In this week's " Sex Talk Realness ," Cosmopolitan. For trans women, this means taking extra estrogen. An orchiectomy involves the surgical removal of one or both testicles, and vaginoplasty is a reconstructive plastic surgery and cosmetic procedure for the vaginal canal and its mucous membranes. How old are you now? Woman B: Fifty-two.
If you're interested Forced feminization hormones implants feminizatio by way of laser or electrolysis, create a financial game plan for getting rid of your unwanted hair and look for hair removal specialists that have worked with trans patients before. Even Anabel which pornstar and bruised, the line kept running through my mind. Goodman says. Traditionally, patients have been advised to cryopreserve sperm prior to starting cross-sex hormone therapy as there is a potential for a decline in sperm motility with high-dose estrogen therapy over time Lubbert et al. Probl Endokrinol Mosk in Russian. Transgender Medicine. Woman B: Do as much as you can as soon as you can. Both hormones were then withdrawn, and daily injections of increasing doses of prolactin and somatotropin were given for four days; at the same time, feminizatuon patient used a breast bump four times daily for 5 minutes on both sides. Implanrs doesn't get better with age. Male-to-female hormone therapy causes the hips to rotate slightly forward because of changes in the tendons.
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Yes, he is ready now Forced feminization hormones implants implants. Category asian football biography stubs hurt! She explained what she was doing, applying foundation, eye makeup to my lids, and outlining my eyes with a black pencil. The catheter was removed and I peed for the first time sitting down. She can afford it. How Stephen became Stephanie. She is on the trading homones before am most mornings, and often needs to go out and socialise with clients until late in femnization evening. She also controlled my outbursts of independence out of bed by wetting me in some way from her mouth. She is going to be a woman from now on. I am fighting for freedom of speech, freedom of expression, and freedom for artists and creative people to do what they like. My 'Completely Feminised Husbands' video that I posted back in March on YouTube had nearly 30, views, nearly all of them favourable, but it Forced feminization hormones implants banned today by YouTube. You make a very pretty girl! I realized with a sinking feeling that she was in on it with my wife, and all her questions were just to mock me. I should have seen it coming.
Transgender hormone therapy of the male-to-female MTF type, also known as feminizing hormone therapy , is hormone therapy and sex reassignment therapy to change the secondary sexual characteristics of transgender people from masculine or androgynous to feminine.
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In this week's " Sex Talk Realness ," Cosmopolitan. For trans women, this means taking extra estrogen. An orchiectomy involves the surgical removal of one or both testicles, and vaginoplasty is a reconstructive plastic surgery and cosmetic procedure for the vaginal canal and its mucous membranes. How old are you now? Woman B: Fifty-two. Woman C: Thirty-two. How old were you when you came out as transgender to your friends and family? Woman A: Mids. Woman B: Forty-five.
That time in my life feels like a blur and it didn't all happen at once. How old were you when you began to transition and when you completed your transition? Woman A: I started in my mids and completed it when I was Woman B: I started at I was living full-time as myself before my next birthday, but I think of transition as an ongoing thing. Like any other woman, I'll be discovering what it means for me to be the woman I am for the rest of my life. I just started the process later than most.
Woman C: That's such a complicated question because what it means "to transition" is so subjective. I started transitioning when I came out to my friends. As far as "completing" transition, I can't say for sure if that's something I'm ever going to do.
To me, seeing transitioning as something that "starts" or "ends" is really oversimplifying it. Some trans people do think of it in terms of "start here, do this, then do this, fill out this, get this procedure, etc. For me, it's an endless process. It's not the same process today that it was 13 years ago, but it's not over. How did you decide to transition, and whether you wanted to pursue hormones or surgery or both?
Woman A: I knew I had to transition. Deciding to transition isn't something you can look at on a spreadsheet and weigh out intellectually, it's something you just have to do. Like many, I tried to ignore that feeling for a long time but eventually, I had the right combination of financial independence and support to act on it.
