26
Sublingual Estradiol Offers No Apparent Advantage Over Combined Oral Estradiol and Cyproterone Acetate
(pubmed.ncbi.nlm.nih.gov)
you are viewing a single comment's thread
view the rest of the comments
view the rest of the comments
this post was submitted on 10 Jan 2025
26 points (96.4% liked)
Transfem
3417 readers
5 users here now
A community for transfeminine people and experiences.
This is a supportive community for all transfeminine or questioning people. Anyone is welcome to participate in this community but disrupting the safety of this space for trans feminine people is unacceptable and will result in moderator action.
Debate surrounding transgender rights or acceptance will result in an immediate ban.
- Please follow the rules of the lemmy.blahaj.zone instance.
- Bigotry of any kind will not be tolerated.
- Gatekeeping will not be tolerated.
- Please be kind and respectful to all.
- Please tag NSFW topics.
- No NSFW image posts.
- Please provide content warnings where appropriate.
- Please do not repost bigoted content here.
This community is supportive of DIY HRT. Unsolicited medical advice or caution being given to people on DIY will result in moderator action.
Posters may express that they are looking for responses and support from groups with certain experiences (eg. trans people, trans people with supportive parents, trans parents.). Please respect those requests and be mindful that your experience may differ from others here.
To make such a request, at the start of the body of your post, not in the title, the first line should look like the this: [Requesting Engagement from _________]
Some helpful links:
- The Gender Dysphoria Bible // In depth explanation of the different types of gender dysphoria.
- Trans Voice Help // A community here on blahaj.zone for voice training.
- LGBTQ+ Healthcare Directory // A directory of LGBTQ+ accepting Healthcare providers.
- Trans Resistance Network // A US-based mutual aid organization to help trans people facing state violence and legal discrimination.
- TLDEF's Trans Health Project // Advice about insurance claims for gender affirming healthcare and procedures.
- TransLifeLine's ID change Library // A comprehensive guide to changing your name on any US legal document.
- Gender Spectrum // Resources for youth, parents and family, educators, mental health professionals and faith leaders.
Support Hotlines:
- The Trevor Project // Web chat, phone call, and text message LGBTQ+ support hotline.
- TransLifeLine // A US/Canada LGBTQ+ phone support hotline service. The US line has Spanish support.
- LGBT Youthline.ca // A Canadian LGBT hotline support service with phone call and web chat support. (4pm - 9:30pm EST)
- 988lifeline // A US only Crisis hotline with phone call, text and web chat support. Dedicated staff for LGBTQIA+ youth 24/7 on phone service, 3pm to 2am EST for text and web chat.
founded 2 years ago
MODERATORS
💀
Why the skull?
Sexual desire & function decreasing is commonly seen as a negative thing, and dysphoria not improving is clearly negative - so I am attempting a kind of sympathetic humor at the unfortunate irony of a treatment being unsuccessful. It makes me sound monstrous, now that I have to explain it.
Thank you for explaining.
Personally we do not think desire decreases completely, but in our own experience it has changed and made us wish for different functioning. Perhaps we always had that to some degree but the problem is that medical science is not really a place for many of us to feel congruent in our desires and functioning, that is why it is a problem for many trans femmes, we believe.
As for functioning without the medical science currently able to provide us what we require, this can be true somewhat. However, it can be mitigated by alternative practices.
Personally, my desire pretty much disappeared... sometimes it super bothers me, especially since I know things need to stay engaged down there if I ever opt for certain surgeries. It's not bothersome enough that I've seriously brought it up with my doctor, but I did ask to be prescribed progesterone to help as I've seen many anecdotes about it increasing sex drive and desire....zero change so far. I'd say it's pretty nice for the most part as there's this edge which is no longer there, buuuut I do sometimes miss actually feeling that type of desire. I have read that it just randomly returns eventually, so just doing my best to enjoy whatever this is for now 🤭
Progesterone can make desire or horniness return. However, in our experience and this might just be us it can bring with it a certain amount of dysmorphia.
Estrogen increased desire significantly for me, but I personally wish it had decreased desire and functioning. I like the atrophy (esp. when I started to think of myself in normative terms as a woman), and I would prefer a much lower libido, I think I would (selfishly) be happy with no libido.
Part of the problem with this study is that it has such a small sample size, dysphoria clearly decreases for many trans people when they take HRT and there are many, much larger and better studies showing this.
I don't really follow what you mean about medical science and congruence with desire and function, or what you mean by alternative practices.
We mean that medical science cannot give us certain body parts that would increase sexual functioning such a clitoris, certain glands nor ovaries, a womb etc (yet) and by alternative practises we mean kink or possibly certain cultural practises like tantra etc.
