Medical Transition - the mechanics of it all - medication
if you have read my other posts about medical transition you 'll be aware that one of the results of my private sector assessments was the decision to start medical transition proper.
for transgender women there are two main thrusts to medical transition
1. causing feminisation
2. preventing and to some extent reversing masculinsation
Point 1 above is relatively easily achieved by administering Oestrogens, typically as pills or transdermal patches / gels.
point 2 can be more complex, in that some people's testosterone production is well suppressed by a therapeutic dose of Oestrogen but in some people it's not. If that is the case the current UK practice is to use a GnRH analogue to fool the body's self regulatory systems into shutting down production of sex hormones.
Sheffield's core guidelines for hormones for trans women
NHS national care pathway
I don't have a link to an internet copy of CX's guidelines or an electronically shareable copy of the document Dr Seal works from, but it along with most of the UK GICs is all pretty similar to the document from Sheffield I link to above one of the main differences being choice of GnRH analogue
for transgender women there are two main thrusts to medical transition
1. causing feminisation
2. preventing and to some extent reversing masculinsation
Point 1 above is relatively easily achieved by administering Oestrogens, typically as pills or transdermal patches / gels.
point 2 can be more complex, in that some people's testosterone production is well suppressed by a therapeutic dose of Oestrogen but in some people it's not. If that is the case the current UK practice is to use a GnRH analogue to fool the body's self regulatory systems into shutting down production of sex hormones.
Sheffield's core guidelines for hormones for trans women
NHS national care pathway
I don't have a link to an internet copy of CX's guidelines or an electronically shareable copy of the document Dr Seal works from, but it along with most of the UK GICs is all pretty similar to the document from Sheffield I link to above one of the main differences being choice of GnRH analogue
Dr Seal recommended Decapeptyl (Triptorelin) to my GP, where Sheffield's initial recommendation is Leuprorelin.
Generally the aim is to get Oestrogen levels to 300- 600 pmol/l and to get testosterone levels under 1.8 nmol/l these are typical values of a cisgender woman in the follicular phase of her cycle.
How you get there is generally by trial and error titrations, starting from 2mg / day and then test bloods every 8- 12 weeks to see what the levels are doing , while my oestrogen levels were coming up nicely my testosterone levels stuck in double figures - hence the decision to commence a GnRH analogue in December 2018.
Generally the aim is to get Oestrogen levels to 300- 600 pmol/l and to get testosterone levels under 1.8 nmol/l these are typical values of a cisgender woman in the follicular phase of her cycle.
How you get there is generally by trial and error titrations, starting from 2mg / day and then test bloods every 8- 12 weeks to see what the levels are doing , while my oestrogen levels were coming up nicely my testosterone levels stuck in double figures - hence the decision to commence a GnRH analogue in December 2018.
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