Content Warnings: Adult language, dysphoria, transphobia, transphobic portrayals of trans people in media, 4chan, homophobia, pornography, suicide , talk of sexuality and anatomy
|< The Six-Month Post||The Two-Year Post>|
It’s an honest question. I had never considered it before, that might’ve been the privileged of having been assigned male at birth, but changing my name was not something that was ever seriously on the table for me. Even when I considered going through the legal process of having it recognized – the same process I’ve only just finished, it was only going to be to the nickname that literally everyone already called me.
How long does it take to forget your name? The name you had been using for more than thirty years?
It is hard to say, but a year in, I’ve gone from constantly perking up at it, to “only” having a strange semi-conscious bias toward it. I remember having gone by it at some point in my past, but it’s becoming nebulous, tenuous, even. And then, one morning, after spending an hour explaining how to spell your name to a receptionist at a doctor’s office – it pops up.
I hadn’t even used “Nick” in months. It’s always been “Nicholas” because I’m generally dealing with matters that require one’s legal name. And yet, just before the month of August began, I called myself “Nick” when baby-talking with the cat.
Brigid and I both caught it nearly immediately. It felt, weird, admittedly. Wrong. But it came out naturally, so I can promise you, it takes more than a year to forget your own name. Your old name, as it were, because as of August 17th, neither “Nick” nor “Nicholas” is my legal name. It’s a ghost lingering behind me.
It just isn’t me.
Especially the first name. Especially your pronouns. When you think about the countless people (mostly women) who have changed their last names, consider what it means to change your first name. The trepidation to ask someone to use not just a new name, but a new set of pronouns. And not just a new name like when a friend of mine asked for us to stop using the diminutive of his name, but to completely up-end it. I’m not “Nick”, I’m “Niamh”.
In the six months since my last update, I’ve mostly settled on the pronunciation “NEEV”, one syllable, easier to get across, and I’m more consistent with it. Perhaps it was my Dungeons and Dragons group, a group of folks from the UK who did in the two-syllable pronunciation. “Niamh” (with one syllable) is a recognized name there, and so there was no explanation needed. It just was. It’s comforting to log in and hear the lads all going “Hello, Niamh!”
I’m tearing up just thinking about it.
The last six months have been marked by periods of comfort and periods of excruciating pain, almost in equal measure. So maybe I’ll give a brief overview of those months.
Two Months of Hell
I last updated you all in February. Around then, I had just gotten done with a bloodwork exam and my injection dose had been increased from .5ml every other week to .6ml, despite me asking to go to .75ml. I had been doing laser hair removal since September, and that was going well. I had been presenting as female since November and it was becoming more and more usual. I was putting off starting my name change.
But I was finding the injections too much to handle. After each one I would black out, most likely because I was tensing up so hard to get through and even thinking about the injections now makes me sick. I’ve since called around and there are no pharmacies around here that offer injection services, which is ridiculous. I was legitimately told to hire a nurse to come by once every other week and inject me for god knows how much. It has just crossed my mind, though, I never thought to call the urgent cares in the area. (I just did – the answer remains “no”.)
I cannot imagine how much that hurts other people’s ability to take their drugs as prescribed.
I got both my vaccines and eventually I went and had another round of bloodwork done in early May, arriving with a laundry list of things I wanted changed. First – I wanted off injections. Second – I wanted on progesterone. Third – I wanted off spironolactone and onto bicalutamide. Forth – I wanted an orchiectomy. Let’s break that down.
Item 1 – Off injections. This was easy enough. I explained my predicament, my doctor agreed, we switched to patches – .05mg/d transdermal patches. Marvelous.
Item 2 – My doctor waffled on this, and suggested we wait for the 1 year mark. I laughed and said that I assumed that’d be the answer, but I wanted to make sure it didn’t come out of no where at the 1 year mark and get kicked to “the next bloodwork”. He said that wouldn’t be the case, that he’s a big proponent of progesterone as part of HRT, but obviously doesn’t want to prescribe expensive drugs if they aren’t desired or needed.
