Identity Crisis: Addendum

Unexpected HRT side-effect #9

I sometimes get asked by people that have to stare intently at my face (usually in some professional capacity):

“Your skin is so good! What’s your secret?”

And I tell them:

“Every two weeks I shoot my thigh full of the cool, sexier estrogen!”

As with a number of other effects, I knew that I could expect softer, better skin. However, I didn’t truly appreciate with any kind of granularity as to what that actually meant.

For one thing: I have no breakouts, no blemishes; I changed literally nothing about my diet or skincare routine, and suddenly my face is completely crystal-clear.

(The one exception to this seems to be immediately after I load up my progesterone; although even here, ‘blemish’ seems kind of a strong word for a series of nearly imperceptible bumps.)

For another: my pores have shrunk! This caused some issues in the first couple of weeks, as it effectively forced some of them to trap their contents; but that went away after a little over a month and it’s been plain, small-pored sailing ever since!

The one downside - and it really isn’t much of one - is this: I am actually allergic to cats (which is probably not a great trait in a cat owner); but have great tolerance providing said cats are not rubbing themselves on my face. Doing so would set off a reaction where my lips would tingle and I would break out in hives.

Since starting HRT, the time in which this reaction occurs has gone from many minutes after the initial contact to practically seconds. It really isn’t much of a problem (and truthfully, I’ll gladly accept hives as a consequence of cat affection); but it’s interesting to see how yet another tiny part of my life has been impacted by the simple expedient of transposing my hormone levels!

25g

I’ve written before about how I administer my estradiol in form of a fortnightly intramuscular injection. The chief benefit is that it offers the greatest degree of bioavailability; but at the cost of... you know, routinely poking myself.

I actually use two different needles. There is a large, 18g needle for drawing the medication from the vial (because you want a large needle when pulling liquid into the syringe); and a 23g needle for injecting (because the smaller the needle, the less discomfort it causes going in).

Thankfully, the needles are color-coded; and over time, I learned to recognize them. When I’m having blood drawn, it’s with an 18g (which is why the “You’ll feel a sharp pinch” speech has some merit to it). One time the technician used a 23g needle (maybe my vein was inaccessible that day; maybe it was from personal preference) - I barely felt it going in!

(I think next time I’m getting blood work done, I’m going to ask them to use a 23g...)

I’m fascinated by vaccinations, because they give the same “You’ll feel a poke” talk but honestly, there’s hardly an sensation at all compared to my routine injections. I looked up the spec sheet and discovered they are using 25g needles; and the last time I saw my endocrinologist I requested they proscribe me some to test with.

Anyway, this is a very long-winded way of saying that I got to try out a 25g needle today and honestly, it was such an improvement - there was no pain popping it in! I do have to be a bit more careful now as depressing the syringe plunger required a lot more effort (I assume estradiol cypionate is a bit more viscous than whatever medium vaccines sit in); and that has to still be done in a very controlled way.

All the same though: great experience; would recommend!

Scars

I should probably preface this with a content warning for discussion of self-harm.

I’m left-handed; when I’m receiving a vaccination or having blood drawn, I will normally offer up my right arm - as was recently the case when I received my first COVID vaccine dose.

While staring at my arm in the mirror, I realized that I had self-harm scars that are still very visible; and based on their appearance, very obviously self-inflicted. (This is not the case elsewhere - they have either faded, or are normally hidden.)

I’m mortified, as it means the provider that administered my dose absolutely saw them (and will again, as I tend to get pretty mean injection site pain and I really don’t want to experience that in my dominant arm).

More generally though, it got me thinking. The reason I struggle with others seeing what I did to myself is not because I’m ashamed, but because on some level I feel that my suffering was not legitimate - that I hurt myself not because I was truly in pain, but for attention. An imitation of the struggles of others.

There isn’t really a good answer here; just another piece of the puzzle to make sense of.

In my experience, there are four approaches:

Take an existing name, and translate it into a unisex or opposite-gendered equivalent. (I went from 'Lawrence' to 'Lauren'.)

Select a different - but otherwise traditional - name. (Often this is as simple as a person seeing or hearing a name and thinking "I like that; I could be a _____".)

Choose a name with symbolic connotations. (I know a devout trans girl that settled on 'Faith'; and another that chose 'Phoenix' for fairly obvious reasons.) This option appears to be particularly popular with non-binary individuals.

Create a new name from whole cloth; running letters together until something unique and lyrical emerges.

Of course, one can combine these approaches in various ways. (One girl I know chose a new first name; and then converted her original first name into a female equivalent, and made that her new middle name.)

As for suggestions? Well, that depends on what direction your child wants to go in. Do they want to retain the spirit of their current name? Then seek out other-gendered versions. Are they looking for something different? You could stroll through a baby name website together. Perhaps a more representational name? Then discuss how they see themselves and how they want others to see them.

Lastly: don't feel pressured to get this right first time. Let your child try different names on; call to them by their new name, and see how they feel. Even if you get all the way down the road to a legal name change, there's generally very little preventing you from changing it something else if needed.

(I mentioned that I went from 'Lawrence' to 'Lauren'; I skipped over the year in between I spent as 'Lawrie'. It's okay to take your time on this!)

So like, if you’re a parent whose child not only trusts you enough to discuss their trans journey egg hatchery with you, but asks for your input on their new name-

Like, that’s a big deal and you’d want to do right by them, right? So how would you go about finding/making suggestions? Aside from avoiding names prevalent in pop culture and/or that can be overtly or incidentally connected to people/things that suck.

