Reaching the End

When transpeople get approved for Hormone Replacement Therapy (HRT), which can take months going through the process for the appointments for the initial prescription, they feel it's the start of their transition.

They may or may not have lived as the gender they know who they are, depending on their situation and requirement for HRT (yes, some programs require living as women first, which escapes me why when it has nothing to do with one's gender identity, just their public presentation).

They may or may not have come out to anyone but a few people, usually family or close friends, as some work through the initial process just with medical professional first to ensure everything is approved to transition before coming out to others.

But once they start HRT, they usually feel it's the right road and feel it will make them into something new. Well, it may and may not, because there is the idea of diminishing returns on HRT, meaning the longer you take HRT, the less the effect of the drugs after awhile and the more you take produces less change from the drugs.

This means there is a point where the time on HRT and the dosage of the HRT drugs reaches an optimium and then lessens over time when the continued use of the same dosage or any increase in the dosage won't produce more changes.

This is totally dependent on your body's response to HRT, the your body's capacity for change with HRT, and your body's reaction to or tolerance of HRT. Some people respond well  to "normal" dosage, some need higher dosages and some don't tolerate HRT beyond more than a minimal dosage.

That's why you have to monitor your physical and mental health on HRT to ensure you aren't doing more harm than good. You have to monitor your physical health, your mental and emotional health and your body for adverse reactions or changes.

But through it all there will be a point when you've reached the end of the HRT's changes for you, or at least where you only need a sustaining dosage to keep what changes you have, which is often a lower dosage since the necessary basic change in your hormone levels has been achieved.

This may occur early in the transition if the person takes a high dosage, usually 2-3 years, longer on lower dosage for personal choice, and it may take more years if the person has to take the lowest dosage to prevent damaging side effects.

But there always is an end, and the reality there is no more help from HRT, and the person has to decide what's next in their transition. Some may have made the decision earlier with cosmetic surgery, but most don't because of the expense of surgery. Either way, it doesn't change the end.

And this is my point, start HRT knowing there is an end, and be realistic about your expectations from HRT. Remember it's about your life and your future. HRT won't guarrantee that, only help along the way to becoming who you are.