Item 3 – My side effects with spironolactone were getting pretty bad. First, I constantly had to pee, and it was starting to effect my sleep quality as I was constantly fighting the feeling of urgency when laying down even though I was taking it in the morning. It got so bad, I was taking a UTI medication every night for relief and that was getting both expensive and also just needlessly taxing my liver. The alternative was bica. I got prescribed 50mg/d of bica and was told to start the bica one month later in June, that way if there was a reaction to the patches, we would know the source – and similarly if there was a reaction to the bica, we would know the source – because I hadn’t started both at once. I asked if we should overlap the spiro and the bica and was told “no”.
Item 4 – I was told that I needed to wait to the 1 year mark as the cis gatekeepers of trans healthcare looked for that when deciding if I was “mentally sound enough” to have the procedure done. For the confused, an orchiectomy is the removal of the testicles. It would allow me to quit anti-androgens like spiro and bica all together. It would also mean that if I suddenly ran out of estrogen, I wouldn’t begin to detransition – an issue I was about to become very acquainted with.
Something felt wrong almost immediately. I had joked with some folks that on injections there was this weird feeling of not doing enough to be trans. Like on the pills each day you took a pill and you felt medicated, but the injections? They were once every now and then. In my head I felt like I could order more. Inject more. The patch, though, was there, all week, and I could touch it, see it, and feel like it was working.
But it didn’t feel like it was working.
All the things I associated with transitioning – the sore breasts, the thinning body hair, the dead libido, the complete inability to get an erection, hell just the way I saw myself, started to slowly slip away. My body hair was getting thicker. I was waking up to painful morning wood. My libido was quickly reëstablishing itself. I emailed my doctor and shared my concerns. They were noted but otherwise we kept moving forward.
In June, I switched from spiro to bica, right on schedule, and everything got worse. So, so much worse.
My mood completely collapsed. If you ever ran into me during June or July, understand that I was completely falling apart behind the scenes. I couldn’t even cry, the estrogen well had so thoroughly dried up. Hair was growing again up my chest, across my breasts, and onto my shoulders again. I was shaving my legs like weekly again, after only needing to do it monthly. I hadn’t felt breast growth pain in months. So I reached out to my doctor again and insisted things were going south quickly and it was agreed that we’d pull up my August bloodwork to later that week.
The one good thing was that I was prescribed progesterone immediately, but we’d wait on the other results before making any other changes.
And those results were stunningly bad. I was basically at cis male levels of E and T. I had been detransitioning for two months and it was torture, literally killing me mind, body, and soul. We upped my patch dose from .05mg/d to .1mg/d, added the 100mg/d of progesterone, and kept the bica the same.
The .05mg/d patch was far too little it seemed and the bica had lagged. By the end of July I had actually noticed that I was way more tired during rec soccer than I had been in May or June, which leads me to believe that the blocker had taken a month and a half to start having a noticeable effect.
Since changing, things have felt better and that gets into a while new discussion: how do you know? Well that’s hard to answer, right? It’s internal. You can never be totally certain of how I feel. You have to trust me. And if you already don’t trust me or already have ideas on what trans people are and why we transition, I can’t convince you otherwise. It’ll always be a lie. An excuse.
What I do know is the two months I was effectively detransitioning were two of the worst months of my life, stressful and constantly filled with dread. I absolutely hated it, and seeing hair growing on my chest again and having to shave my legs every week again was killing me. It was horrific and I felt awful, I could hardly look at myself in the mirror and I can actually see it in my google photos timeline.
For the first time since starting my transition, I took fewer photos in July. A lot fewer. Because I wasn’t taking selfies and I wasn’t taking selfies because I absolutely hated looking at myself again. All that self esteem had been sapped and I felt lost without it. Anyone who says “HRT isn’t life-saving” has never seen a trans person panic when they’ve thought they’ve lost or misplaced it, or gotten the call from the pharmacy that it’s been delayed, again. Never seen me in the midst of despair as I feel it all slip away.
That whole episode of detransitioning led to some awkward conversations, both with lay folks around me and my doctor. When you live in your body, you become accustomed to the ins and outs of it, and you can tell you feel off, I think most people understand this, but what one might not understand is what that feels like when you’re undergoing hormone replacement therapy. The number one thing that comes up when discussing it with cis people is “Wait, that changes?”
And yeah, the list of changes is pretty long and sometimes weird to talk about. Some of them are just awkward in the abstract, because it’s weird to be 32 going on 33 and talking about your second puberty with people, but at least this time it’s a puberty I like and I am at least mature enough and aware enough to understand the consequences.
