I went to Planned Parenthood for an STI check, and I, a trans woman, was asked when I last menstruated. I had a light chuckle before clarifying I was a trans woman, and she said "Oh, guess we don't have to worry about that then!" Felt incredibly affirming, because I passed well enough even after 15 minutes of conversation that she didn't realize I was trans! Especially funny because it was at Planned Parenthood of all places, so she's obviously dealt with a lot of trans women.

I struggle to think I "pass" to other people, but I've had these kinds of things happen enough that I'm maybe starting to believe that cis people really can't tell lol.

cross-posted from: https://lemmy.blahaj.zone/post/41790661

So, without context, this question sounds really strange. I've been on DIY HRT since the 15th of January, 2025 (started on estradiol valerate pills with cyproterone acetate). I switched to estradiol cypionate injections on the 6th of May, 2025, and have been using it since then. I've dialed in a stable EC dose for monotherapy that has given me adequate testosterone suppression (this month's labs show 15ng/dL). I've been getting regular bloodwork, and have an exact timeline of my dosage adjustments since I started HRT. I'm also in the US, since that's likely relevant.

I now want to start progesterone, and I want to just get a prescription for 2 reasons: price, and a letter of support for surgery showing I've been on HRT 2+ years by the time I get surgery (for insurance coverage). But if I'm to get a progesterone prescription, I'd also be getting an estradiol prescription. The problem is that I'm stable on EC, but even if my insurance were to cover it (under the brand name Depo-Estradiol, it's a Tier 3 drug since it doesn't have a generic), it would be $100 for a 90 day supply (3 vials). Uninsured, it's $250/vial, and I find it likely it won't be covered, as EV is a Tier 1 covered drug (they'd want me to take that instead because it costs the insurance less for a generic).

I have concerns with starting EV, because my dose would have to be dialed in again, and my estradiol levels would be far, far more erratic. EC has a much longer half-life than EV, so it keeps hormone levels much more stable. With EV at an "equivalent dose" (keeping the average over the week the same as the EC I'm currently on), I'd have much higher peaks, and much lower troughs, and I'm concerned that it will worsen my mood swings (I'm bipolar, but have been doing better with medication). There's also the downside that Depo-Estradiol is only available in 5mg/mL concentration, so I'd be injecting 8x more volume than my 40mg/mL DIY vial.

So, if I were to get a prescription, here are my options (in no particular order):

• Switch to EV and be forced to dial in the correct dosage to adequately suppress testosterone while minimizing supraphysiological serum levels of estradiol
• Get an EC prescription and risk no coverage (and pay as much for 3 months as I do for 2 years DIY if it is covered)
• Get an EV prescription and fill the drug, but keep taking my EC
• Get an EV prescription and don't fill it while continuing EC
• Get an EC prescription and don't fill it while continuing DIY (because I don't have that kind of money)

I believe the insurance will not be checking my prescription history, since I could choose not to use insurance at all for it; they just ask for a letter from my prescribing provider. I'm also aware that in the US, providers can check if you've filled a prescription (and sometimes even be notified when you fill/decline to fill a prescription). I'm apprehensive to discuss this with the provider I'll be seeing, as they may become suspicious that I'm not following my treatment regimine, and thus may deny me a letter when the time comes.

So I'm kind of at a loss for what to do here. The option I feel most comfortable with is filling EV, but continuing EC, as EV is really cheap (<$10/month). That also leaves a trail of prescription history. But my labs might show unexpected serum estradiol levels, so my dosage may be adjusted, and then I may get questions about why my serum estradiol levels didn't change when the prescribed dosage changed. I also feel like throwing out good vials of EV is a waste. So my next preferred option would be to get prescribed EC, and not fill it because it's so expensive. That way, my bloodwork lines up, but again, prescription history wouldn't match up.

I just feel a little overwhelmed.

So, without context, this question sounds really strange. I've been on DIY HRT since the 15th of January, 2025 (started on estradiol valerate pills with cyproterone acetate). I switched to estradiol cypionate injections on the 6th of May, 2025, and have been using it since then. I've dialed in a stable EC dose for monotherapy that has given me adequate testosterone suppression (this month's labs show 15ng/dL). I've been getting regular bloodwork, and have an exact timeline of my dosage adjustments since I started HRT. I'm also in the US, since that's likely relevant.

I now want to start progesterone, and I want to just get a prescription for 2 reasons: price, and a letter of support for surgery showing I've been on HRT 2+ years by the time I get surgery (for insurance coverage). But if I'm to get a progesterone prescription, I'd also be getting an estradiol prescription. The problem is that I'm stable on EC, but even if my insurance were to cover it (under the brand name Depo-Estradiol, it's a Tier 3 drug since it doesn't have a generic), it would be $100 for a 90 day supply (3 vials). Uninsured, it's $250/vial, and I find it likely it won't be covered, as EV is a Tier 1 covered drug (they'd want me to take that instead because it costs the insurance less for a generic).