When I first started transitioning, I had no idea whether or not I wanted to have surgery. I definitely didn't like what I currently had between my legs, but "surgery" is such a scary word. The further I got in my hormonal transition though, the more I felt a painful disconnect between the way I wanted my body to work and feel sexually, and its then-current state. Entering a relationship with my partner only heightened that feeling.
She could tell how dissatisfied I was with my body and felt firsthand how it affected our sex life. I wanted to have surgery for me, and for us. Woman B: Once I realized what my issue with gender was, I had to transition. I was at a place where I knew that if I didn't transition, I wouldn't live to see my kids graduate from high school. To function as the woman I am, I needed to have what I saw as a woman's face to present to the world.
Breast implants allowed me to walk around in a woman's body without falsies in my bra. I also discovered that with a typical woman's secondary sex characteristics, I could also experience sexuality as a woman. I had FFS and implants within a year of coming out to myself. It took me six years to get bottom surgery. My credit was awful, and I had to wait until the state of California mandated that insurance carriers had to provide all medically necessary treatment for transgender people.
Then, I had to wait two years before my insurance actually started providing the surgeries. To be clear, surgeries don't define trans people. Surgeries and hormones and all the other steps are just tools to help us live our true gender with as little pain and dysphoria as possible.
Not everyone has access to or can afford the treatments they need. Woman C: I didn't know if transition was really what I wanted because I had no idea what to expect. All I really knew was that I didn't want to live the way I was living any longer. Every step of my transition was more about being fed up with how things were than having a set goal for how I wanted them to be.
What were your biggest fears about transitioning? Woman A: Before transitioning, I was worried that if I didn't know exactly what I wanted and when, then I should never start. But if you allow the complexity of transition-related decisions to overwhelm you at the beginning, you'll never get anything done. I remember my amazing therapist once calming me down by saying, "If you want hormones, take hormones. If you don't like what they do, stop taking them. It's not a single process, it's 1, days of little decisions that you have to take on individually until you're happy.
Woman B: I didn't have to deal with a lot of the more practical fears many trans folks have to deal with. My job was secure. My ex-wife couldn't take my children away from me even if she wanted to, and she didn't. I just wanted to be very sure of why I was doing it. Woman C: Really, everything about it was scary. I was afraid of the possible medical complications, like blood clots and breast cancer.
I was afraid of being disowned by my friends and family, I was afraid of living my life as a pariah. I was afraid I wouldn't be able to find work and that I would face discrimination in public.
I was afraid that people were going to laugh at me or try to hurt me. I don't know if I could have done that. How long after you began your hormonal transition did you start noticing a change?
It was like someone had put out a forest fire in my head. Physical changes are slower but start to be noticeable within a few months: breast development, changes in face shape, thinner body hair, etc. It represented a gateway to changing my body and addressing my gender dysphoria.
Emotionally, that was huge. Physically, the effects of estrogen treatments are fairly subtle. I started to notice a tiny bit of breast tissue growth after about nine months. About that time, the connection between sensation in my breasts and my genitals seemed to appear. In many ways, it was like a typical adolescent girl's experience with her hormones kicking in.
Over the years, my skin has gotten softer, my body hair is more fine, and when I gain weight, it congregates on my butt and breasts rather than my belly. I'm not sure that other people really noticed the changes from the hormones. I started noticing some physical changes within the first few weeks.
I couldn't even begin to guess when other people started noticing changes. I remember that it was a few years before I was consistently being read as female by strangers. Were there any aspects of the hormonal transition that surprised you? I try to think back to a time before hormones, and it's so blurry, it's like I was barely alive. So much of the discourse around hormones is about how it changes you physically, and that was great, but hormones are so much more than just a means to an end of bodily transformation.
They also alter how you feel and think, and for me, that was more important than the physical stuff. One night I was walking through the hallway in my house wearing a silk nightie and the sensation was overwhelming. I literally had to sit down because my legs wouldn't support me. I was still pretty young when I started and most of the stuff I was able to find about transition seemed to focus on the experiences of older folks.
