Reply To: Gender affirmation surgery questions

Emily Alt

I live in the US so can’t advise about the UK healthcare system.  That said, it is medically possible to do HRT without taking an anti-androgen.  This is commonly referred to as monotherapy.  The basic idea is to take estradiol (valerate or cypionate) at a dose high enough to suppress testosterone.  Injections are the most reliable way to do this.  I inject estradiol valerate subcutaneously twice a week.  This puts my estrogen and testosterone levels firmly within female ranges.  Docs that are firmly adherent to WPATH guidelines may balk at this method.  But it does work….and avoids anti-androgen issues.  My advice would be to find an endocrinologist that specializes in treating trans patients and tell them your concerns.

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