He’s also dropping me from 6mg/day to 4 of estradiol. His thought is that my estrogen (~4,500, literally an order of magnitude higher than it should be) coupled with my testosterone (a reasonably low 12) means that A) I can afford to drop estrogen more without impacting my testosterone levels, body hair, mood, etc, and B) dropping estrogen might actually help with my anxiety and depression.

This isn’t new info, but he also gave me a temporary perscrption of klonopin, a much stronger anti-anxiety medication. The idea is that I’ll use that to keep me sane for the next week or two, until the reduced estradiol and increased lexapro kicked in.

Fingers crossed, cuz what I’m experiencing right now fucking sucks.

In fact, I’d say part of what has been so stressful and unpleasant about the last week has been being so aware of being so ‘off.’ My brain isn’t working as quickly as it should be, I’m not as able to think straight as I normally am, I’m overall feeling fuzzy and it takes a large amount of effort to really bring my consciousness to focus on a task. Since all of those are important things to me, their (temporary) loss is getting to me, above and beyond the actual symptoms, into a really awful feedback loop: stress -> realization of stress -> more stress, and so on.

Serum estrogen levels measures all estrogens in your blood whether given as an Rx, or produced naturally. Estradiol measure a single type of estrogen that is made naturally in a genetic female. So, for our purposes estrogen is what we measure.

In the meantime, I’m down to 3 pills (6 mg) a day, from the original 10. Hopefully I won’t start sprouting gorilla hair.

Good news first: No HIV, gonorrhea, chlamydia, or syphilis. Huzzah! (Again, I had no reason to suspect I was carrying any of those, but it’s nice to be told “You’re not sick.”)

I also feel pretty good about my cholesterol. Historically, my overall levels have been fine, but my HDL (‘good’ cholesterol) has been low and my LDL (‘bad’ cholesterol) has been high. Like, way high. It’s supposed to be under 100 units per whatever (I have no idea, honestly), and mine has historically been near 200. And my HDL has usually been in the 20s, when it’s supposed to be above 40. But today, my LDL was 101 and HDL was 41! Not amazing, sure, but it’s awesome that my relatively moderate dietary changes, coupling with exercising more, have paid off.

Much more interesting, however, were my hormone levels.

‘Proper’ hormone levels for trans folks is apparently a pretty open debate. Different doctors shoot for different levels, and there’s no set-in-stone policy. It’s also difficult because women’s hormone levels shift throughout menstrual cycles, so there isn’t even a definitive ‘normal’ for cis women’s levels. But doctors generally shoot for levels similar to the luteal phase (that is, not-currently-menstruating) for cis women.

I can’t find my hormone numbers from my most recent doctor’s visit, in late 2010, but here’s info from late 2009, about 18 months on hormones (parentheses are for reference ranges for cis women, as provided on the patient report my doctor gave me)

• Progesterone: 5.4 (generally between 4 and 20 for cis women)
• Testosterone: 24 (between 20 and 76)
• Estradiol: 254 (between 247-280)

So everything seems pretty normal. However, on my most recent doctor’s visit, to this new doctor, he A) checked for slightly different things and B) used a service with slightly different reference ranges:

• Progesterone: 1.5 (0.15-28)
• Testosterone: 12 (8-48)
• Estrogen: 4237(!!!) (200-460)

Progesterone and testosterone are, he said, nothing to worry about. And from what I can find online, ‘estrogen’ and ‘estradiol’ tests mean the same thing. But that estrogen level is HUGE! Ten time the desired range! I have no idea how or why that happened, nor did he. However, he suggested I go down from 10mg daily of estradiol to 8mg. And I admit: Lots of trans folks I’ve spoken with have expressed surprise at my taking 10mg daily, saying that was lots higher than their dosages.

I’m keeping my fingers crossed that going down will actually have a bonus effect of getting some of my anxiety and depression under control. My doctor said it’s definitely not a given that such a thing will happen, but hormonal imbalances sure as hell don’t help with emotional issues. So I’ll keep my fingers crossed, and report any changes.

