you're so pretty it hurts 💔

If you were denied a hormonal blood test, it could be because the doctor didn't think there was sufficient reasons. Do you have significant facial hair, male-pattern baldness, dark hairs growing on your chest and belly, etc.? What is the evidence you actually have that you need an anti-androgen?

For context, when I had some cysts between my ribs as a teenager, the doctors took one look at me and immediately ordered hormone blood labs to check my estrogen because I looked feminine (soft skin, light body hair, not much facial hair for my age, larger breasts than boys my age, etc.). Doctors generally will run labs if they believe there is a credible reason to do so - all this tells me is the doctor you saw didn't think there was justification for it.

While doctors are not always right, they're also not always wrong; sometimes an issue like this could be a mental health concern and not a physiological issue, to be worked on in therapy.

It would be nice if you had a doctor who could explain to you why you don't need your hormones checked, but if they didn't think you needed it, one possibility is that you just don't have the typical signs and symptoms of someone with an endocrine disorder (or intersex condition).

maybe do a spin cycle class at home, hooked up to a generator?

just an example: if you look like a man because you have estrogen insensitivity, buying and taking extra estrogen won't help at all and you're wasting money and taking needless risks.

Cis people have more diversity in their bodies and the way they look than most people realize, and cis women are confronted for being "trans" in womens' restrooms all the time, way more frequently than trans women are, because there are way more cis women who don't look like the perfect ideal of feminine beauty than there are trans women.

I'm not denying your suffering or distress, but I am saying that it's entirely possible nothing is medically wrong with you and you are well within the natural diversity of human bodies.

Spironolactone is a pretty weak anti-androgen and will also cause lots of side-effects, some of which can be life-threatening. You should absolutely be monitored by a doctor when taking spiro, it's not an exaggeration to say you are taking your life into your own hands. Spiro is not a typical part of a DIY regimen for trans women (for lots of reasons, but the medical risks are one of them).

The protocols and treatments designed over a century now for trans women are rooted in empirical evidence and studies that evaluate the risk / benefit of HRT and other interventions like surgeries, and they absolutely do not apply the same to cis women - in fact, the empirical evidence we have about body dysmorphia in cis women is exactly the opposite of the findings for trans women (i.e. for cis women interventions like surgery generally don't generally improve outcomes or reduce distress or symptoms, and meanwhile they increase risk significantly; there isn't even a protocol for HRT in non-menopausal cis women because there is absolutely zero reason for it, HRT is only needed when your body doesn't produce enough of its own hormones - and we have no evidence your body isn't producing enough estrogen let alone that it's producing so much testosterone that you need an anti-androgen).

It's a pseudo-science myth perpetuated by influencers and grifters that "more estrogen = more feminine". The informed consent paperwork I signed to take HRT as a trans woman specifically says that taking more estrogen increases risks and does not increase feminization. And worse, unlike a trans woman whose body does not produce female levels of estrogen, your body likely already produces estrogen in more than sufficient amounts for your body's functioning; it's very unlikely you need more estrogen, and taking extra estrogen like this can increase your risk of breast cancer as well as disrupt your monthly menstrual & hormonal cycles.

Your body will also seek to maintain homeostasis and will likely reduce the amount of estrogen it produces in response to taking exogenous estrogen (the same as taking any other hormone your body naturally produces - e.g. if you took melatonin every night, eventually your body will just produce less melatonin and rely on the exogenous melatonin, you essentially form a "tolerance" over time that brings you back to where you started), so again you're wasting money and risking your health for no added benefit.

I'm very open and happy to answer questions like this publicly, but thank you for your sensitivity 😊

I took 50 mg of bica once a day for two months at the very beginning of when I started E.

During that time my E dose fluctuated a lot, but I was injecting estradiol valerate in oil subcutaneously, averaging a little more than 5 mg / week total (I think a lot of that time I was taking ~2.5 mg twice a week).

When I quit bica, I increased my dose to 5 mg every 4 days or so, but kept tweaking my dose chasing more efficient and reliable T suppression. (Usually a day or two after trough I would have physiological signs of T with corresponding mental health symptoms like anhedonia, depression, anxiety, parasomnias.)

For context, when I first started HRT I was pretty neutral about my genitals and thought I had no dysphoria, but once I socially transitioned and started E, my experiences shifted (I think I had suppressed feelings from before, e.g. I experienced dissociation commonly during sex but always understood it as something other than dysphoria - now I understand it was probably caused by gender dysphoria, as a vaginoplasty has significantly improved my dissociation and other symptoms during sex).

