the above website.
   
3.  5 mg Finsasteride in the morning (in the U.K., you can get this from your G.P. on the NHS, if you have a dodgy prostate – BHP – Benign Prostatic Hyperplasia).
4. (Optional) 25 mg Spironolactone (Spirotone) in morning, 25 mg Spironolactone in evening – building up to 50 mg Spironolactone in morning, 50 mg Spironolactone in evening after 6 weeks, and thereafter optionally building up to as much as 200 mg per day, according to the transgender care website (http://www.transgendercare.com/medical/resources/tmf_program/tmf_program_regimens.asp)  BUT BEWARE! I don’t actually take this myself, because I had a severe allergic reaction to Spironolactone.
   
5.  (Optional) Progestin : 5 mg daily for 10 days at beginning of the month.

From: http://www.transgendercare.com/medical/resources/tmf_program/tmf_program_regimens.asp

PLEASE NOTE:  I am not a doctor or medically trained.  You should NOT start taking feminizing hormones unless you are absolutely sure you want to do this. In my case it came from somewhere so deep down in my psyche and subconscious that it was inevitable that I would do it eventually.

It SHOULD be done under medical supervision.  If you don’t want your transition to be medicalised and controlled by an ‘expert’ gender identity clinic, involving psycho-sexual psychiatrists and psychologists, endocrinologists and SRS/GRS surgeons, whether private (or if you are in the U.K., at an NHS clinic such as the one at Charing Cross Hospital), you can obtain the feminising hormones from a reputable Internet supplier such as InHousePharmacy – I can recommend this company without reservation.  They deliver anywhere in the world, it’s the real proprietary medicine, and thay are prompt and reliable on delivery.  In the U.K., you may have to pay 20% V.A.T. plus £8 handling charge to the Post Office when you import the drugs, but this is quite hit and miss.  The last two deliveries from InHouse Pharmacy I had to pay it, but on the most recent one I didn’t, so it seems to depend on the efficiency (or otherwise) of the local Post Office.

It is wonderful and truly liberating that one can control one’s own feminizing drug regimen, and it has only been possible to do this since the advent of the Internet – certainly no one could do it in the 1970s, or 1980s – or I might have started a lot sooner.

BUT, and here is a very important point, you should still at least tell your G.P. what you are taking, in case there is any conflict with other medication. My G.P. (who is female), knows what I am doing, and so far she has been pretty good about it.  She hasn’t commented on the full transsexual drug regimen, as above, as she admits honestly that she is not an expert in this area.

UPDATE: I am about to start sessions with an NHS Gender Identity Clinic (October 2011), and I am guessing they probably won’t be that pleased that I have been self-medicating.  I hope they don’t tell me off too much!  Hopefully I will finally receive some advice from an expert clinician in transgender endocrinology and be able to get the hormones on NHS prescription in future.

Please be warned: it is best NOT to do what I have done.  Taking female hormones has well-known risks associated with it for women or men.  If becoming the woman you have always felt yourself to be is important enough to you, you will no doubt proceed in spite of the risks – but be aware of them.

I was surprised to realise recently, looking back on my invoices from  Inhouse Pharmacy http://www.inhousepharmacy.vu/transgender/transgender.html that I have been taking female hormones for over 5 years, so I guess it’s not surprising that I have boobs and a curvy shape – my hips have broadened, and my fat distribution is pretty female – my arms and legs look feminine, and it has also feminised my face.

I did not begin with the full pre-SRS MtoF transsexual feminising regimen as above, but started with just 2 mg of Estradiol (Estrofem or Progynova) for most of that time, building up to 4 mg per day.  That is enough to promote breast growth and body feminisation- you start to see the difference after 6-9 months.

I was lucky in that I started with a fairly un-masculine body to begin with – I am not that tall, I can wear a normal female size of shoes and clothing, and I have always had broad hips and rather narrow shoulders, and not much musculature – so my body lapped up the female hormones from the beginning.  I am also blonde, which means that body hair has not been a great problem, and it has now reduced to a female level anyway.

I have had quite a lot of laser hair removal treatments to get rid of facial hair, and can now manage with only light foundation or no foundation at all. I will probably also have to have electrolysis eventually to get rid of the remaining facial hair, as I want to look as natural a woman as possible.  I would love also to have Facial Feminisation Surgery (FFS), but I am frightened to do it.  My face is reasonably feminine anyway, and since I went full-time as a woman from July 2011, I haven’t really had any problems so far. (However, see update below about Facial Feminisation Surgery – I have decided to go for FFS.)

I am able to go shopping en femme with my wife, and I don’t get stared at.  I can go into the female changing rooms  – I guess I just look like a woman.  I can hardly believe it myself!  My wife says when we are shopping and she looks round, she just sees another woman – and doesn’t always realise it’s me!

