Scarleteen

Hi! I'm posting on behalf of my girlfriend, who will be starting HRT very soon (yay!)

She is worried about how estrogen and androgen blockers may impact our sex life, particularly in regards to erections and ejaculation. She doesn't currently experience dysphoria regarding her genitals, and actually prefers how they work at the moment.

I'm trying to help her find information on how estrogen and androgen blockers have impacted other transfolk. Has anyone else here gone through something similar regarding anxiety about hormone treatments and changes in sexual activity?

Thanks in advance for any help!

Follow up questions cause I just did some reading up on specific effects of estrogen and anti-androgens.

1) Should she consider taking just estrogen without any anti-androgens? How would that effect the progress of medical transition?

2) A lot of her dysphoria is tied with body hair, particularly with having to frequently shave her legs and underarms. I read that anti-androgens help with reducing body hair growth. Would estrogen have any effects on body hair? Are there alternatives to body hair removal that don't involve anti-androgens?

The best person for her to have this conversation with are her own healthcare providers. Is she already in contact with the healthcare provider(s) she'll be getting HRT and other healthcare related to her medical transition through?

Heather wrote:The best person for her to have this conversation with are her own healthcare providers. Is she already in contact with the healthcare provider(s) she'll be getting HRT and other healthcare related to her medical transition through?

Yes she's in contact with her providers about HRT and related care. I think her main worry in bringing up doubts about treatment is the provider not seeing her as ""trans enough"" to transition if that makes sense. I've also been seeking care at the same place, and I know that most (if not all) of the staff at this clinic are very accepting and understanding about all sorts of gender presentations, experiences, and needs. I'll keep encouraging her to speak withher doctor personally about the matter, thanks!

I'm really sorry to hear she has that concern. (And also that I'm late to this: I took a few days off.) I certainly get why she does, especially if she knows or feels anything when it comes to the history of medical transitioning and how pervasive that attitude was -- the giant batch of bullshit ideas that fueled care being given only to people who conformed to cisgender people's ideas of what transness meant, and what was required for transition, including things like the necessity of dysphoria with genitals.

But trans care has changed so much, even just over the last ten years, and I'd be quite shocked to hear a current provider, with current education, not follow through with care they have otherwise okayed because someone was cool with their genitals and/or how they function as they are. If she is worried about things like this with her provider, I wonder if she's sure this is the right provider for her, someone she feels very comfortable with? If not, does she have options to switch to someone she'd feel more able to talk with honestly about things like this?

If not -- if she is comfortable with her current provider -- then I'd say she should go ahead and ask about this. But maybe before then she could have a conversation about having these kinds of concerns: worries about asking questions about the effects of her medical care and treatments (something every patient should be able to ask, with any kind of healthcare) because she's worried they'll disqualify her from medical transition. It seems to me that feeling confident she can ask literally any questions without having to worry that's an issue seems pretty vital to her quality of care and peace of mind, you know?

Yeah I think it's more the history of trans healthcare that kind of put her off in the first place, but after her first visit she was telling me about how this is one of the first doctor's she's actually felt relatively comfortable around.

She's coming around to the idea that talking with her doctor won't put her healthcare needs at risk. I think she mostly just needed time and patience to quell her anxiety about actually having to address her worries regarding her care. I'll encourage her to address her concerns too, since I'm sure her doctor will be able to ease her worries!

Thank you so much again for your help!

I get it! I'm so glad she's been feeling better about asking and that it sounds like she's got a good healthcare provider for her transition. That's awesome.

I want to pipe in here, but I'm on androgen blockers at the moment and only androgen blockers, but I'm still able to get erections and all that jazz. Now, it's dependent on which blocker she's on, however. If you have any other questions, just ask.