I’ll get it out of the way quickly – the biggest change was obviously that I got glasses! This was something I should’ve been up front about earlier, but it’s important to note.
Actually, no joke, I had been wearing protective “anti-bluelight” glasses for a while before this, but Brigid and I finally got to the eye doctor and were diagnosed with various sight issues. Even though mine are rather slight, I’ve actually noticed some pretty big improvements to my quality of life and a reduction in issues such as auras and silent migraines.
All joking aside it’s hard to take stock at the one-year mark when significant portions of that year were spent with bad levels or even effectively detransitioning. However, they are numerous and they have been very fulfilling and affirming. A lot of it is just internal, even, the way I feel about my self and about my body. I’ve talked at length about the mental changes, having self-esteem for a change or better control of my libido. Even with progesterone added to the mix, I still have better control over my libido than I did on testosterone, which is crazy. I’m interested to see how the combination of orchi and progesterone will go, once all the T is flushed out and any off side-effects are gone.
Physically, I’m definitely more curvy. Most of the changes have been slow, subtle, as one would expect for hormonal changes, but my thighs have definitely grown some, waist has pinched in ever-so-slightly. Butt has grown a bit as well, and the fat on my belly is more femme as well, not quite the beer-gut shape any more, but certainly still there.
I have tits too, those have been pretty nice, I’ve even gotten pretty good at how to puff them up a bit for the camera. Are they massive, earth-shattering knockers? No. But they’re mine and they’re doing their best. Actually one of the signs I got that my levels were bad is the pain that had been plaguing my breasts and nipples almost constantly since December/January dried up. That has since returned.
Most of my muscle mass that was lost was lost pretty early. My arms still have a bit of tone to them, but even then it was nothing like before. I’ve also lost a lot of fat and muscle over my shoulders and neck, so I look much thinner now and there’s more of a boney look now.
My face has changed a bit. Seeing fat buildups on my cheeks and away from my chin and jowls. Despite not picking up my father’s genes when it came to hair, my hairline has seen improvement. Not sure if I’d call it a “drastic” improvement, but especially up over the temples it’s been slowly creeping forward again. I wasn’t really expecting any changes with that, but it’s welcomed regardless.
Hair is over-all one of those bigger problems with transitioning, getting it where you want it and removing it from where you don’t. My body hair is obviously recovering from the two months of bad levels, where that was some of the first stuff to reverse. Luckily it’s already thinning out again and growth is slowing down. Hair on my thighs has thinned a bit, as has the hair on my legs and arms. I can go pretty long before the need to be shaved and I’ve even started noticing that when I decide the hair is “long enough” to be cut is changing as well, with my tolerance getting shorter and shorter. But still the time between shaves increases.
I’ve been doing laser hair removal on my face for about eleven months now, and my chest for about two. Seen pretty big improvements there, as you can tell by the pictures, my shadow is mostly gone. Cleaning up the last of my my stubborn chest hair is one of my higher priorities along with the last of the shadow. Laser (and soon electrolysis) remain the only procedures related to transitioning I’ve had done, if you don’t count coloring and cutting my hair (which would be extreme if you did). I’m set on the orchi, but that’s probably a ways off. The consultation is at the end of September and I’ll almost certainly need to jump through some gatekeepy hoops before I can actually get it done. Even that isn’t particularly massive. But other than maybe considering breast augmentation in three years or so, I have no real drive for surgeries.
Yes. Including that one.
I’m sort of in the air about that one. I don’t really care one way or the other. The orchi is a pragmatic decision about getting off anti-androgens, preventing future detransitioning, and improving the quality of my tuck. Plus a lot of folks have said they get a little boost to their estrogen effects since there’s no testosterone getting in the way at all.
Lastly there’s a grab-bag of effects that HRT brings. Progesterone has given me some of the best night’s sleep I’ve had in literal decades. After years of sleep problems, progesterone knocks me out cold and I love it. I specifically take it at night because it was actually putting me to sleep during work! My genitals actually smell different… actually all of me smells different, but this is the most notable and was another one of those changes that losing it tipped me off to there being an issue with my levels.
