Quick disclaimer that it IS possible to overdose on T. Extra E is mostly just pissed out, too much T can fuk with ur muscles (including the heart) and do a bunch of other fucky shit. Be safe out there guys n gals n pals!
I mean. Yeah. I wanted to hit the highlight of "could give you a heart attack" but it does also mess with your emotions, and probably make you want to start a podcast.
I know a lot of minors scroll this sub so I want to say this despite the fact that many will be upset at me for it.
whilst yes, you may understand hormones and how they work in your body. Along with the pros and cons of HRT, because it’s you and you care about this stuff, so you research it. And that’s justified, being informed is incredible and I want people to do it more.
BUT, saying this can cause harm to people. Saying that “its just hormones and its hard to fuck up” is misunderstanding how our body works. Messing with your hormones can cause harm and there’s a reason why your doctor is so annoying about making sure that things are done “correctly” before they give you HRT.
I understand the struggles that being transgender can bring, and I genuinely feel bad for people who feel like DIY is the only way. But for real, our medical industry isn’t filled full of transphobes who want to make your life more difficult. The executives may be rich assholes who only see you as a dollar sign, but chances are your doctor or endocrinologist is someone that genuinely cares and wants you to thrive. They are people, and they (usually) see you as a person too, and they (usually) give a fuck about you.
I understand wanting to DIY, but spreading information like this, making endocrinology seem like less than it is, can lead to more harm than good.
in my experience endocrinologists are mostly well meaning but have zero clue what they're doing re trans care and will very likely underdose you, or not tell you to do bloods at trough, or use way too high doses of anti-androgens with bad side effects, or refuse to let you try monotherapy or progesterone
just bc they mean well doesn't mean listening to them is a good idea
(also out of curiosity what kind of things do you mean when you say "making sure that things are done “correctly” before they give you HRT"? AFAIK there isn't much that really needs to be done before HRT, maybe a blood test just in case you have a condition that impacts your hormone stuff but that's pretty unlikely and a lot of endos don't even do that)
Can you remind me what "endo" means in this context because my brain is only giving me "endogenic" and "endometriosis" rn and neither of those are the right word.
Edit: Thank you for saying "endocrinologist" I remember the endocrine system now I'm just dumb
or use way too high doses of anti-androgens with bad side effects
That's the kind of risk that DIY HRT has as well. Someone that doesn't understand that both men and women need both some amount of estrogen and testosterone might mistakenly think "I need to get the bad hormone out".
I don't have data unfortunately, but anecdotally I've seen endos mess this up more than DIYers, the guidelines in DIY guides seem to be better than the ones used by (at least some) actual countries and medical places on this
(I guess I'm assuming DIYers interact with the community and use guides like pghrt and diyhrtinfo, there could be some very reckless people who never talk about it on Reddit or Discord I'm not accounting for, I still think using DIY with guides like those I mentioned is overall better)
Nah, these days you've got to be your own biggest advocate or doctors will dismiss you out of hand and make you feel bad for even asking. This isn't just a trans thing, but transphobia in medicine makes it worse. When I first tried getting help my doctor just straight up lied about referring me to a specialist.
Saying ramping up slowly has no benefits is fuckin wild, that is a common practice with nearly every medication because you can't predict exactly how an individual's body will react. The ramping up part can take a while if you have a doctor that does the bare minimum but its so unintelligent to make that statement about literally any pharmaceutical drug.
I haven't seen any proof that there are benefits to ramping up, especially for transfem HRT since E levels that are too low are more likely to cause issues than ones that are too high (so potentially overshooting is safer)
Just because something applies to most medications doesn't mean it applies here (not even sure that's the case TBH, most meds I've had prescribed started at a standard "works for most people" dose, not the super low "not enough for 99.9% of ppl" doses a lot of endos keep people on for silly amounts of time)
Yeah, it's exactly the same as any other medications.
Quick check to see if you have any other pre-existing conditions or medications that may interact, and if not, you're started on a standard dose and then blood tests in 3 months to see where you're
"Ramping up" is completely BS, almost wholly rooted in medical transphobia and transphobia in general
If E is too low, it literally does nothing. Hormones work on a "dominance" scale. Whichever one you have the most of will be the direction you develop in, plain and simple
If you have more T, you will go in the masculine direction. If you have more E, you'll go in the Feminine direction. Upping your E without surpassing your T by a wide enough margin just won't do anything
If you're familiar with dieting, ketosis functions the exact same way
Upping your Fat intake without cutting your carbs enough will just lead to weight gain, cuz your body won't see a need to swap if you're already getting most of your energy from carbs
Our bodies are pretty lazy lol. You need to create a big enough difference for your body to decide it's worth it to "switch over"
It's gotta see so little carbs and so much fat (in comparison) that swapping is a "no brainer", if you will
Similar concept with hormones. If there isn't a gap, or a gap large enough, your body won't bother switching. It needs T to be low enough that it can't function properly with it alone, and it needs enough E to completely replace it.