Smelling differently was a surprise though. Woman C: There was a gap and it had everything to do with money. I didn't have insurance and finding a doctor was a big issue. When I first started taking hormones, I ordered them online and self-dosed. It was very expensive.
Over the years, I've gone on and off hormones a lot because they're not cheap, especially if you're not getting them through a clinic. Since some transgender people don't feel it necessary to get any surgery, why did you feel it was necessary for you?
Woman B: It was a means to the end of more ease in my body and more importantly, a means to be able to transition socially. Everyone sees my face and to function, I wanted a face they could look at and recognize as female.
I'm not sure if I'll ever have vaginoplasty, or if that's something I want enough to deal with the risk and the expense, but orchiectomy was a pretty straightforward decision for me. How did you pay for the surgery?
Did you have insurance when you began transitioning? My insurance covered mental health counseling, hormone replacement therapy, and a portion of the surgery. Friends and family members helped me pay for the rest.
Belinda delighted in seeing me in my panties and bra when I was getting dressed, particularly how femininely smooth and flat my crotch looked now, and how well my boobs had come on, although she still urged me to have implants to make my chest a bit bigger. How Stephen became Stephanie. Labels: boys turned into girls , boys turned into school girls , complete feminisation , facial feminisation surgery , female hormones , forced feminisation , forced feminization. For bed she began dressing me as a slut in the laciest, sheerest lingerie. You did a beautiful job! And after you have both moved in with me, think how ideal life will be, with our own maidservant to wait on us and render us every intimate service.
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Transgender hormone therapy of the male-to-female MTF type, also known as feminizing hormone therapy , is hormone therapy and sex reassignment therapy to change the secondary sexual characteristics of transgender people from masculine or androgynous to feminine. Some intersex people also take this form of therapy, according to their personal needs and preferences.
The purpose of the therapy is to cause the development of the secondary sex characteristics of the desired sex , such as breasts and a feminine pattern of hair , fat , and muscle distribution. It cannot undo many of the changes produced by naturally occurring puberty , which may necessitate surgery and other treatments to reverse see below.
The medications used for the MTF therapy include estrogens , antiandrogens , progestogens , and gonadotropin-releasing hormone modulators GnRH modulators. While the therapy cannot undo the effects of a person's first puberty , developing secondary sex characteristics associated with a different gender can relieve some or all of the distress and discomfort associated with gender dysphoria , and can help the person to "pass" or be seen as the gender they identify with.
Introducing exogenous hormones into the body impacts it at every level and many patients report changes in energy levels, mood, appetite, etc. The goal of the therapy is to provide patients with a more satisfying body that is more congruent with their gender identity. Many physicians operate by the World Professional Association of Transgender Health WPATH Standards of Care SoC model and require psychotherapy and a letter of recommendation from a psychotherapist in order for a transgender person to obtain hormone therapy.
The accessibility of transgender hormone therapy differs throughout the world and throughout individual countries. Some medical conditions may be a reason to not to take feminizing hormone therapy because of the harm it could cause to the individual.
Such interfering factors are described in medicine as contraindications. Absolute contraindications — those that can cause life-threatening complications, and in which feminizing hormone therapy should never be used — include histories of estrogen-sensitive cancer e.
Relative contraindications — in which the benefits of HRT may outweigh the risks, but caution should be used — include:. As dosages increase, risks increase as well. Therefore, patients with relative contraindications may start at low dosages and increase gradually.
A variety of different sex-hormonal medications are used in feminizing hormone therapy for transgender women. Estrogens are the major sex hormones in women, and are responsible for the development and maintenance of feminine secondary sexual characteristics, such as breasts, wide hips, and a feminine pattern of fat distribution. In addition to producing feminization, estrogens have antigonadotropic effects and suppress gonadal sex hormone production.
