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Transfem
A community for transfeminine people and experiences.
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This community is supportive of DIY HRT. Unsolicited medical advice or caution being given to people on DIY will result in moderator action.
Posters may express that they are looking for responses and support from groups with certain experiences (eg. trans people, trans people with supportive parents, trans parents.). Please respect those requests and be mindful that your experience may differ from others here.
Some helpful links:
- The Gender Dysphoria Bible // In depth explanation of the different types of gender dysphoria.
- Trans Voice Help // A community here on blahaj.zone for voice training.
- LGBTQ+ Healthcare Directory // A directory of LGBTQ+ accepting Healthcare providers.
- Trans Resistance Network // A US-based mutual aid organization to help trans people facing state violence and legal discrimination.
- TLDEF's Trans Health Project // Advice about insurance claims for gender affirming healthcare and procedures.
- TransLifeLine's ID change Library // A comprehensive guide to changing your name on any US legal document.
Support Hotlines:
- The Trevor Project // Web chat, phone call, and text message LGBTQ+ support hotline.
- TransLifeLine // A US/Canada LGBTQ+ phone support hotline service. The US line has Spanish support.
- LGBT Youthline.ca // A Canadian LGBT hotline support service with phone call and web chat support. (4pm - 9:30pm EST)
- 988lifeline // A US only Crisis hotline with phone call, text and web chat support. Dedicated staff for LGBTQIA+ youth 24/7 on phone service, 3pm to 2am EST for text and web chat.
I wouldn't recommend doing this if you have been prescribed oral estradiol (that is, taking the pill you are prescribed daily in a single sublingual dose). The significantly higher bioavailability of sublingual administration can cause incredibly high spikes, and the significantly shorter half life over oral necessitates taking the estradiol 3-4x daily to maintain (only semi) stable levels. This requires a dosage and schedule adjustment; it is not sufficient to simply take the same dose of oral prescription and start taking it sublingually once daily.
Additionally, the stomach does not destroy estradiol. The reason behind the low bioavailability of oral estradiol (and by extension, also oral progesterone) is that it passes through the liver before entering the bloodstream. The liver processes the estradiol before it enters the bloodstream, resulting in significantly less E2 available in the blood. This also presents an additional long term problem that has been well documented at this point: liver flooding. The high concentration of estradiol entering the liver in a short amount of time puts an incredible amount of strain on the liver, and can cause long term liver damage. This is alleviated through sublingual administration.
The sublingual route has its own pros and cons (mainly the incredibly spiky and unstable hormone levels and requirement of frequent 3-4x doses per day), and it is not advisable to recommend someone take the medication their doctor prescribed them in a manner that is not consistent with their prescription. OP's prescription was written with the intention of it being taken orally, thus the dosage has been planned for that, not for sublingual.
I took mine sublingually for awhile, but I am now switching to injections, as I am not happy with the dosage frequency. I've missed doses because I also struggle with ADHD, and it's resulted in me feeling really off when my levels get too low. I would never do oral, as it isn't an effective way of taking estradiol. It's incredibly inefficient and presents its own health issues. Injections are the most convenient and most stable option (although I haven't looked too deeply into the implants, those may potentially be more stable, but estradiol cypionate allows me weekly injections that peak at ~175ng/dL and trough at ~135ng/dL, which is very stable inside my target range), as well as being quite cheap and well studied.
TL;DR: Either talk to your doctor about adjusting dosage and scheduling for sublingual administration, or do the due diligence of reading about it. I recommend the meta-analyses from Transfeminine Science. The dosage and scheduling need to be adjusted if switching to sublingual.