Possible new way to inhibit sex-hormones discovered

Late in December last year I read an interesting article in Science Daily that in the future might have some interesting relevance for transsexual people.

Many know that one way of inhibiting production of reproductive hormones are by injecting a GnRH antagonist. GnRH in itself starts a cascade of reproductive hormones, a GnRH antagonist inhibits this reaction.

Ten years ago a hormone called GnIH (Gonadotropin Inhibitionary Horomone) was discovered in birds. The main function of this hormone is to inhibit function of GnRH. It has also been identified in several different mammals.
This hormone has now also been discovered in human brains.

It has been suggested that GnIH might be of use in contraceptives.

I would like to suggest that this might be useful in HRT for transsexuals, as a way to inhibit the natural production of reproductive hormones.  This will of course be dependent on if it is even possible and if the potential side effects are less than the alternatives.

Regardless of that, this is a fascinating finding.

Source: Science Daily, Press release


Effects of HRT on hair growth

I have not updated this blog for three weeks, oh well. It wasn't meant to be updated regulary.

A few days ago when doing som research about how the growth of hair change due to HRT I found this really nice study "Effects of Sex Steroid Deprivation/Administration on Hair Growth and Skin Sebum Production in Transsexual Males and Females".
There seem to be few studies about how HRT affect hair growth, and I was lucky to find this study from 2000. Best of all, it is free to read.

I will only focus on a part of this study, they did study more than hair growth but hair growth in MtF TS are the part that interrests me. Acne and sebum production are not as relevant from a personal point of view.

Twentyone MtF and 17 FtM TS had their hair growth measured before and after 4, 8 and 12 months of HRT at which point the study ended. Hair was measured using the Ferriman-Gallway score where forearms and leg skin was not measured since these are nonhormonal. They were presented seperatly.

The relevant results are presented in table 1 and there a many interested points to make.

First I note the top three lines about body compostion. There is a significant rise in BMI and total body fat. Weight gain are one of the normal side effects when on HRT. Lean body mass on the other hand show no significant change, muscle loss is normally associated with HRT for MtF TS and would habe been noticed here. On the other hand, change in muscle mass are reported to be slow and might not give a significant result in only twelve months.

The body hait growth are also very interesting. Over twelve months the Ferriman-Gallwey score halved. A change from 21 (19-25) to 10 (8-13.8) is really significan, there was also no noticable plateu at the end indicating the hair growth will continue to lessen for some time.
Hair on the legs and forarms did also have a significant change of growth, even due these part are considered nonhormonal. Leg hair score had a significant change from 3 (3-3) to 2 (2-2) and forearm hair-score from 2 (2-3) to 2 (1-2).

When one search for information on the web about how HRT affect facial hair one most often find that there will be no change, possible somewhat finer hairs and slower growth. This is often considered a "fact".
The most fascinating information in this study is that this "fact" is not true.

At four months there has been a significant drop in hair diameter, 90 (70-116) to 67 (56-94) µm. At eight and twelve months there was no further change.
The hair growth rate on ther other hand show a significant drop over to complete twelve months, 0.31 (0.28-0.38) to 22 (0.17-0.29) mm/day. The rate seem to taper of somewhat at the end, but a longer study would be needed to make certain.
Hair density did also show a significant drop, 32 (27-41) to 18 (15-23)  hairs/cm^2. This measurement did not show any form of plateu at the end, indicating a further drop.

Measurements of facial hair was only done for the cheek, which might not be relevant for the chin or the upper lip.
A further study with more measurements over a longer time would be needed. If someone knows if this has been done, plase notify me, it would be a interesting read.


Prevalence of transsexualism in New Zealand

In 2008 a study was published about the prevalence of transsexualism among New Zealand passport holders which was rather interesting.

Prevalence of transsexualism are generally thought to be in the range 1:10 000 to 1:30 000, with some studies references even lower number at about 1:100 000.

