Re: sexual changes:

I’m turning 40 this year, and I started injections a couple of months ago. My libido and ability to get erections have not really changed at all; the only real difference is that I don’t have morning wood anymore and I find that I tend to use my imagination more than porn nowadays to finish if I’m on my own. Smut books are wonderful, lol. Still early but I am pretty happy with retaining function so far, it was the thing I was most worried about.

Re: passing, and other people’s concerns:

Respectfully, who gives a shit what other people think? If a bigoted patient was uncomfortable because you were a person of color, or a cis woman, or a gay man, or disabled, would that be acceptable? Should someone hide those things for the sake of said bigot? What makes being trans any different? Don’t let fear of assholes stop you from being who you want to be. They’re gonna be assholes anyway. Be an enby if you want or go full woman if you find that suits you, or be gender fluid or whatever, but do it because you want to, not to avoid stepping on someone else’s toes. I’m an old punk so maybe I’m biased toward being actively visible, but fuck those people. I can’t tell you what to do, and stay safe, obviously, but don’t hide your light under a bushel; the world would be lesser for it.

You sound a lot like me 6 months ago, though, as far as not knowing where you might fall on the gender spectrum. At that point the only thing I knew for sure was that I was sick of pretending to be a man and I wanted out. I thought of it as “defecting”, lol. I’ve gone from “I’ll be an enby because I’ll never pass as a girl” to “I wanna be a pretty pretty princess, let’s do makeup tutorials and look like a clown” to “I’ll just be a butch lesbian, where are my cargo pants and flannel, I already own that” to “I wanna be exclusively made of goth eyeliner and oversized hoodies and thigh highs” to “maybe I’m actually some kind of horny chaos gremlin, and it’s more fun if what’s in my pants is a mystery”. Next week I will probably feel differently. It’s a real exploration of a space I previously thought I wasn’t allowed into; I am “boldly going where no man has gone before”, lol. It’s a lot to take in and exploration takes effort and time, but it’s very rewarding to learn about what I like and don’t like. Turns out there’s a lot of ways to be a person.

Also hey, good job for asking. It’s scary to ask for help, often the hardest part. You got this. If you wanna talk more I’m open to messages and happy to talk about my experience.

this article by transfem science has stuff on the timeline of hrt effects, as well as reversibility, in compact and digestable charts (which you might have to scroll past a bunch of text to find).

i’ve seen a few old interviews of elderly and middle-aged trans and enby folks. you can probably find them on youtube. from what i remember, they still consider their gender a significant part of their identity.

passing is subjective but i think it’s easier than most people say. it involves a lot of effort (because being a woman demands work in a patriarchy), but a timeline of 1-2 years like you said, is reasonable. most hrt-taking trans people i know start passing as their gender within that time or less.

good luck on your journey :)

Your questions are all questions I had. It’s a lot of “what if?” The breakthrough for me was that when I started, I had already been living as a man for many years and felt like I had missed out on all that time I could’ve been who I wanted to be. Hypothetically, if I went on hormones, felt like they didn’t help, and never wanted to pursue further transition after several years, then how much masculine life have I really missed? That hypothetical hasn’t happened, and I’m so glad I didn’t wait longer.

Hormones are not the “turn into a girl instantly” button, the effects take time. If you started today, you’d probably still have way more time to mull over your decision than you’d like. You will be fine.

As for a doctor’s concern, that’s complicated, I guess. It’s well established that hormones are generally very safe, and unless you’re going way off a standard dose there’s no real cause for concern. Meanwhile, doctors have been unduly tasked by government with arbitrarily gatekeeping access to hormones, and this is part of why many people do DIY.

I also want to note that I went through the same thought process about “if I can’t be a girl, then maybe I’ll just ‘settle’ for being enby”, and I think it was the wrong attitude to have. There are plenty of binary women that don’t pass and maybe never will. Passing to yourself or anyone has no bearing on your gender. Maybe you are nonbinary and engaging with your gender and the transition process will affirm that, but don’t gatekeep yourself.