Another one of those effects folks are surprised to hear about is your libido changes and that can be hard to describe without playing into stereotypes of binary sexuality. I can say that it is different, there’s more desire to be held? Cared for? I don’t want to go as far as say the desire has switched from fucking to being fucked, but I’m not turned on just by like raw pictures of nudity, I want and even need some sort of emotion or rationale behind it. I want to feel invested in it and it’s more mental than physical.
Briefly, I’d like to touch on the actual drugs and methods, because I think that sort of transparency is important for trans folks and I’m sure a number of folks reading this are going to want feedback to bring to their own transitions or to add to the growing pile of anecdotal accounts that passes for trans research in the early 2020s.
Estrogen methods: I am current on patches. I’ve done pills, injections, and patches. Pills and my liver didn’t play together nicely, so that’s completely off the table. I did injections for six months. First 10mg as .5ml 20mg/ml EV per injection every two weeks. Then it was 12mg as .6ml 20mg/ml EV per injection every two weeks. If this is confusing to you, welcome to being trans, where you get to be a lawyer, doctor, endocrinologist, pharmacist, and nurse all rolled into one little dysphoric package! But I personally couldn’t handle injecting myself. So I moved to patches. First a single .05mg/d patch per week, then later a single .1mg/d patch per week.
When it comes to preference, the problem is the act of injecting myself. I asked around the local pharmacies to see what the cost was to have them do the injection and they just don’t, suggesting I hire a nurse instead. If I could’ve had that done, I would’ve stayed on injections no problem. When the pros do it, there’s no worries! I prefer the injections, tbh, I just can’t do them. They last for two week, gave good results and good changes, are easier to change dosages, and they can’t fall off under your shorts. That said, patches have been working admirably and am happy to continue with them
Anti-Androgens: Spiro. fucking. sucks. The side effects were horrendous. Between the brain fog, the constantly needing to pee, the fucking with my sleep, the only good that seemed to come out of it was it completely nuked my masculine libido. All that said, I am way happier with bica, even if there’s like a zone of protection around my junk that seems to still be under the immediate influence of testosterone. I’d rather the occasional boner than constantly feeling like I need to pee and being perpetually tired from bad sleep. Preference is 125% bica all the way.
As for the actual methods: I went from 100mg/d of spiro (taken in the morning) to 50mg/d of bica (taken in the morning).
Where does that leave progesterone? Progesterone is useful both as an anti-androgen and a hormone for transitioning. For all I know my E2 levels are still shit, but the progesterone is over-riding it all. The big downside is constantly being horny again, I’m interested to see how that plays out when I’m post orchi and my testosterone is dead forever. But that’s really the only downside! I am currently on 100mg/d (taken orally about two hours before bed) of progesterone and I love it. Helps improve so much about both my transition and my quality of life. Seriously, the sleep is worth it alone.
A Reflection on Adulthood
For the longest time, I’ve dealt with intrusive and often extremely negative thoughts and memories. HRT has not fixed that, unfortunately. That is an important lesson, though, transitioning has done so much to make me feel better, make me be better – but it is not a panacea. It doesn’t make everything work instantly.
I wish it would, honestly.
My general health and well-being is better now because I care. Because I want to be around for years and years and years to enjoy this new lease on life, but depression and anxiety don’t just disappear. And in a way, I have gained new fears and anxieties, mostly related to the way I interface with a cis world. As I write this, I am dealing with a clinic stonewalling me from trans-related care. Something that should’ve taken minutes has taken weeks, and I’ve given up. I’m not dealing with their bullshit.
But there is one intrusive thought that doesn’t cross my mind any more – that I should transition.
In the last update, I talked at length about what it was like discovering trans people, something I had to do myself and a lot of the information I got was, perhaps obviously, from transphobic people. But I mentioned that when I was nineteen, I actually conceptualized myself transitioning in the post-knowing world. So to sort of wrap up this update, I wanted to expand on that a bit.
One summer, when I was nineteen, I was back home between freshmen and sophomore years of uni. I worked at a local store selling shoes, slept in what before my going off to school was my sister’s bedroom, and I flirted with a really cute redhead at a couple of things I went to.