A vaginoplasty absolutely can provide you with some of the anatomy like a clitoris and vagina ... ovaries and a womb might be necessary for reproduction, but HRT substitutes for the ovaries and I don't see how a womb necessarily increases sexual function in the sense that the researchers meant (which is the ability for arousal and orgasm).
I hear you about the womb, though - it's painful to me in ways I don't understand that I can never become pregnant. This is a bizarre change for me, since I have been very clear about not wanting children my whole life, and I felt the biological urge to reproduce only after taking estrogen. I completely understand why Lily Elbe tried (and tragically failed) to have a uterus surgically implanted.
Well, yes to a certain degree, however, most endogenic clitorises are inside the body and look like a wishbone in a way that no surgery or other medical procedures etc can currently do which is what we want, plus we believe ones created by vaginoplasty surgery don't have the same number of nerve endings as endogenic ones. This is what we meant about sexual functioning as we want to be able to do all the things people who have them endogenically can do which isn't possible sadly, we just feel empty and might still if we did have such surgeries.
Vaginas are similar in that we believe no current procedures can make them fully feel or function like endogenic ones inside, so we are hesitant about having surgery, it might help us, it might not.
Okay, fair about them only being needed for reproduction but we would very much like to be pregnant and would solve this situation we have gotten ourselves into where there's probably no chance of having bio children any other way.
Yeah, we have seen that awful film about Lily Elbe, plus looked into it and it is possible but it would mean somebody with an endogenic womb dying currently as it is massive surgery and not sure whether the recipient would survive either. Given what happened to Lily Elbe, who knows. Guessing it would require some kind of crispr modification currently to be anywhere close to successful, even though that technology is nowhere near ready for that kind of modification.
We guess what we mean basically is that for us sexual functioning is tied very much to having certain body parts in an endogenic way because every time we think about any kind of sexual stuff currently we just get dysphoric and dysmorphic in a way that we aren't sure would be solved by surgery completely.
We're very glad if this doesn't happen to other trans femmes though, because either it doesn't or they don't talk about it or they aren't allowed to lest they get some transmisic somewhere to say some bullshit, for us though it hurts a lot and we're glad if no others are going through this.
You might feel empty still, but you might also feel a massive improvement. A vaginoplasty is a known effective treatment for the feelings you are having, and it honestly sounds to me like you are sacrificing the potential and known good because you can't have the perfect.
When I was in denial before my egg cracked, I often rationalized that I shouldn't transition because as you mention I can never be a woman for a million reasons - that even with estrogen and surgeries I would never experience a woman's orgasm, I even had the same thought as you about the number of nerve endings in the clit vs a penis.
But I can tell you I definitely have what would be characterized as powerful female orgasms now despite the supposed deficiencies of my genitals. I underestimated how it would feel on the other side.
What I have heard about neo-vaginas is that they are not distinguishable from natal vaginas, in they way they look, feel, or function. We can nitpick and find minor differences, and we can certainly focus on those differences to fuel dysphoria and insecurities, but choosing to do nothing makes less sense to me since the outcome is obviously worse (genitals that won't ever or in any way work).
All this to say, I share your fears and capacity for rationalizing myself out of difficult choices like this, but I have gotten to the point where I feel more pragmatic and I am willing to trust that there is potential for a vaginoplasty to improve my situation.
Of course I am terrified of how I might feel, how my perfectionism and dysphoria might respond and reject my artificial genitals, but it is a leap of faith, and one that I feel is justified by extensive research that over and over confirms that this procedure improves the kinds of suffering we are experiencing. Hopefully it improves things, but worst case scenario I think it will still have been a rational choice to take that risk given the alternative.
We will get back to this more fully soon. However, we appreciate you actully engaging with us about the negative stuff. We find much of the time the rest of the trans community doesn't want to engage with this kind of stuff and a lot of the time it feels like they're saying "shut up, we only want positivity."
It helps to work through this stuff where we're not being told to shut up, condescended to, demeaned or being told to be happy with what we have or might get which is what happens all too often for some reason.
I was worried you might feel I was somehow dismissing your needs, so hopefully my response did not feel dismissive. I was just hoping to show that how even if those are your needs, that satisficing might still make sense here. It probably helps that I have some similar feelings as you, it is painful to me that I will never be a cis woman. For years I dismissed the possibility of transition because I could never be a cis woman, but I still affirm my transition - life is better for it.
I hope not to be demeaning, condescending, etc. but I admit I can sometimes mess up or not see how something I say comes across - hopefully you will grant me grace in those moments if they do occur. Also, I am sorry that you feel alienated this way in the community, but it is my experience that the trans community is filled with negative emotions and especially accounts of dysphoria as you just gave. At the very least, you are hardly alone in your "negativity". :-)