I think that preparing to transition and starting HRT might help me reach greater certainty about whether I want to continue.

Very reasonable. I started HRT specifically to see if it was right for me. It very much was!

Do you think a doctor in an informed consent context would have concerns with starting me on HRT if I said that?

Some will have a problem with this and some will understand perfectly. It’s always best to lie to your doctor, which sounds like a terrible thing to say but this is the truth when you’re trans. Always lie unless you for sure know they are fully supportive of the trans experience. Don’t lie about everything ofc :P lie away uncertainty and the like. Some doctors in some places don’t recognize non-binary people so it’s unfortunately best to present as binary, unless you know they accept enbies. In some cases hamming things up is also necessary. If you only care about HRT you can also fully bypass doctors and do HRT on your own. I do this. I only go to doctors to get regular blood tests.

Also, is it fair to say that I can probably look androgynous or plausibly cisgender (especially with effort - if I had a need to) for a year or two after starting HRT?

Maybe. I started around 30 and I think I could pass with great effort now after two years on HRT. A big part of it is actually hair removal as well. You should also start looking into voice training if your goal is to pass. It requires a lot of effort and takes a lot of time, so start looking at it now. Maybe find a voice therapist.

Edit: Results vary a lot. It depends mostly on genetics, and then there’s stuff like make-up and clothes and all that. Exercise can help you as well.

In that case, is there any sort of detox/withdrawal, pain, or significant health-related complications associated with stopping HRT?

• Your testicles will atrophy somewhat on estrogen, but tmk they always start up testosterone production again when not suppressed.
• You will suffer from some very temporary menopause like symptoms when you stop taking HRT.
• A lot of people experience dysphoria from being on the wrong hormone, and once they go back to testosterone they start feeling that dysphoria again.
• If you don’t have enough sex hormones over a long time there can be negative effects such as osteoporosis. You won’t suffer this if you still have your testicles.
• The effects of testosterone will return once you’re back on testosterone. This means masculine fat distribution, more body hair, masculine smell and sweat, etc etc
• Estrogens and androgens have different risk profiles, which means while on female sex hormones you will be more predisposed to the things cis women tend to be predisposed to and visa versa. Not really a complication, but something to be aware of.

Reversibility

You have a lot of questions about HRT. I very much suggest you read this: https://genderdysphoria.fyi/en
It’s a great guide and explanation for a lot of stuff, including what hormones do to you.

As for the penis. Testosterone maintains the penis via random erections which you will no longer have, or at least, way less random erections. This means if you wish to stop atrophy you must induce them yourself. You can also use topical testosterone gel or cream, but be aware that this will likely increase your blood testosterone levels in general. But it’s an option.

I hope this answers some of your questions! <3

i can only speak about uncertianty and “trial”. i was in deep denial for years, while also finding opportunities to crossdress.i live in a queer community for almost 15yrs (am now mid 30s), so none of that was ever a problem. it was only the wedding of my closest friends (1.3 years ago), that pushed me over the edge. i felt ugly weeks in advance and couldn’t find a fit for the occasion. i felt wrong in this highly gendered context (suits&dresses) i couldn’t express myself, couldn’t exist. even though i was surrounded by good (queer) friends. i realised a day or two later that if i had to play a role i wanted to play the fem part. i realised that i always disliked my male features. i actually thought that every guy i was with didn’t desire me because of my male features but despite them. (i constructed heterosexual men out of gay guys)

so. t had to be blocked (we are 2 days after the wedding, 2 a.m.) that wouldn’t do a lot but prevent worse. also, having estrogen instead would be better for the bones. that was my initial thought. i framed it as a aesthetic neccessity. i would come to terms with having boobs more easily than with the beard in my face, and i survived that a long time.

