Mang, shit is bullshit: a rant not in need of solutions
Hokay, so.
I’m on HRT and have been for a decade and change. This is real cool, except how basically every interaction with cisgenderedists gets me misgendered, and a hearty “sir” or a flurry of “he/hims” levied my way. I mean, fuck, I can be standing there in knee-high boots, a leather skirt, and a cropped hoodie and I get misgendered as fuuuck.
“So change shit up, motherfucker.”
I do a phone job and my voice is believably feminine in both English and Japanese, which is cool, but something about my real life existence just reeks of masculinity.
Can’t really do makeup cause the structures responsible for processing my face are damaged. I can tell what emotion I’m making, but I can’t perceive enough of my face to draw well on it. Also since I’ve had two strokes, even if I could, I’d prolly do eyeliner wings like a fuckin’ gridiron player.
I got beautiful wavy blonde hair that goes down past my butt, and though I don’t have the manual dexterity to style that really well with buns and braids and such, I can at least try shit other than the basic nape-of-neck ponytail.
Also I’m flat as your average golf course: maybe two discernible bumps, and that’s fuckin’ it. Also I’m ace as fuck so if they were any bigger I’d get real self-conscious about it.
At least I got a fashion sense that makes Square Enix jealous.
I’m gonna figure shit out that works for me, either that or I’m gonna keep on tolerating the injustices of the bastards who never thought to play with the character creator.
Also I guess they want me to add a photo so here you are.
Apologies for my shitty English. It’s fuckin’ terrible.
You've been on HRT for a decade? If you don't mind me asking, what ester & dose and what route of administration? Do you get blood tests and if so what are your levels like?
IRL I met some trans elders who had been on HRT for a while and didn't see any effects from it (almost no breast growth or much change to their face beyond skin softening some, etc.). I think they were taking the estrogen orally, and they weren't sure exactly about their blood levels, but they thought they were fine.
When taken orally, I think around 80% of the estrogen is filtered out by the liver, so it can be hard to get enough estrogen that way and there are peaks and troughs multiple times a day (it is ideal when taking oral to dose 3 - 5 times a day to ensure even and adequate estrogen through the day). Patches & gel are all better than oral, but injections seem the best in terms of getting a consistently high enough level of estrogen.
So your testosterone is really low !! But I would personally consider estrogen too low, though you know your own body best. When did you get the blood work done compared to the last dose you took?
I think the common conservative recommendation is to have between 100 - 200 pg/mL so your blood work looks good on paper, but I personally found below 300 at trough was mentally difficult for me. I use estrogen as my anti-androgen ("monotherapy"), so I take a larger dose than most.
You might consider aiming for higher blood levels of E and with a better & safer route of administration.
I am a wuss too, it was extremely difficult for me to overcome my needle phobia (I mean, literally breaking down crying after some injections, taking a long time to overcome the mental block to actually push the needle in, just so so so hard for me). But you do get used to it, and it's not bad after you get some practice.
Also, I inject subcutaneously, so I use really small needles that don't hurt at all (literally, I sometimes can't feel the needle). That was crucial for me in overcoming needle phobia, I think it would be much harder to inject intramuscularly (IM).
Even if you still can't do injections, I would encourage doing something to avoid oral, even sublingual troches which have their own problems might still help with absorption, and even better would be patches or gel.
My blood work was done a week ago and I think it looks pretty alright. Next I talk to my general practitioner, I’m gonna ask her to bump my E to 8mg from 6mg per day.
Usually the blood work will vary heavily depending on when you last took a dose. When I get blood work, I do it right before I am going to inject so that the blood levels are at the lowest they could be (the "trough"). With oral I would imagine your E blood levels will fluctuate significantly, so when you last took a pill will make a big difference in terms of what your blood labs show.
The problem with taking larger and larger oral doses is that it doesn't absorb better and you are just potentially taxing your liver. At the very least I would try out sublingual route and see if that helps 🤷♀️
I wish you luck dear, it's not easy figuring this stuff out (esp. with clueless doctors).