In New Zealand it is possibly to change the gender on the passport to an X if you send in a statuary declaration stating how long you have lived as the opposite sex and that you have changed your name to something more appropriate of the opposite sex. This study got the number of changes to the gender-field on all passports and how many do hold a passport in New Zealand.

Their results are interesting, they found that the prevalence of transsexualism among passport holders are 1:6364, which is atleast twice as high as most other studies.
They also had a rather large difference between MtF and FtM TS, 1:6. That is comparative to Australian studies but does not match any other modern study of prevalence of transsexualism.

There is several things to consider in this:
  • About a third of all passport holders had just a X, there were no record of any earlier or later passport with a different gender. This may account for some of the rather high difference in prevalence between MtF and FtM.
  • If a person has gone through SRS without applying for an X in their passport, the gender will be changed from M->F or F->M without any stop at X. These are not taken into account.
    This would imply a higher prevalence.
  • I would think that transsexuals are less likely to get a passport, and some transsexuals do not want an X in their passports and wait for SRS to change the gender in their passport.
    This would also imply a higher prevalence.
  • Is it possible for crossdressers to change to a gender-neutral name and apply for an X in their passport? To make it less a hassle to travel either as presenting as female or male?
    This would lower the prevalence.
The last point is not considered in the study, probably due to good reasons.

Most studies of prevalence of transsexualism only take into account those that have started HRT, are seeing a gender therapist or have gone through SRS, compared to some definition of relevant population.
In most case I find these only in part relevant and interesting. Then only as a lower bound on the prevalence.

What I want to see is some studies of how many have been, are and will be transsexuals. This is probably very hard, maybe close to impossible but some educated guesses with some basis in facts should be possible.


Changes to my body-measurements due to HRT

As a companion to my posts about my trans-history and year-collage this post will be focused on the changes to my body-measurements due to HRT.
I started to measure my body after four weeks, at which time I already had a surprising growth of breast. I got two to three centimeters just in a few weeks.

Since I live in Sweden everything is measured in centimeters.

First I have these two graphs of my breast development. The left graph is the measurement at bust-level and under bust, the right graph is the difference between these measurements.

If you ignore the plateau in the middle of the graph I have grown one centimeter every three or four weeks. That is really good results from HRT.
The plateau is due to me trying to halve my dose of cypro and therefore losing all of the feminization effect.

Secondly I have put together two graphs of my waist and hips. To the left is the graph of those measurements, and to the right the ratio of these.

These measurements are relevant since I have neither lost or gained any weight during HRT and therefore the changes are probably due to bodyfat redistribution thanks to HRT.
I have lost four centimeters of my waist and gained five centimeters both ar the hips and tighs.

My waist-hip ratio which at the beginning was close to the male norm of 0.9 slowly crept closer to the more female norm of 0.7. Already halfway there!


Year-collage of myself

As a companion to my earlier post about my trans-history I decided to also post a collage of photos of myself. Each photo is taken in the beginning of every month and is sorted by month.

This is especially interested to make the changes to myself and my transition visual and maybe more real to readers.

The first photo is maybe the most interesting for more casual readers, is taken very early. It was just less than two weeks after I understood that my gender identity not necessarily was male and I have yet done anything to change my face.
That is my old male look.


Cyproterone acetate and liver damage

Cyproterone acetate (CPA) are in Europe often used as an antiandrogen by transsexuals on HRT but there is not much information about which side effects are associated with doses typical for transsexual women.

CPA are often used in treatment of prostate cancer with severe side effects that sometimes lead to death.[1] Most often due to severe damage to the liver. It is important here to note that a typical dose of CPA to treat prostate cancer is 200 - 400 mg/day.
There exist some studies where prostate cancer patients received a lower dose of CPA with resulted in elevated liver enzyme concentration but where the treatment was not discontinued due to side effects in any patients.[2]

A more typical dose for transwomen are 50 - 100 mg/day which are if possible lowered after a year. This amount of CPA seem to be associated with a much lower risk for damage to the liver[3], som studies has even found the risk to be no higher than for the general population.[4]

[1] Savidou I et al "Hepatotoxicity induced by cyproterone acetate: a report of three cases" (2006)
[2] Hinkel A et al "Cyproterone acetate in the treatment of advanced prostatic cancer: retrospective analysis of liver toxicity in the long-term follow-up of 89 patients" (1996)
[3] Kaiser E er al "Liver structure and function during long-term treatment with cyproterone acetate" (1987)
[4] Watanabe S "Follow-up study of children with precocious puberty treated with cyproterone acetate. Ad hoc Committee for CPA" (1997)


My hormonal regime

Which hormones do I take in my HRT?