That said, I do take some consolation in the fact that I haven’t gained weight. (Indeed, I’m down from my max weight sometime in college.) I’d still like to lose about 10 pounds, but hopefully with the regular exercise from class and finally being able to bike to work, that’ll be achievable. We’ll see.

(As a side note, on the topic of being able to bike to work, what the fuck were the two inches of snow doing falling from the sky on Monday?)

-R

-Lyrics from ‘Castle on a Cloud’ from Les Miserables

Les Mis is some of the earliest music I learned on the piano that I still play regularly. In fact, come to think of it, I’ve probably been playing Les Mis (and using the same beat-up book of sheet music) for over ten years. And, although ‘Castle on a Cloud’ isn’t my favorite song from the musical, a place usually reserved for ‘I Dreamed a Dream’ or ‘On My Onw,’ I do think it’s an evocative metaphor.

That said, the verse I quoted above never sat right with me. I completely understand wanting to exist in a place where no one is lost, and where there is no need to cry. That makes perfect sense. But the idea of not being allowed to cry always made me kind of sad; sometimes the grief of living just needs to come out in tears.

I’ve been crying a lot more lately than I’m used to, and it’s made me think about how I handle my emotions.

I think it is untrue to say that trans people get to experience life as ‘both’ genders. As a trans woman, I didn’t experience ‘boyhood’ in same the way cisgendered men presumably did, in that I didn’t want to be a boy. Likewise, as a trans woman, I don’t experience ‘womanhood’ in the same cisgendered women presumably do, as I wasn’t raised and socialized as a girl.  I In fact, I think it’s somewhat untrue to say any two people will experience  gender in exacltly the same way.

That said, I do think trans individuals who go on hormones and transition are some of the very few people who get to have the unique experience of living life with both male and female hormones. (Or are forced/obligated/required to have the unique experience…) As far as I know, I did not have any (male) hormone imbalances, even though I wasn’t particularly happy with the amount of testosterone coursing through my system pre-transition. And now that I am on hormones, my doc tells me my levels are pretty standard for a so-called ‘biological’ woman.

Coming back to emotions, this has given me the opportunity to see the dramatic shift in how my emotions manifiest themselves pre- and mid-transition. As other trans women have said (and I’ve said something similar before) it’s not that what my emotions are has changed, it’s how I experience them that’s changed. That is, I don’t suddenly find different things happy or sad, but I feel that happiness or sadness more poigantly. So, it takes a lot less to make me cry now. I’m actually pretty OK with that, although sometimes (often…) it’s a little overwhelming. I’m less happy about my inability to keep a straight face, as I prided myself on being able to dead-pan jokes with the best of them, but maybe that’s something that will come back as I get used to the heights of my emotions.

I also don’t want to imply hormones are the sole cause of these emotional shifts. Transitioning has meant a lot of soul-searching, and that process has definitely (hopefully?) put me more in touch with my emotions outside of any hormonal shifts. But I do think there’s a physical/hormonal aspect as well. And, bringing it all the way home to Les Mis, I’m not particularly interested in living in a place where crying isn’t allowed.

I don’t feel like I’d last very long there.

-R

So yeah. I’m going through puberty in a major way. The first time around wasn’t very fun, and this time (even if it’s going in a better direction) still isn’t too fun.

-R

-R

Just got a call from the lab tech at the fertility clinic I ended up going to and he said he was able to recover four viable samples from second ‘deposit,’ for a total of five viable samples. (Which means that if/when I chose to use ‘em, I’ll have five tries.)

So I get to go back on hormones!

It’s not all great news, as the samples apparently had about 50% mobility, which means I have tired, lazy sperm. As a result, if/when the samples are used my partner will have to be impregnated by in-vitro fertilisation, rather than artifical insemination. There’s sort of nothing to do about that now (ideally, I would have made the deposits before going on hormones at all, and hopefully had a higher mobility rate) but IVF is more expensive and more medically complicated than artifical insemination, which is unfortunate.

All in all, I’m ready to go home right now and start popin’ hormone pills again.

-R