I have my own shoulder length blonde hair, and so don’t have to wear a wig, and my boobs are big enough to give me some cleavage.  I dress sensibly, and wear what other women around my age wear.  It’s great to be able to spend as long as I want looking at lingerie and women’s clothes and shoes without feeling embarrassed!  I have debit and credit cards in my female name, so paying is no problem.  I am working hard on developing a feminine voice – so far without much success – more on this is a future blog.

UPDATE:  I AM having Facial Feminisation Surgery this November 2011 at the Facial Team Clinic in Marbella, Spain – and I am still frightened!  But I am going ahead anyway, as I think it will give me more confidence that I just look like any other woman.  I will post about this nearer the time and after the surgery.

I hope this has been some help to a few of you – please do let me know by commenting.

Hugs and kisses x x x

Amber (Kate)

Spironolactone, estradiol, feminising hormones, female versus male orgasm

I have updated my views on feminising drug regimens since I wrote this in 1998 – see my latest blog on this:

https://ambergoth.wordpress.com/2011/04/23/feminizing-drug-regimens-pre-srs-transsexual-medications/

It will be clear when you have read the above that I have recently stepped up my feminizing drug regimen to a full transsexual pre-op. dosage.  I guess I am moving closer to the transsexual end of the spectrum.  I am spending more and more of my life living as a woman, and so I guess it’s starting to look as if it’s only a matter of time before I transition completely.

I would love to have facial feminisation surgery, but I am frightened to do so – in case it goes wrong and I end up looking like one of those ‘after plastic surgery’ horror stories.

My wife says she likes my face as it is, and as I can pass as a woman even in busy shopping streets now, go shopping en femme whenever I like, etc., I guess I should be satisfied with where I am now.

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These were my previous comments from 1998 on Spironolactone, estradiol, feminising hormones, female versus male orgasm, etc.:

I think taking Spiro (at the 100 – 200 mg per day level) did stop me having erections; it was several years ago when I took them, and it was only for a period of about six months.  It might also have been something else that affected me that way.

My wife enjoys having sex with me when I am performing as a male; it wasn’t much fun for her when I couldn’t do the business, but everything seems okay in that respect now, in spite of the (relatively low) 2 mg daily dosage of estradiol I am taking.  As far as that goes, it doesn’t seem to be true in my case that taking female hormones stops me getting an erection, although as Lucy (a friend on TrannyWeb) says, it might do eventually (in which case, we’ll cross that bridge when we come to it).

On the other hand might not this be a sort of myth – an urban legend among the transgender community?  Whether one can or cannot still perform sexually as a male, whether one would want to anyway, and how long one can still do it for if taking female hormones all seem to be issues which cause some of us more concern than others.

 I have heard some people reporting that taking female hormones does not interfere (much) with sexual potency as a male – and what about the she-male phenomenon?  Others say it definitely kills Lord John stone dead, and good job too.  It seems that yet others are able develop female breasts but still be able to function as a male sexually more or less indefinitely – is there a discussion string on TrannyWeb or any other TG forums on this (if so, I haven’t found it yet).

Obviously if I take female hormones, at whatever dosage, for long enough, I am going to get to the point of no return as regards having boobs, even if I stop the hormones.  I think I am probably approaching that point fairly soon.  But this doesn’t worry me – I guess I am that far gone already in my transgender journey – neither does it worry my wife, who is delighted with my female breasts.

I am happy as I am –  and in doing what I am doing as regards the hormones, and don’t see why I have to say either ‘yes, I am transitioning towards SRS’ or ‘no, I am not.’  Let’s wait and see. The only important thing is to make sure that what I am doing regarding taking feminising hormones is done in the safest way possible;and my G.P. knows about it now and I absolutely take on board what Lucy said above taking the lowest dose possible of Progynova or Estrofem, whilst still getting the feminising effect that I desire (and I realise that I desire it very strongly – so maybe I am transsexual). I am getting the breast growth and feminising effect that I want on 2 mg per day, and I do not need to take Spiro, so I’m not.  I am following Lucy’s advice on this.

 I don’t think my wife would mind me saying that she has discovered that she has lesbian tendencies and she also has quite a strong masculine side which she likes to express in various ways (eventually she will probbly read this posting and she will probably hit me..!)

A couple of further things I will say – I very recently (at the Harmony Weekend) met a ‘professional’ transsexual who seemed personally affronted that I was taking female hormones but did not necessarily self-identify as a transsexual myself and was not seeing a National Health shrink or counsellor, like she is.