I did start out not much different from where I am now, I have always been more or less on the same regime.

At the moment I take:
  • 50mcg 17b-estradiol as transdermal gel two times a day
  • 50mg cyproterone acetate once a day
I find this regime very effective and pretty safe, the most safe one I have found so far.

More will be written about potentially sideeffects in the future.

I have not changed my regime much during these seven months since I began.
In the beginning I used 50mcg transdermal patches, changed twice a week. This was after two months changed to 100mch patches. These patches were large, 8x8cm! After just a month I gave up and switched to the gel. I find gel most practical and have been happy with it for several months.
I also started with 50mg CPA/day. It was really effective, so I tried to cut back the daily dose to 25mg but noticed rather fast that the feminization effect had disappeared. 50mg/day seem to be perfect for me.

My trans-history

The logical place to start is with my history as a transsexual.

From birth I had an ok life. It was not bad, but it was not really good either. I was mostly without friends during my school-years, in the last few years of school I discovered BBSes, fidonet and later internet. This is where I got most of my closest friends in my late teens and early twenties.
My third decade of life was full of work, I tried to study several different subjects and had a few serious girlfriends.

Everything was ok, I could live with it. But not much more than that.

Then late in 2008, 21:st December to be precise, I sat down and thought about my life, about why it never was that great, what was wrong?

The only thing that I could think of was my gender identity. I have never been comfortable doing typical male things and has most often had female friends and was much more comfortable hanging with them.
Maybe I was a crossdresser? (In Sweden we really say transvestite)

Everything after that was fast. In a year I went from not-a-clue to full-time-and-on-hormones.
I will just make a quick time line from then to now. Some things I may flesh out in future entries.
  • Dec -08: I bought my first clothes for women online and started to try it on.
  • Middle of Jan -09: I started my Swedish blog. And started to come out to friends as a CD.
  • Early Feb -09: Went to my first trans-meeting. Switched clothes there, met up with a friends and drove home in female clothes. I turned 31 years old about here.
  • Early March -09: Started to come out to family as a CD.
  • Late March -09: Realized I was transsexual and not CD.
  • Early April -09: Told my last close family about me being TS.
  • Late April -09: Went to Scandinavias largest trans-convent. Also probably my last time presenting as a male when meeting family and friends.
  • Early May -09: Talked to a psychologist and got a referral to TS-care. Told it was nine months until I could get a time, total waiting time for first visit will probably be close to 14 months.
  • Mid May -09: Came out at work. Last time presenting as a male outside of work.
  • Late May -09: Started on HRT, self-medicating. Was godmother for my brothers daughter.
  • Last of June - 09: My last day ever presenting as a male, even at work.
Everything after that has been more or less normal life, but know as a female instead of as a male.
And for the first time in my life I am really happy and satisfied.

This is my new english blog

I have for some time thought about starting a blog written in english, parallell to my current blog in swedish. Today I finally decided to at least create this blog, now with the first step taken it will probably be easy to update this blog from time to time.

My Swedish blog is most focused on my private life. About 80-90% of all entries are about personal stuff, what I did today, what I got on my latest shopping spree, what I ate for dinner and so on. Interspaced with this there are a few more informative entries, trans-related science or my own deeper thought about trans-issues.
The focus of this blog will lean more towards the second part, facts, information and science. But I will ofcourse write a lot of more personal entries also, but that will not be the focus.

English is not my native language, so I will in advance apologise if I am not always clear in how I write. I also see this as a way to enhance my written english.