Prior to orchiectomy surgical removal of the gonads or sex reassignment surgery , the doses of estrogens used in transgender women are often higher than replacement doses used in cisgender women. Antiandrogens are medications that prevent the effects of androgens in the body. Antiandrogens that directly block the androgen receptor are known as androgen receptor antagonists or blockers, while antiandrogens that inhibit the enzymatic biosynthesis of androgens are known as androgen synthesis inhibitors and antiandrogens that suppress androgen production in the gonads are known as antigonadotropins.
Steroidal antiandrogens are antiandrogens that resemble steroid hormones like testosterone and progesterone in chemical structure. Spironolactone is an antimineralocorticoid antagonist of the mineralocorticoid receptor and potassium-sparing diuretic , which is mainly used to treat high blood pressure , edema , high aldosterone levels , and low potassium levels caused by other diuretics , among other uses.
Cyproterone acetate is an antiandrogen and progestin which is used in the treatment of numerous androgen-dependent conditions and is also used as a progestogen in birth control pills. Medroxyprogesterone acetate is a progestin that is related to cyproterone acetate and is sometimes used as an alternative to it.
Numerous other progestogens and by extension antigonadotropins have been used to suppress testosterone levels in men and are likely useful for such purposes in transgender women as well. Nonsteroidal antiandrogens are antiandrogens which are nonsteroidal and hence unrelated to steroid hormones in terms of chemical structure.
The nonsteroidal antiandrogens that have been used in transgender women include the first-generation medications flutamide Eulexin , nilutamide Anandron, Nilandron , and bicalutamide Casodex.
GnRH modulators are powerful antigonadotropins and hence functional antiandrogens. GnRH modulators are highly effective for testosterone suppression in transgender women and have few or no side effects when sex hormone deficiency is avoided with concomitant estrogen therapy.
But they are under patent protection and, as with other GnRH modulators, are very expensive at present. In adolescents of either sex with relevant indicators, GnRH modulators can be used to stop undesired pubertal changes for a period without inducing any changes toward the sex with which the patient currently identifies. There is considerable controversy over the earliest age at which it is clinically, morally, and legally safe to use GnRH modulators, and for how long.
The sixth edition of the World Professional Association for Transgender Health 's Standards of Care permit it from Tanner stage 2 but do not allow the addition of hormones until age 16, which could be five or more years later. Sex steroids have important functions in addition to their role in puberty, and some skeletal changes such as increased height that may be considered masculine are not hindered by GnRH modulators.
Progesterone , a progestogen , is the other of the two major sex hormones in women. There are two types of progestogens: progesterone, which is the natural and bioidentical hormone in the body; and progestins , which are synthetic progestogens. Clinical research on the use of progestogens in transgender women is very limited. Progestogens have some antiestrogenic effects in the breasts, for instance decreasing expression of the estrogen receptor and increasing expression of estrogen- metabolizing enzymes ,     and for this reason, have been used to treat breast pain and benign breast disorders.
In terms of the effects of progestogens on sex drive, one study assessed the use of dydrogesterone to improve sexual desire in transgender women and found no benefit. Progestogens can have adverse effects. Progesterone is most commonly taken orally. Galactogogues such as the peripherally selective D 2 receptor antagonist and prolactin releaser domperidone can be used to induce lactation in transgender women who wish to breastfeed. Many of the medications used in feminizing hormone therapy, such as estradiol , cyproterone acetate , and bicalutamide , are substrates of CYP3A4 and other cytochrome P enzymes.
As a result, inducers of CYP3A4 and other cytochrome P enzymes, such as carbamazepine , phenobarbital , phenytoin , rifampin , rifampicin , and St. John's wort , among others, may decrease circulating levels of these medications and thereby decrease their effects.
Conversely, inhibitors of CYP3A4 and other cytochrome P enzymes, such as cimetidine , clotrimazole , grapefruit juice , itraconazole , ketoconazole , and ritonavir , among others, may increase circulating levels of these medications and thereby increase their effects.
The concomitant use of a cytochrome P inducer or inhibitor with feminizing hormone therapy may necessitate medication dosage adjustments. The spectrum of effects of hormone therapy in transgender women depend on the specific medications and dosages used. In any case, the main effects of hormone therapy in transgender women are feminization and demasculinization , and are as follows:.