I have concerns with starting EV, because my dose would have to be dialed in again, and my estradiol levels would be far, far more erratic. EC has a much longer half-life than EV, so it keeps hormone levels much more stable. With EV at an "equivalent dose" (keeping the average over the week the same as the EC I'm currently on), I'd have much higher peaks, and much lower troughs, and I'm concerned that it will worsen my mood swings (I'm bipolar, but have been doing better with medication). There's also the downside that Depo-Estradiol is only available in 5mg/mL concentration, so I'd be injecting 8x more volume than my 40mg/mL DIY vial.

So, if I were to get a prescription, here are my options (in no particular order):

• Switch to EV and be forced to dial in the correct dosage to adequately suppress testosterone while minimizing supraphysiological serum levels of estradiol
• Get an EC prescription and risk no coverage (and pay as much for 3 months as I do for 2 years DIY if it is covered)
• Get an EV prescription and fill the drug, but keep taking my EC
• Get an EV prescription and don't fill it while continuing EC
• Get an EC prescription and don't fill it while continuing DIY (because I don't have that kind of money)

I believe the insurance will not be checking my prescription history, since I could choose not to use insurance at all for it; they just ask for a letter from my prescribing provider. I'm also aware that in the US, providers can check if you've filled a prescription (and sometimes even be notified when you fill/decline to fill a prescription). I'm apprehensive to discuss this with the provider I'll be seeing, as they may become suspicious that I'm not following my treatment regimine, and thus may deny me a letter when the time comes.

So I'm kind of at a loss for what to do here. The option I feel most comfortable with is filling EV, but continuing EC, as EV is really cheap (<$10/month). That also leaves a trail of prescription history. But my labs might show unexpected serum estradiol levels, so my dosage may be adjusted, and then I may get questions about why my serum estradiol levels didn't change when the prescribed dosage changed. I also feel like throwing out good vials of EV is a waste. So my next preferred option would be to get prescribed EC, and not fill it because it's so expensive. That way, my bloodwork lines up, but again, prescription history wouldn't match up.

I just feel a little overwhelmed.

I understand if this post is a bit off topic, but I am going to a gay bar with the intention to meet mostly other queer women, and I'm specifically looking for advice from other lesbians, so I thought it would be relevant.

Okay, so I'm planning on going out to a gay bar soon just to like...meet some other queer folks? I have a long drive to the closest one (about half an hour to get to the city if there's no traffic), but I haven't gone out anywhere just to meet new people in...many, many years, so I'm looking for some advice (Side tangent: I'm sober and would only be drinking mocktails, so no, I'm not gonna be any danger driving).

My main concern is just how I even start to talk to people/approach anyone. I feel like sitting at the bar, I could really only interact with a couple people at a time (most of whom are probably out with friends anyway). Would anyone approach me if I sat alone at a table/booth? How do I look approachable? I feel uncomfortable approaching, say, a group of other people, because I don't want to intrude. Honestly the only experiences I have with bars is reading books where the characters go to a bar, so I don't know what to actually expect in reality.

I suppose I'm just very unsure what to expect/how to engage with the space. And I should probably clarify: I'm really just looking to meet new people/potentially make friends, not go home with someone. I'm demisexual, so I really don't see that happening, although I certainly wouldn't mind if other women flirted with me.

Is there any advice any of y'all have about how I should go about meeting new people there?

So, I'm gonna preface this by saying that I know my own sexuality is for me to define, and me alone. I'm just looking to hear some outside opinions to hear more than just my own internal voice.

For quite some time, I considered myself a lesbian. I only really felt like I could be attracted to women or perhaps some enby folks; men for me felt completely out of the question. I'm demisexual (perhaps demiromantic as well, but I haven't really been in situations where I could test that out), and so I need someone that I can connect with emotionally. For me, that's always been women, as we just get each other on a level that I have never found with men, and with an emotional maturity that's lacking in the men I've met in my life.

Then I met a trans man that I really hit it off with, and after getting to know each other really well, I fell into a situationship. At that point, I considered that I must be bi, because I was having feelings and open to doing things with a man. But now that I've been out of that situationship for quite some time, I can't help but think that despite our initial emotional connection, him and I didn't really connect the way I wanted. It was more trauma bonding than anything, really. Of course, that was clouded by the fact that he was my favorite person at the time, when I didn't realize I had BPD, so any connection felt amazing in the moment. I'm not sure if anything would have ever happened if it weren't for my BPD.

