Yup, it’s hormones

The human body was not designed to thrive with extremely low levels of hormones, including the sex hormones, testosterone and estrogen. I have been learning this the hard way.

Sitting across from my doctor for the first time in fifteen months, there would be no thoughts of any other situation as behind my troubles.  She confirmed all the suspicions of which I wrote in I am at another crossroads.

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On November 9, I saw my endocrinologist. I had previously emailed with her, so she knew that I had been off hormone therapy since last winter. I now filled her in on what I’ve been experiencing.

I began with the hot flashes, which began in May. She nodded, completely unsurprised. I said, “I put myself into menopause, didn’t I.” She agreed.

I continued, explaining the muscle soreness, stiff knees, burning sensation in my thighs when I stop running, and how hard it is for me to run anything more than a very slow pace. Again, she was not surprised. Again, she confirmed my thought that it was occurring because my estrogen and testosterone levels have dropped to very low.

Remembering how I always had my blood drawn after all of my previous appointments, I asked if that would be the case after this one. When she replied in the negative, I asked why. She said, “I know what your levels are.” She explained, saying that my estrogen and testosterone are obviously, tremendously low; so low, she finished up, that they might not even register on a blood test.

Oh, my.

And, regarding the future, the goal won’t be to know, in numbers, where my hormone levels are, because the goal now is for me to feel better, to feel right, not to reach X, number-wise. My situation now is entirely different than when I was on hormone therapy for the purpose of transitioning, when knowing my levels, and keeping them constant, was key.

I explained my concern, that disturbing my hormones might bring a return of my gender dysphoria. There is no way to know when that might occur, and what levels could possibly cause it, or whether it will or won’t ever return. I told her, more than once, that this not knowing concerned me a lot.

Being a male, we began talking about my taking testosterone (T). I had difficulty explaining why raising my T level was a concern for me. I attributed my concern to my entire life, how being a guy, with the competing feminine gender identity, made surging T very challenging to how I experienced myself. And, crazily, now that I finally experience myself as fully male, the thought of increasing my T still gives me pause.

I then spoke of how I was feeling last autumn, how my muscles performed so well that I was running the most miles of my life, and I was regularly knocking a few seconds off my per mile pace, and my T was really low because I was a half year post-op from sex reassignment surgery. Though, last fall, I wasn’t yet feeling like a guy, I had gone through the period of once again feeling like myself—and not a person who was a different being from Greg, which is what happened with me over the first years of my transition—thus, if I could find the sweet spot with my hormones, it seems to me that it would be with low T and slightly higher estrogen.

She heard me. She said this is all experimental, and then she reiterated what she had said earlier in the appointment, that mine is an exceptional case. She saw the tears well up in my eyes each time I told her that I couldn’t bear to experience gender dysphoria any more, how much I loved finally enjoying what I had been seeking all my adult life—to be a guy, with no gender issues—and that though I had succeeded at transitioning I had no interest in returning to it.

So, she agreed with my idea, that I go on a low dose of estrogen. After pondering how much I should take, she suggested I begin at twenty-five percent of what had previously been a full dose. She said that even that small of an amount might help my muscles and bones, and that it might stop the hot flashes, but not to be surprised if they do not cease entirely.

I told her what Julie had said to me, that I go into this with the idea that I will go back on estrogen, that it will provide the relief I am seeking, and that the dysphoria will not return. At the time Julie had said that, I had little confidence in it. But, in the days leading up to the appointment, as I pondered it, I grew in my belief of it. Thus, when I left the doctor’s office, as I departed the building, as I drove home, and as I anticipated the return of once-a-week injecting myself, I was okay with it.

Even hopeful.