Maximum effects vary widely depending on genetics , body habitus , age , and status of gonad removal. Generally, older individuals with intact gonads may have less feminization overall. Temporary hair removal can be achieved with shaving , epilating , waxing , and other methods. Breast , nipple , and areolar development varies considerably depending on genetics, body composition, age of HRT initiation, and many other factors.
Development can take a couple years to nearly a decade for some. However, many transgender women report there is often a "stall" in breast growth during transition, or significant breast asymmetry. Transgender women on HRT often experience less breast development than cisgender women especially if started after young adulthood.
For this reason, many seek breast augmentation. Transgender patients opting for breast reduction are rare. Shoulder width and the size of the rib cage also play a role in the perceivable size of the breasts; both are usually larger in transgender women, causing the breasts to appear proportionally smaller. Thus, when a transgender woman opts to have breast augmentation, the implants used tend to be larger than those used by cisgender women. In clinical trials , cisgender women have used stem cells from fat to regrow their breasts after mastectomies.
This could someday eliminate the need for implants for transgender women. In transgender women on HRT, as in cisgender women during puberty, breast ducts and Cooper's ligaments develop under the influence of estrogen.
Progesterone causes the milk sacs mammary alveoli to develop, and with the right stimuli, a transgender woman may lactate. Additionally, HRT often makes the nipples more sensitive to stimulation. The uppermost layer of skin, the stratum corneum , becomes thinner and more translucent. Spider veins may appear or be more noticeable as a result. Collagen decreases, and tactile sensation increases.
The skin becomes softer,  more susceptible to tearing and irritation from scratching or shaving, and slightly lighter in color because of a slight decrease in melanin. Sebaceous gland activity which is triggered by androgens lessens, reducing oil production on the skin and scalp. Consequently, the skin becomes less prone to acne.
It also becomes drier, and lotions or oils may be necessary. Many apocrine glands — a type of sweat gland — become inactive, and body odor decreases.
Remaining body odor becomes less metallic, sharp, or acrid, and more sweet and musky. As subcutaneous fat accumulates,  dimpling, or cellulite , becomes more apparent on the thighs and buttocks. Stretch marks striae distensae may appear on the skin in these areas.
Susceptibility to sunburn increases, possibly because the skin is thinner and less pigmented. Antiandrogens affect existing facial hair only slightly; patients may see slower growth and some reduction in density and coverage. Patients taking antiandrogens tend to have better results with electrolysis and laser hair removal than those who are not.
Body hair on the chest, shoulders, back, abdomen, buttocks, thighs, tops of hands, and tops of feet turns, over time, from terminal "normal" hairs to tiny, blonde vellus hairs. Arm, perianal, and perineal hair is reduced but may not turn to vellus hair on the latter two regions some cisgender women also have hair in these areas.
Underarm hair changes slightly in texture and length, and pubic hair becomes more typically female in pattern. Lower leg hair becomes less dense. All of these changes depend to some degree on genetics. Head hair may change slightly in texture, curl, and color. This is especially likely with hair growth from previously bald areas. The lens of the eye changes in curvature. Because oil prevents the tear film from evaporating, this change may cause dry eyes.
The distribution of adipose fat tissue changes slowly over months and years. HRT causes the body to accumulate new fat in a typically feminine pattern, including in the hips, thighs, buttocks, pubis, upper arms, and breasts. Fat on the hips, thighs, and buttocks has a higher concentration of omega-3 fatty acids and is meant to be used for lactation. The body begins to burn old adipose tissue in the waist, shoulders, and back, making those areas smaller.
Subcutaneous fat increases in the cheeks and lips , making the face appear rounder, with slightly less emphasis on the jaw as the lower portion of the cheeks fills in. HRT causes a reduction in muscle mass and distribution towards female proportions.
Male-to-female hormone therapy causes the hips to rotate slightly forward because of changes in the tendons. Hip discomfort is common. This can cause a reduction in total body height.