So, almost from the start, I had it as a goal to maximize penile atrophy, and I had little interest in erections.

All that said, I suspect the combination of bica and estrogen will absolutely risk penile atrophy, and I definitely experienced atrophy on bica + E.

Atrophy is what impacts the ability for the phallus to be erect, and in particular the spongey material to hold blood and stay hard enough for penetration. What happens is that the spongey material is a "use it or lose it" situation, and testosterone dominance causes the phallus to become erect while you are sleeping ("morning wood" is just a form of what is formally called nocturnal penile tumescence - a fancy way of saying a night time erection).

Those erections maintain the ability of the spongey material to hold blood in the future, and without involuntary night-time erections, there is a loss of that function (it can't hold as much blood, etc.).

Your mileage may vary, as is usual with HRT, but my experience with penile atrophy was that after I started HRT, I stopped having those involuntary erections when I was sleeping (mostly) and I noticed when my penis became erect, it just wasn't as "hard" as it could be before. This was maybe a bit like when you're not fully aroused when first forming an erection, but instead you couldn't get any more erect. In terms of penetration, this made it harder to feel safe when penetrating, because a semi-hard penis can sorta bend. That said, I was able to generally make it work and penetration was possible if not as safe or easy as before when the penis could get harder - but I also formed a preference for not penetrating over time, so eventually that just wasn't so relevant and I just stopped using my phallus for penetration and started treating it more like a clit (e.g. I liked to tuck it into underwear so I couldn't see it and so it would be held to my body, and then using a vibrator on it through the underwear - that helped with of the distress I increasingly felt).

I actively wanted to cultivate penile atrophy, but in the end I wasn't able to prevent erections, and my erections remained semi-hard (maybe like 70% of the original?) and still technically capable of penetration even to the end.

I occasionally would get involuntary erections, but it became a rare occurrence, and it usually bothered me significantly when they happened.

If you want to maintain function, the advice I've heard is: give yourself fully hard erections on a schedule, I would personally aim for once or twice a day to be conservative simply to replace those erections you would have had overnight. You might want to make sure the erections last long enough. I don't think orgasm is important or anything, it's just about getting the penis as hard as possible and staying that way for a bit. If you read that wikipedia article on involuntary night-time erections, it looks like the average number of erections is around 5 - 6, and the average duration of the erection is 15 - 30 minutes. You could use this to form a basis of a schedule, if you wanted - maybe try 2 erections a day maintained for 30 minutes (set a timer, use reminders and / or keep a log to track).

Another common suggestion is to rub testosterone gel / cream into the phallus and testes to help maintain their function - but whether you can tolerate the added T dose is dependent on how sensitive you are to biochemical dysphoria (I suspect T cream would have given me worse mental health symptoms, for example - I didn't ever achieve consistent freedom from those symptoms until I had my orch, fwiw).

I suspect the T cream on the testes is how trans porn-stars are able to keep functioning ejaculation, etc., though it's also possible they just don't take anti-androgens and they maintain feminization through surgeries or lower dose E without T suppression? Honestly it's unclear, and I know a girl IRL who reported T-cream did not succeed in maintaining her male-style ejaculations. (Obviously you still produce ejaculate on E, it just won't be like a man's semen, it's like a clear fluid - more akin to female ejaculate.)

Hope this helps, let me know if you have any questions!

I live in the US, which is admittedly not a climate-focused culture.

Even though Americans tend to be aware and concerned about climate issues, they don't tend to see it as a high priority relative to other issues:

Among the leading issues confronting the nation, the environment ranks as a lesser public concern, with 37% saying they worry a great deal about environmental quality. This contrasts with much higher levels of concern shown for inflation (55%), crime and violence (53%), hunger and homelessness (52%), the economy, healthcare, and federal spending, all troubling to more than half of Americans.

from: https://news.gallup.com/poll/643850/seven-key-gallup-findings-environment-earth-day.aspx

even worse, the neutral framing is just wrong, there isn't a medical reason to treat trans people as their assigned sex rather than their actual sex, and in fact there are medical reasons to view trans patients as their actual sex and not their assigned sex (as I get into in my comment above).

There might still be other neutral framings that can be used to undermine trans rights, I think the trans athletic bans are a good example (though, the more evidence we get on that, the more it is looking to be the case that trans women on average are like cis women in their physical fitness and ability, not like cis men).

Hi!

Trans person here.

The answer to your question is no, there is no medical reason for the sex marker on the driver's license. (Nor would it make sense to carry a medical card with your assigned sex marker on it.)