I've been beginning to think that I'm not sure about the bi label anymore, because for the most part, my lack of attraction to men hasn't really changed, at least not on the emotional/romantic part. It feels like he was an exception, which feels very strange to me. I mean, I have no fear in who I'm attracted to, so I don't feel like that's a denial response, I think more than anything I'm still just figuring out who I am? Or maybe my BPD led me into a situation that defies my sexual or romantic orientation? I think the way I'm most comfortable identifying myself is that I'm romantically a lesbian, but sexually bi, though my being demisexual kind of means I don't see myself ending up in a situation in the future where the distinction matters.

Does that make sense? I just wanna hear someone else's thoughts on the matter because I've had a tough time fully resolving my thoughts by myself the past 5 months.

If anything, this is kind of just a vent post.

For context, see my initial post here.

I've made a plan with my therapist, and I'll be admitting myself. I've also been advised that given some recent behaviors and events, it's in my best interest to be evaluated for bipolar disorder or borderline personality disorder (yay ;-;). Whatever happens, I'm mentally prepared to step through the doors and allow myself to seek treatment. Maybe all I need is a change in medication, or a place where I feel safe enough to process my emotions and work through them. Regardless, I understand what to expect, and I'm confident that it's what I need right now. I can't get by just letting things happen as they are currently, because I'm only continuing to get worse without proper treatment. I'll likely make a new post when I'm discharged about my experience. See y'all on the other side.

If any trans women here have been admitted to a psychiatric ward, I'm looking for advice/experiences. My main concerns are the following:

• Losing access to DIY HRT
• Inability to shave, or is I can shave, having to be watched while doing it
• Being strip searched
• Transphobia from other patients and staff
• Food

Context - I live in a blue part of Washington State, fairly progressive, and I'm working with my therapist to get a personal recommendation for a facility (she mostly treats LGBTQ+ patients, so I'll be asking specifically about that).

I currently take Estradiol Cypionate by injection, once per week as monotherapy. I've used a tool to estimate my E levels, and I've determined I could likely go 14 days before things get bad (below 100pg/mL), but obviously that would not be an ideal experience for me hormonally. I just tested my levels last week and my E came back significantly higher than I expected (could maybe go longer than 14 days), and my T levels were incredibly low (16ng/dL). So much so that I was planning to reduce my dosage this week, though I think I'll wait to reduce until after my stay in case it lasts longer than I expect. I am almost 100% not going to be able to get them to administer my DIY hormones to me, but if anyone else has had this experience, please comment. I think I've rationalized it enough that I wouldn't be devastated if I were denied access (or more accurately, when I am), assuming my stay isn't longer than 2 weeks. I'm worried that they'll see them and throw them away instead of just locking then up, which would be a big problem because shipping would take about 2 weeks and I don't even have the money for it right now.

However, I am quite concerned about shaving. Since I'll be a voluntary admission, I've heard there's sometimes leniency for supervised face shaving, but I'm also worried about being able to shave my body. Granted, I'll be wearing clothes that cover up all my skin, but the feeling of being unshaven is incredibly dysphoric for me. I could live with it, except for genital hair. I unfortunately have extremely sensitive skin, and I'm pre-op, so if I don't shave for a few days, I will get intense chaffing and irritation, which is the most dysphoric thing I have ever felt in my life. I would be in genuinely severe mental distress having to live like that. But even if I were granted some exception to let me shave there...I'd have to be supervised. And I'm having a really hard time trying to mentally prepare myself for someone watching me shave naked. Especially because I don't know if I'll be allowed to ask that it be a woman that supervises. I've been told it varies wildly from place to place for strip searches, and I assume it would be the same case here.

And then...there's being strip searched. Again, no idea if I can decide if a man or a woman watches me strip and reveal every square inch of myself, which is horrifying. I would feel mildly less mortified if my genitals matched my gender identity, but...I'm not there yet.

The fear of experiencing persistent transphobia while I'm there is also incredibly present for me, especially given that I'm nowhere close to passing. This will be my first time publicly presenting femininely but I think it's what's best for my mental health because it's exhausting having to hide myself in person when I have been open online for almost a year now, and on HRT for 5 months as of today. The only thing holding me back has been living with transphobic parents with a long history of abuse. There are two angles to the transphobia fear. The first is that there may be other patients admitted who are transphobic, and in severely deteriorated mental states, and the second is that staff could be transphobic, and they hold an immense power over me as a patient. Both are terrifying to me, and I don't know how I would deal with it.

And perhaps something more inconsequential is food. I have a milk allergy, so I'd need that to be accommodated, and I'm also autistic so I have a lot of food triggers. I'm worried about not being able to eat enough, to be honest.

None of these things are going to prevent me from admitting myself, I know I need help right now, and I need serious intervention to be able to recover and to keep myself safe...from myself. I'm not going to get into the details because that isn't what this post is about, I've just been having some anxieties about what it's going to be like, and the chances of me leaving the hospital severely traumatized.

If any of you have been through it, what has it been like for you? Any advice?