Extraordinary Short-term Benefits of starting Therapy and HRT

In my previous article, I wrote about the cost of living your truth as a transgender man or woman. I also spoke about the impact on one’s family and relationships, and how it still scares me. After two months it surely has been a rocky road for my spouse and me. It is hard to come to terms with the fact that your spouse has come out as transgender.

I believe, like many other trans women, that I have been patient, and tolerant of my spouse’s anger, confusion, reprimands, and unwillingness to accept my truth. We all have extended families, children, and our circle of friends. What if most people in your extended circle of friends and family are unwilling to accept the truth and allow you to be your authentic self. I find myself in the unforgiving maze of cultural, religious, and societal taboos that directly oppose who I am. It is these taboos and social expectations that cause so many of us to hide or even take our own life, let alone fall into a deep dark pit of despair and depression. I learned that we could hide until eventually reaching the breaking point, and I never want to feel broken again.

I came out to my spouse 20 years ago. The pain it caused her, and the tremendous shame I felt served as motivation to keep on trying to be a so-called normal husband. Thirteen years ago, I came out to my parents, again with rejection and subsequent pain for everyone. I kept on hiding. This process has been repeated over the last 10 years. In the end, I broke down and couldn’t live in the shadows of my mind anymore. My family still refuses to acknowledge the truth about me. I take part of the blame. Each time I became overcome by shame and guilt. I continued pretending to be okay and happy to be a man. I created the impression that being transgender is something we can switch on and off again.


Despite rejection and dehumanizing comments and assumptions about trans people, I moved forward with counseling and gender-affirming treatment (HRT). I started therapy with an open mind and promised myself that if at any point I felt factors other than me being born this way, I would seek a course of treatment that would help me to continue functioning as a man in society, a husband to my wife and father to my children.

After starting HRT, I presumed that the hormones would clear things up and help me decide where I stood in terms of how my future treatment should proceed. My thinking was that if my gender-identity problems had an external source (like unresolved issues from my childhood) then introducing oestrogen and testosterone blockers would make me feel horrible. That would confirm that my problems were all because of past trauma or other past events from childhood.

I am now in month three of HRT and continue to see my counselor weekly. I have an open relationship with my doctor and this small support network along with my interaction on TGH has proven to be more than helpful, it has become a lifeline. HRT has, however, yielded unexpected results. At first, I thought it could be bad, and I would resolve to find a way of being what was expected of me in my family and society. And it could also be reaffirming, making me feel more like a woman.

I was wrong on both counts.  With testosterone almost shut down completely and much higher oestrogen levels in my system, I have realized two especially important things about myself:

  1. I don’t feel more like a woman. I feel exactly as I did previously about my gender identity.
  2. HRT has not only disproved the fact that I had other unresolved issues in my life that caused my gender identity as a woman but proved that I now have the correct hormones in my body. I am and always have been a transgender woman.

It is like reaching a point of clarity that cannot be refuted any longer. In addition to the two truths, I became aware of so much more after the second month on hormones. My transition so far has been purely emotional, cognitive, and psychological. My body has responded to HRT extremely well. I have experienced only benefits on all levels of my personal transition. Let me put this into perspective by referring to emotional, cognitive, and psychological benefits first and then the physical benefits:

Emotional, Cognitive, and Psychological

I am grouping these together under one umbrella because for me they are all connected.

In the first three weeks, I had a sense of euphoria I believed was psychological. My body still had too much testosterone for me to experience anything but a placebo effect. This was caused by a sense of being proactive and for me, it was a victory in finding out who I truly was.

Then I noticed my mind and thoughts became clearer. It was like the fog of depression and anxiety lifted and my mind started functioning like it has never truly been able to in the past.

I felt almost no anxiety by month two even though I have had lots of opposition from my spouse concerning my course of treatment.

I started smiling and experiencing true inner joy for the first time in many years.

I became much more focused and grew in confidence daily.

This week, I was asked about a poem. I could easily recall the name of the poet and even the year I first encountered the poem (1991).

I am not aware if other transgender people experience similar effects after starting the transition, but I can honestly say that by far the benefits of my emotional, cognitive, and psychological transition are much more than I could have ever imagined possible.