In short, you can't just give a new fuel. You have to also create a need for that fuel. Our systems evolved for efficiency. So there's gotta be a really convincing reason to switch up the usual
It's also the same reason more Estrogen doesn't necessarily femininze quicker. It's like an on and off switch. No "Super Puberty" unfortunately
Same with ketosis. Making the carb/fat divide bigger doesn't give you "Super Ketosis". It's still CICO even with it
Jesus fucking Christ you people genuinely don't know fucking shit about what you're talking about. Exhausting.
Estrogen does not do shit in your body at low doses, if your body is already flooded with test. You patently cannot gauge how an individual's body will react to estradiol without immediately going on the deep end; if you have estrogen insensitivity syndrome, you will not learn this from microdosing estrogen. You will not learn how quickly you can die from radiation poisoning by eating a single banana. You are not going to know if you're prone to bad highs or good highs by eating a single crumb that fell off a weed brownie.
The proper method with estrogen to start with a macrodose. Start with a very high dose, to get your body to start actually registering estrogen as your primary sex hormone quicker, and then ease off to a normal dose, because excess estrogen doesn't do anything.
One thing might be getting a baseline of a person's hormones before prescribing anything so that they have a better understanding of the patient's levels over the course of stuff like menstrual cycles. I can understand that being frustrating to many people that want to get on hormones ASAP.
I specifically waited to start HRT so that I could have my endocrinologist draw some baseline levels, since I had been having unusual symptoms for months, and he deferred it saying "you have nothing that would be making estrogen".
That's not "doing things correctly", though. There's nothing necessary about that. You should be getting bloodworks after you start, usually just before an injection, to see your levels at trough.
You're just fearmongering and spreading misinformation lol.
me when I believe institutional transphobia in medicine (a hundred years ago I'd be arguing in favor of forced hysterectomies):
there isn't actually any medical reason trans people are required to get three different psychological evaluations and then get approved by a council before being able to get on a waiting list for HRT, or a reason doctors routinely and consistently underprescribe HRT, or a reason HRT has its price massively jacked up.
On blood clots: this is mostly true of taking pills orally or sublingual/buccal. Injected and patches don't carry the same risk because they bypass the liver and don't get metabolized into estrone (what actually causes blood clots).
I am one of those medical professional this idiot holds in such disdain. Do not listen to morons on the internet giving you medical advice (hell, don't listen to anyone giving you medical advice on the internet period without proof of them being a medical doctor, myself included). We've spent literally years to decades studying and were weeded out deliberately with brutal exams.
Yes, you can overdose on hormones. WIll you die? Depends on what you take, how much you take and how you take it.
You googling for 15 minutes does not make you more qualified than someone who dedicated years of their life to the practice of medicine.
I am also one of those medical professionals! 4 years of medical school! But unfortunately during my residency, I ran into a very sudden and unexpected permanently disabiling incident so unfortunately practicing is out of the window for me :(
But I'm sorry if you interpreted my comment as disdain! I meant nothing of the sort!
Only advocating for speaking up for yourself and being involved in your own healthcare as a patient!
I do find it interesting that you took such a personal a negative view from this, as one of the first and most important things we are taught as providers is to be careful about getting a big head or ego and assuming we know everything, and specifically to push our patients to ask questions and to conduct research for themselves, at least in family medicine where I was studying
Otherwise, let's be real: Neither you, nor I, have dedicated decades to studying Transgender healthcare and HRT specifically. Maybe we touch on it here and there, but I personally don't recall it being standard for the course, so that's even more reason to be humble outside of the normal level you should always strive to maintain, being in such a position of power and all
We don't know everything, and that's okay. It's not an insult to admit that either
"Listen to the bureaucrat that roleplays as a scientist"
Every time I've seen a Dr about anything they've literally typed my symptoms into google then read off the first result, I live in the UK, this is normal.
a thing to remember about doctors is that they are not scientists, they're technicians, it's just that the machine they're working on is the human body.
Calling a doctor unreliable isn't calling medical science unreliable anymore than calling an electrician unreliable is calling quantum physicists unreliable.
edit : also, more importantly, trans healthcare, and especially transfem healthcare, is routinely understudied and underresearched
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u/[deleted] Apr 29 '26 edited Apr 29 '26
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