Purges

A friend introduced me to Andrea Jenkins and her powerful work “Eighteen”; and I recall thinking to myself “Well, at least I can be thankful I never purged my belongings.

Then I remembered that I threw out my dress because I was convinced I wasn’t going to live much longer (i.e. experiencing a particularly strong episode of passive suicidal ideation) and needed to make sure nobody would find it when sorting through my belongings.

The more I think about this, the more I realize there have been other times in my pre-out life when I’ve permanently disposed of items; either because my self-esteem had hit rock bottom and I was in full “I’m a monster” mode, or because I feared their discovery (or both).

I suppose it’s better that I’m being honest about this with myself; but all the same, it’s not a happy set of realizations.

Well woman

A few week’s ago I had an annual check-up; the first in two decades. (Hooray for America’s dysfunctional healthcare system!) I wasn’t particularly concerned ahead of time; but then I received an automated reminder from my provider that had the appointment listed as a “Well Woman Exam”. This lead me down a bit of a rabbit hole as to exactly what that entailed; and then I proceeded to freak the fuck out. Even now, I’m not entirely sure what the problem was - there was definitely some anxiety centered on the more intimate aspects of this kind of exam; but having spent a significant amount in analogous settings (e.g. laser hair removal), I didn’t think this was the issue. (There’s also the matter of my PTSD cranking up in some medical settings; but again, there doesn’t seem to be a particular rhyme or reason as to why and when that fires off... or doesn’t.) A friend suggested that perhaps the issue stemmed from having to speak to my provider, openly and honestly, about my transgender status. My provider is a very nice fellow, and has a fantastic bedside manner (something of a rarity in the US); but even so, transitioning is in many respects a form of magic, and pulling back the curtain on how the trick is performed is not fun. When the actual day rolled around, my heart was racing; and I had to apologize repeatedly to the nurse practitioner for my ridiculous pulse. Thankfully everybody was very understanding; and my provider made the necessary conversations about as straightforward and easy as they could be. (It actually turned out that between various changes in recommended screening guidelines and where I am in my transition, that there’s basically nothing to screen for for the next five years or so; so no poking or prodding there.) I did elect to get caught up on some immunizations while I was there; including getting the HPV vaccine (which is now recommended for everyone, up to the age of forty-five). The administering nurse was perfectly nice; but her technique was slow and methodical (not what you want when getting needled); and the HPV vaccine in particular stung something fierce (which I guess is a known issue with whatever they put in it). In the end, everything worked out okay; but I worry that there will be more of this sort of thing in the near future - I’m out, and as far as the majority of big ticket items are concerned, transitioned; but I feel far from confident in my newfound place in the world as a woman or my ability to pass, and it’s going to be quite some time until that changes.

Current song: "By Any Other Name"

Well... That's not great.

Clothing

It’s fascinating to me how much male and female fashion differ; and how much variety there is in the latter.

It used to be that I would buy shirts; and I would buy pants; and generally speaking, pretty much any shirt would match any set of pants. Getting dressed was limited to randomly picking out one of each.

(To be fair, one can go fairly in-depth with male fashion; and I will be the first to put my hand up and state that I did not do so, as - I now recognize in retrospect - I found the act of shopping for male clothing dysphoric.)

Now I have all these amazing pieces of clothing; but there is so much variety - so much range! - that that any one item will only match a few others (or even none at all)!

I will invariably find myself thinking: “Now I need to buy x to go with this”... And I am loving it!

It's just business

I don't think anyone here needs convincing that there's a bit of a sociopathic streak running through the C-level suites of American business.

I was reminded of this however when I witnessed an executive use the idiom "It's not personal; it's just business" unironically while discussing potential layoffs.

This phrase was purportedly coined by mob accountant Otto Berman, and famously popularized by fictional mobster Michael Corleone (signaling his murderous adoption of the criminal life).

Suffice to say: anyone that uses this phrase as originally intended lacks empathy; that it has gained such traction in America's corporate sector (and as justification for profit over all other concerns) speaks strongly to the moral terpitude of the latter.

Tests

Every six months I have my hormone levels tested. I take a lab order from my endocrinology office, pop into a local clinic, have blood drawn, and see my endocrinologist a week later to review the results.

It was during today’s review that we discovered the lab had missed a test. It was okay - my provider was still able to make sense of the results.

However, I did give the clinic a call to find out what happened. I really, really like them - they are very pleasant to deal with, there’s no waiting, and their pricing is very reasonable.

However, this is the third time something like this has happened; so I gave them a call to figure out what the problem was and what I could do to avoid it in future.

Her: “Hi, this is [the laboratory]. How can I help you today?” Me: “Hi, this is Lauren. I think I might be missing a test result?” Her: “Well let’s see if we can find it for you, Ms. Lauren.”

I already like this person - calling me ‘miss’ instantly melts my heart!

Her: “Can I have your date of birth?” Me: “Sure, it’s- oh god, I just remembered I’m forty again.” Her: *Laughter* Her: “That’s okay! Welcome to the club.”

Seriously, this is one of the best personal interactions I’ve had all day!

Her: “So what test do you think you’re missing, Ms. Lauren?” Me: “Uh... testosterone.” Her: “Oh. Oh!” Me: “Yeah... Probably the last one you would have guessed!” Her: *More laughter*

It took some digging through their records, but this wonderful person helped me figure out that my lab order did indeed have a testosterone reading on it, and that this was overlooked. (Most likely because the lab order is a piece of paper that the blood draw technician is required to read and then re-enter into a terminal; there’s much lost between finger and screen!)

Going forward, I’ll be keeping a much closer eye on which tests were ordered and what was actually entered into the system - hopefully that way nothing else gets missed!