Physical Transition:

My body has responded in positive ways just like my mind with the start and duration of HRT. I am grateful and sad for the fact that I had denied myself the right to transition for far too long. My body responded very well to all the expected changes within the brief time I’ve been on HRT.

At first, my libido crashed.  This relieved a ton of my dysphoria and anxiety. What I would like to focus on however is the unexpected changes I didn’t think would be possible.

I have been on medication for hypertension for over ten years already and received anti-anxiety chronic medication in 2018, but within two months of starting HRT, I have been able to stop taking my chronic medication. I have lost weight although I read that I would gain weight. I also developed cravings for food I never used to indulge in. My diet now consists of less meat (although I still love meat), but I now eat salads and vegetables daily. Therefore, I have been losing weight consistently over the past few months.

This article is not merely an account or testimonial of how I experienced and responded to treatment so far, but there is a clear conclusion in it for me. After trying to deal with being transgender for many years by simply denying it, staying in the closet, taking anti-anxiety and depression medication, withdrawing from friends and family, and at times even unable to function properly at work, I now cannot imagine ever going back to a state where I deny myself what I now regard as a basic human right to try and live my life as my authentic self. I still face daily opposition to my transition, and I must deal with all the difficulties life throws at us, but I feel better equipped to deal with everyday problems. Most of all, I finally made peace with myself. I fully accept that I am indeed a transgender woman. What is left is a journey that will lead me to finally living my life as it is meant to be.

I am sure I am going to lose people and things that I hold dear in my current life. I am strengthened by what I said when I first started therapy and HRT. I told my counselor that I regarded treatment, despite the opposition from family, as a matter of survival. What started out as such has evolved into me wanting to live a full life where I can truly reach my potential and make a positive difference in this world.


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Michelle Stephenson

I came out a few years back, but haven't truly allowed myself to start my transition journey. I really do need to network and meet other transgender women who can offer support and advice. I love reading books...truly anything I can get my hands on. I work in and ICT and training profession and love problem solving. I would certainly describe myself as a patient person who emphasizes easily with others.

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Kitty Amorosa
Kitty Amorosa(@kittyamorosa)
6 months ago

This article made me feel loved and beautiful. Thank you so much.

1 year ago

Such a wonderful article, Michelle, very helpful for anyone contemplating HRT. I really appreciate your honesty. Very well written. Were you perhaps an English major?

Dana Munson
Dana Munson(@misstranslation)
1 year ago

Thanks for this very informative article, Michelle! I am on blockers now (spironolactone). Due to my age, my doc wants me to be on those for a few months before we do an “orchi." Then after the testosterone is well purged (about mid ’23), I can start estrogen. I can reIate to the “euphoria" thing. I’ve kind of felt it since I came out to family and friends in July. But I went to a whole other level when I popped that first blocker tablet in August!! I’ve settled down (a bit), but there have been so many new experiences… Read more »

1 year ago

Living in Sweden, hormone theraphy is nothing I can choose to have for the benefit of itself. It is only provided on a need basis as a tool among others to help someone in their transition. l see no use for the whole package at age 57 and 10+ years with Parkinson’s disease, so the team at the clinic came to the conclusion that l did not need it bad enough. To be honest I have been successfully presenting female in public since 2014 and also at my work place since two years back, but it is now getting almost… Read more »

John Freer
John Freer(@aletheia)
1 year ago

I am 66.I decided to find out why as my wife as said numerous times,Why do you have so much anger? Well after Lexapro,cymbalta and huge quantity of Zoloft not to mention alcohol sex addiction and other issues.I am now in therapy and after 1session my physiologist addresses me as Aletheia.I think I know where this is headed. I hope my wife participates in the journey…….

Kelly Blind
1 year ago

Michelle, I can relate to your experiences. I have been on HTR approximately a year. For all my years I had this internal anger and frustration I didn’t understand, I didn’t know why or where it came from. It was an effort for me to socialize and a smile was always force, never genuine, fake. There was even a long period of time when I felt I was looking out of a Halloween mask with a yellow smiley face. Outside everyone though I was this wonderful person while inside it was the farthest thing from the true. Once I finally… Read more »

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