Assigned sex at birth is rarely relevant in medical contexts, and in fact is probably misleading (causing doctors to inappropriately treat the patient based on their assigned sex rather than their actual biological characteristics).

A trans woman is truly more like a cis woman than a cis man when it comes to medical needs, e.g. she will need mammograms like cis women, and (assuming here that trans women are on estrogen) they metabolize drugs like cis women and almost all of their biology is not different from a cis woman who lacks a uterus and ovaries.

A study from Oct 2025 found that within 12 months of taking HRT, trans people have a heart mass that matches their gender:

The troponin threshold to predict cardiovascular events is lower for women due to the greater cardiac mass typically seen in men.

Since estradiol and testosterone were not thought to directly impact cardiac mass, researchers expected that troponin would remain similar to individuals’ assigned gender at birth.

However, they found the opposite to be true.

The clinical research team found that troponin levels shifted towards the affirmed gender after 12 months of hormone therapy.

Troponin decreased in transgender women to a level not statistically different from cisgender women, but which was 78% lower than in cisgender men.

Another recent study published in Oct 2025 found that on the molecular level hormones change the protein biomarkers in cells:

https://www.erininthemorning.com/p/study-finds-trans-womens-blood-proteins

“For transgender women, we found gender affirming hormone therapy alters the levels of many protein biomarkers,” Novakovic said, noting that this could impact risk assessments for things like autoimmune disease and heart conditions. Usually, these assessments factor in any number of variables, including sex as well as lifestyle or genetic components.

“Feminizing GAHT [gender-affirming hormone therapy] skews the plasma proteome toward a cis-female profile,” the study concluded. It should be noted that people of any sex or gender can exhibit a vast and evolving spectrum of these biomarkers—there is no “one size fits all” model for biodiversity.

The more evidence that is collected the more we realize that biological sex is not fixed but instead the human body is plastic and the sex really does change, so it's not really an exaggeration to say that trans women are biologically female in most medically relevant contexts.

The only exceptions I can think of are due to organs developing a certain way, e.g. trans men with a uterus still might technically have a rare chance of becoming pregnant or developing cervical cancers.

On the flip side, in rare cases, a trans woman (esp. one who transitions late and has a family history of prostate cancer) might develop a prostate cancer (fun fact: cis women have an organ similar to a prostate called the Skene's gland that, like the prostate, produces ejaculate; it's not a male-only organ), so that is one difference - trans women might need prostate exams that cis women wouldn't need.

But for almost all medical contexts, trans people should be treated as their gender and not their assigned sex at birth. For trans folks who have been on HRT for >6 - 12 months, it is genuinely a risk to their health to view them as their assigned sex at birth.

EDIT: for what it's worth, my doctor basically told me not to out myself to other doctors and this advice is not uncommonly given; he said the only thing I need to figure out in the future is possibly getting prostate exams when I'm much older - but even that is not clearly indicated given the treatment for prostate cancer is anti-androgens and estrogen, which I'll have been on for decades before the screening would start for prostate cancers; the needs vary, a woman who transitions later in life and has a family history of prostate cancer will have a different need for prostate cancer screening than a trans woman who transitioned before puberty and has no family history of prostate cancers, for example.

congrats girl, but you need to wear a bra.

If you can see your nipples through the shirt, you might need a bra with more padding. Bralettes sometimes come with removeable foam pads, those are the ones that work really well.

welcome to girlhood :-)

the question you have raised is about moral responsibility - who is more responsible for the shitty behavior of the influencer, the influencer doing their behavior, or the consumer who subscribes and consumes their content?

I don't think there is any question that the consumer's views and subscriptions provide the basis of the success or failure of an influencer - and in that sense, what consumers tend to view controls what influencers succeed and fail.

But consumers are not choosing to view content in a completely neutral context, i.e. they aren't looking at influencer A or B on their merits or behavior alone, instead there are all kinds of ways that consumers are directed to view some content and not other content: SEO manipulation, the algorithm, etc. all change what consumers even see and interact with.

So no, I don't think it's the consumer primarily responsible for driving traffic to one kind of influencer or another.

And regardless, I think it's the influencer who is most morally responsible for their behavior regardless of the audience that might motivate them.

Finally, I think you have ignored the most important factor in deciding who succeeds or fails: the corporate platform and how it prioritizes one kind of content over another. Neither the influencer nor the consumer are primarily in control of where attention is placed, the platform which manipulates and controls what content shows up in search and recommendation feeds are primarily in control.

oh, we're really going to blame the consumer on this one?

get your grindset on, girl 😤

(but srsly, buy & wear sunscreen 😱)