As part of my transition, bringing my body in line with my gender identity was crucial for me, and so last year I opted to start hormone replacement therapy (HRT), which changed my life in the most amazing ways.
I had been living as a woman for most of last year and had begin to feel like I was ready for the next step, hormones. This involved a massively long process at Groote Schuur Hospital (GSH). In order to access hormone treatment through the state, you need to see a number of medical professionals from psychiatrists to endocrinologists. GSH has a number of checks and balances to make the treatment safe while acting in the best interest of the patient.
Not to go into too much detail about the medicine, here’s a quick summary…
At the onset of puberty, hormones are produced and released into the body. For males, they grow taller, grow facial hair, they start producing sperm, voice deepens, gain muscle mass. For females, their hips widen, their menstrual cycle begins, skin softens, they develop breasts.
All these changes are a direct result of the particular sex hormones present. Males produce androgens (hormones involved in the development of secondary male sex characteristics) which includes testosterone, and females produce estrogen.
HRT aims to make you feel more comfortable in yourself, both physically and psychologically, by replacing the naturally occurring hormones in your body with the sex hormones of your desired gender. This is usually the first course of medical treatment provided to trans people.
Gender DynamiX have a number of digital booklets available on their website about transgender rights, primary healthcare, and sexual and reproductive health. Check out their Transgender and Gender Non-Conforming Health Care guide.
It is important to note that HRT is not compulsory or essential in transitioning as not all trans people feel the need for medical or surgical intervention, and some don’t feel the need to transition at all. These choices in no way lessens anyone’s transness. They are all valid identities and ways of being.
For me, HRT has completely changed my life. I am so much more at ease with myself and how I feel about my body. The changes are slow, but massively noticeable (to me anyway).
Since I’ve been on androgen blockers and estrogen (both are tablets I take daily) my skin is so much softer, like super smooth! It’s far less oily and I now have ZERO pimples (I used to get them so often). Estrogen also helps with fat redistribution in a more feminine shape (less fat on abdomen and more on hips, thighs and butt), so a nicer booty for me! I’ve lost so much muscle mass it’s ridiculous (shopping bags are so hard to carry now). Also, I have BOOBS! They’re painful as fuck though because it’s pretty much like going through puberty again (this time as a girl, obvs).
By far my favorite thing is the way the estrogen has changed my brain chemistry. I’m somehow a lot more connected to my emotions and experience them so much more intensely. Like really intensely. Things affect me now a lot more than they used to. And they mean different things now. It’s hard to describe, but I’m able to process and feel things in a completely new and different way. Living as a boy was so difficult because I was rarely able to cry or process my emotions by just feeling them. I only discovered this after being on hormones when I was finally able to do those things. And so my issues around my transness became even clearer and I was able to work through that.
It’s a really interesting position to be in, having experienced both “man brain” and “woman brain”. It was really difficult in the beginning because all the coping methods and strategies for dealing with emotions were all for “man brain”, and now I’m having to develop new ways of dealing with the way I experience things.
While I am able to access this treatment, many trans people remained blocked from these essential medical services as there are only 2 transgender specific state facilities in the entire country, one in Cape Town and the other in Pretoria. This makes it incredibly difficult for people living outside those cities to access treatment, and even more so for those living in poor economic conditions. You can read more about this at DAY 12: RIGHT which speaks to some of the issues around access faced by trans people.
Hormone replacement therapy has made a massive impact on my quality of life. And I’m so grateful to be living more comfortably in myself.
Thank you, estrogen.