1-2 month in, i found that my mind worked better on e. anxiety and depression started to go down quickly. i was surprised, it did more than just change my look. now that there’s visible breast growth i realised i really wanted that too. at this point they are still easily hidden/overlooked so i coud still stop. but i don’t want to. i realised i needed them all my life to look more fem.

i really only realised that, when i saw myself in the mirror 2.5 month on hrt. with a new fit. with my tiny breasts.

try it. you might be just as surprised as i was. or just stop. :)

i learned early to be careful with officials. “yes sir/ma’am i want all of these effects.” i voiced my concerns only in transfem groups. none of them knew the notion of not looking forward to having breasts, but they understood that i could have a desire for femininity without knowing how i feel about having boobs. initially i didn’t tell my therapist, even though he is trans himself. i feared anyone who had power over me would ever say something like “maybe you are not ready then”. i wasn’t ready for full feminity. but i was absolutely done with masculinity.

IC-practioners shouldn’t be a problem, yeah. but do they need to participate in your decision making?

There’s a lot to cover there, but it’s worth noting that while libido may change, it’s still possible to get erections and orgasm with your original genitalia. I’ve heard people say that if you stop orgasming entirely for an extended period of time it can be difficult to get there again, but I can’t really substantiate that. What I can say is that orgasming with your original equipment after years on HRT is very much possible, but it’s a little different than if you weren’t on hormones. For example, you’ll likely find you produce little to no fluid, but you’ll also likely find that you have no refractory period, that orgasms feel a little different, and that the period after an orgasm feels pretty different too. Personally, I find it feels quite a lot better.

If you find an informed consent clinic it shouldn’t be an issue to start and see if it helps. I personally found a lot of really notable changes within a few months of starting. The skin changes are profound and in my case happened pretty quickly. Breast development tends to take a little longer, anyway.

Your understanding of the reversibility seems spot on. If you’re not 100% certain, just make sure you are 100% content with the permanent effects. And just be aware, breast growth can be highly variable. You could end up with permanent c or d cups or something impossible to conceal. If you really want to be certain, ask yourself “if I am wrong, am I ok needing ftm top surgery in the slim chance I’m wrong?”

As far as aging, it really varies. Most trans women I know don’t induce an artificial menopause by cutting HRT at age 50 or so. I plan on continuing HRT for as long as I can, into my 70s or 80s, only stopping if I have some severe health effect that hrt would be contraindicated for. I don’t think anyone stops hrt because they don’t feel their gender isn’t important. I think some may do it in their old age simply to address health risks. And for me, I don’t mean, “is there evidence that ancient methods of hrt contributed to risks (like blood clots.)” My standard is, unless a condition would require cis women to get off hrt, or if it would require prescribing estrogen blockers, then I’ll stay on hrt. A lot of docs really don’t get the importance of hrt and are willing to recommend ceasing it on the flimsiest of excuses. Hell, I maintain a very robust HRT stockpile so I never have to worry about a doc cutting me off.

As far as whether an informed consent clinic would prescribe you hrt, I think they would. That’s really the whole point of informed consent. Instead of gatekeeping care, the decision is ultimately left to the patient. The doc makes sure the patient is fully informed and capable of giving proper consent. But if a clinic is truly practicing informed consent, the final decision should be up to you.

Look up the DSM V criteria for a gender dysphoria diagnosis; does that sound like you? Then an IC dr will have no problem starting you on HRT.

Trans healthcare isnt well researched. And detransition less so than transition related topics. Hypothetically the effecrs of HRT are reversible but like if you end up with massive boobs that skin isnt just going to disappear. Obviously surgery is permanent.

When you are old af and come off HRT (if you choose to do so, not all women cis or trans do), you will go through a quasi-menopause. Depending on what gonads you do or do not have at that time will determine what happens. Have testes? You will revert to masc. No testes? You are now a post menopausal woman. Again, not super well researched. Your gender will always matter. Always. Though alzheimers and trans bodies is gonna be a fun time.

You can conceal the changes for a while but how long will depend on your body and how it responds to hormones. Some trans people will never pass without surgery, some a year is enough. Have a massive adams apple? Act like a man? Talk like a man? There is so much that goes into gender perception its impossible to say. It will depend on you and your body.

Everyone else has covered the important stuff, just want to say good luck. I’m similar age, I have similar worries, I’ve had similar questions, I’m starting hrt soon.