Before my senior year of school, I didn’t really do much that was co-ed. Especially outside of school. I almost entirely hung out with (at the time) other boys my age. We played lots of D&D, lots of Warhammer, lots of video games, and all that. But there weren’t really girls involved, as stereotypical as that sounds now. I had a lot of trouble dealing with women in general. Partially because of this lack of exposure, and it was something that plagued me for decades. Which is weird, considering my first best friend was a girl.
In senior year of highschool, I got a girlfriend and began going to more social ‘parties’ for lack of a better word. It was different, but if you knew me at the time, you could attest that I was extremely awkward. Purdue, in some ways, was a step back, but only because I didn’t push myself out of my comfort zone. I got broken up with, and alone, scared, and once again surrounded by men, I had a very toxic idea of relationships and people in general. I went to Purdue thinking I would rebuild myself, and as much as I did that first year, there was a lot of progress still to be had.
When I came back home for summer, there were a lot of reunion get-togethers. And my social circle back home had shifted over the year. The people I was hanging out with were not the same I had hung out with before. But it was an easy-going group, and there were a lot more women involved. I’m sitting here thinking about how I interacted with them, and how I interact with women now, and there’s a weird parallel.
As a trans lesbian, or trans panlesbian, it can be hard to distinguish whether what you feel around women is gender envy, sexual attraction, camaraderie, or all of the above. Part of your social transition is breaking these things down and realizing that they can coexist. And today I can look back and see the first sparks of that camaraderie here in this summer. I wanted to belong, not as part of ‘the group’, but as part of ‘the girls’ in particular. I spoke in a way as to disarm myself. Not talking down, per se, rather, as not a man.
The thought that I wanted to transition literally haunted me for over a decade.
My entire adult life has been defined by these thoughts. I had thoughts of transitioning for this redhead, who (to be clear) was not a lesbian or bi as far as I am aware, because it didn’t work out – it remained a whatif in my life, even after I met and began dating my would-be wife and partner just months later. I had dreams and thoughts that I could’ve started sooner, that it had been there all that time and I just didn’t know it and I hadn’t known I wanted to.
During quiet times, when I was forced to be alone with myself for long stretches of waking time, like long drives, or flights, I thought about transitioning. Over and over and over. For years. I was plagued with doubt. Doubt about the results. Doubt about the effect on my life, my work, my relationships. Doubt about myself.
All my life I had envisioned a life for myself and later a life for me and Brigid, but increasingly it felt like I had missed such a major piece in my own life.
One night in 2017 or 2018, after Brigid and I had spent too much time out and on the town, driving back from Ferndale, she came out to me as bi, and feeling the momentum, I came out to her being extremely gender confused. I had effectively told her, and would repeat, that I was trans but not going to transition because of my apprehensions around transitioning.
It was around this time that I had switched my pronouns to he/they and eventually to they/them to little fanfare on my twitter profile (but never enforced any sort of adherence). I was never non-binary, but the increasing detachment from what it meant to be “a man” made he/him more and more painful.
And though the thoughts of transitioning ebbed and flowed over the next two years, they never stopped. Over those two years I met and formed a number of relationships with trans women and today, with the help of hindsight, it makes it feel inevitable.
But I’m hesitant to say it was. In the end, what really gave me the chance to become myself was the pandemic and the permanent work-from-home. I was offered a chance to get this first, awkward year out of the way in privacy, and I took it. I know I am not alone there. I think we’ve all had a chance over the last year, year and a half, to get reflective and strive to build our lives anew.
And so, the end for now…
So it’s been a year. One whole year of medical transitioning and roughly ten months of “full-timing” it. I will admit, I go into my second year slightly apprehensive. The lockdowns won’t last forever; the masks will eventually get put away, but the head start I have should serve me well. In September I return to the doctor for an early follow up to the changes in my HRT regimen that I spoke of a couple thousand words ago.
My next “official” update for you will be next year for my second anniversary! If you hadn’t noticed, the idea what that they doubled in length each time: 6 months, 1 year, 2 years, 4 years, 8 years.
Of course, there will be social media and my micro updates there, but these updates have proven a nice way for me to process my transition for myself. I can assure you, if you think it’s drastic from the outside, it’s quite a bit more on the inside.
But here we must end it for now! Remember to continue to support the LGBT+ people of all walks in your life. “Accomplices not allies” and all that! I hope this update was informative for everyone!