I am also a little puzzled that some TS’s say that taking Spiro to make them impotent as a male is actually a desirable outcome for them.  I have come across this view before.  For me it would be neither desirable nor undesirable, but an inevitable biological outcome of switching my endocrine balance.

If I had SRS and could be guaranteed that I would be able to function fully in a sexual sense as a female, including experiencing multiple full female orgasms (I wish!) – I might be more inclined to say I’d go for the full transition (that may still happen at some point in the future, okay, I can’t rule it out.)

It seems to me that women experience a far more rewarding and complete orgasm than men – the lucky things –  wow, would I like to experience what they experience, and have the full body sensations and internal glow going on for that long!

We poor creatures that were born with the old gentleman between the legs can have a long build-up, but for me at least, the actual moment of male orgasm only lasts a few seconds (unless I keep holding back on the point of orgasm, which is excruciating, and I’m  not sure it’s exactly a pleasure); and then it’s all over and within a few seconds you are thinking about something else entirely (like eating, smoking (although I don’t smoke now), watching TV or listening to the World Service of the BBC on the radio, while you female partner is all aglow for a long, long time…and usually she falls asleep eventually…still in a state of bliss…

 I may as well hang on to the old wedding tackle until it becomes useless or we decide (both my wife and I, as I would never do it without her permission and support), that I’m going for the full SRS, as at least I still get some pleasure from the sexual act as a male, and no one can guarantee me that if I get an ‘innie’ rather than an ‘outie’.  (I know the theory of the SRS op. about using the sensitive skin at the tip of the penis and from the stem to create the clitoris and sensitive areas of the labia, and I know some post-operative TS’s claim to be able to experience female orgasms while others are still waiting for their clits to ‘wake up’ years after the op. – so it still seems a bit of a lottery.)

I am also quite clear that SRS would be the last step in my transition – there are far more important factors in how well we TG girls can ‘pass’ as a woman when we are out and about than what’s between your legs, such as hair styling, female voice and feminine facial characteristics. Some TS’s will no doubt say I’m missing the point, because it’s all about what you’ve got between your legs – well, that’s a view, certainly.

But one of the tragedies of early gender reassignment surgery on the NHS (and privately) is the number of post-operative TS’s who have to live with having very maculine faces and voices, can’t pass as women in normal life and society, feel like freaks, and are therefore very unhappy and regret their surgery.  Some of them may well now be getting FFS and female voice coaching under the NHS – I think this is becoming more common.  But I do believe it is possible (and many she-males prove it) to function perfectly well in the female gender role socially while still having the male parts between the legs.  And some may well prefer to function sexually in this way, whether with women or with men as partners. Surely that is a personal choice?

I am doing what I can about what I consider are the three most important gender identity cues, which people on the street use to decide what you are – woman or man – and those are H., F. and V. – Hair, Face and Voice.

I am having laser hair removal sessions to get rid of my facial hair, taking finasteride to promote scalp hair growth (although I am fortunate in having quite a good head of hair already, and no obvious signs of male-pattern balding); and trying my best to develop a female voice.  I think this takes about two years.

If I had the money to pay for any feminisation surgery, I would go first for FFS (facial feminisation surgery), which was the subject of my first posting and the starting point of this whole blog) – long before I went for SRS, as this would have a much more immediate beneficial effect on the ease with which I can pass.

 This is one of the great insights (almost an epiphany moment) I have gained recently from looking at all the transgender channels on YouTube (see my own YouTube channel for links to some of the best vids about developing a female voice and the best surgeons for facial feminisation surgery: http://uk.youtube.com/user/ambergoth)

Facial feminisation surgery did not really exist 10 or 15 years ago, any more than it was possible to self-medicate and buy hormones from the Internet.  These recent developments have given TG girls many more options than previously to be in control of their transitioning and to prioritise what is most important to them, rather than relying on NHS endocrinologists, psychiatrists, counsellors and NHS gender identity dysphoria clinics to make all the decisions for them.

Yes, I’ve read all the warnings about self-medication and last weekend had to suffer the patronising remarks and controlling behaviour of a pre-operative TS who was following the NHS route.  She appeared to have had little positive benefit in terms of feminisation from the drug regime she was on, and she unfortunately had very masculine facial features and made the most elementary mistakes in her attempts to ‘pass’, such as walking like a man, talking like a man, and wearing a disastrous hair piece which displayed her male hairline at the back and side of her head.  (And I know I sound like a bitch, but you didn’t have to respond to all her assumptions about ‘what you have to do to be a good transsexual’ and answer the personal and intrusive questions she was firing off at my wife and I. This is why I made the remark about ‘professional’  transsexuals on my last blog upload, see below ).

Anyway, that’s it for now.