X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Postoperative depression is a nontrivial concern and may have some basis in the drastic hormone shifts, including cessation of estrogens, experienced in the perioperative period. People younger than age 18, along with a parent or guardian, should see a medical care provider and a behavioral health provider with expertise in pediatric transgender health to discuss the risks and benefits of hormone therapy and gender transitioning in that age group.

In addition to titrating dosing to both clinical effect and testosterone levels as guided by patient goals, monitoring hormone levels to insure suppressed gonadotropins (luteinizing hormone [LH] and follicle stimulating hormone [FSH]) levels may serve as a surrogate marker to indicate adequate sex hormone levels for maintaining bone density in such patients (Grading: T O W). Oral or transdermal estrogen may be preferred to the potentially cyclic levels associated with injected estrogen. A randomized, double-blind study of two combined oral contraceptives containing the same progestogen, but different estrogens. Honestly, I like your pitch," Andy said, referring to the way that I had approached him and his friends.Once hormone levels have reached the target range for a specific patient, it is reasonable to monitor levels yearly, or only as needed as described below. No outcome studies have been conducted on injectable estradiol valerate or cypionate, presumably due to their uncommon modern use outside of transgender care settings; due to this limited use, manufacturers have little incentive to produce this medicine, and shortages have been reported. Many surgeons insist that transgender women discontinue estrogen for several weeks before and after any gender affirming procedure.

One approach is to continue increasing estrogen until it reaches the upper limit of the female physiologic range.Sexual and gonadal effects include reduction in erectile function, changes in libido, reduced or absent sperm count and ejaculatory fluid, and reduced testicular size. Depending on where you live, it may be legal for your employer to reprimand you for wearing heels, makeup, or having a certain hair style. Men tend to wear baggier clothing than women do, so updating your wardrobe to include some tighter clothing is a simple step you can take to appear more feminine.

Whereas not all participants are interested in BDSM aspects of the practice, and only enjoy dressing up, it may also include things such as spanking, pegging, bondage, [3] and humiliation such as making fun of the submissive for having a small and soft penis, and referring to it as a clitoris.

While androgen deprivation is a mainstay of treatment for advanced prostate cancer, it is unclear if estrogen therapy may confer an independent protection or increased risk of prostate cancer. Sildenafil (Viagra) and tadalafil (Cialis) can be used for preservation of erectile function at any stage or with any feminizing hormone regimen, in consideration of the typical contraindications and precautions when using this class of medication. Nine [times] of out ten, it would be hurtful stuff," Brandon said with a sad shrug of his broad shoulders. Providers are encouraged to review the specific estradiol reference ranges for their local lab estradiol assays, as these can vary.

Titration upwards of dose should be driven by patient goals, in the context of clinical response, hormone level monitoring, and safety monitoring (e. Androgen blockers allow the use of lower estradiol dosing, in contrast to the supraphysiologic estrogen levels (and associated risks) previously used to affect pituitary gonadotropin suppression.So I pried, interrogating them about why they had wanted to feminize their faces, and how they felt sharing her with other people. alpha reductase inhibitors may be a good choice for those unable to tolerate, or with contraindications to the use of spironolactone. Someone else confessed that this is something all men think about: What would I look like as a girl? Have blood tests to check for changes in your cholesterol, blood sugar, blood count, liver enzymes and electrolytes that could be caused by hormone therapy. There is some evidence that the use of oral estradiol results in higher serum levels of estrone due to first pass hepatic metabolism, as compared to parenteral forms.