My First Electrolysis Session

"After all this has passed,
I still will remain;
After I've cried my last,
There'll be beauty from pain."
-- Superchick, Beauty From Pain

On Saturday I had my first electrolysis session.

Not. fun.

I haven't done much in the way of hair removal thus far, mostly because I've never been very hairy, even before hormones. The hair on my arms is pretty light, I've never had any back or chest hair to speak of, and I can deal with shaving my legs on the rare occasion that I actually wear a skirt.

I have, however, been getting laser hair removal on my face for almost two-and-a-half years now. It was actually the very first step I took towards physical transition, and I started just a couple of weeks after coming out to Erin. I wasn't sure at the time if I'd end up transitioning or not, but I knew that I hated my facial hair enough to get rid of it regardless.

I spent more on it than I probably should have, but on the plus side, they gave me a two year guarantee, so I've been going back once a month since then without paying anything more. Laser has eliminated 95% of the hair on my face, but there are a few hairs it just hasn't cleared. Still, I don't regret starting with laser versus electrolysis, because it has saved me a lot of time and pain, while costing about the same in the long run. Laser was also enough to get rid of the beard shadow on my face, which helped me dramatically in passing as female.

I've now started electrolysis for two main reasons, to clear up what's left on my face, and to start genital electrolysis in preparation for surgery. To put it simply, in sex reassignment surgery, some of the outside skin gets moved to become inside skin, and I need to get any hair removed from those areas before then.

Back when I started laser, I did a lot of research on the differences between laser and electrolysis. The only thing I learned with any certainty should probably be obvious: never trust an electrologist or laser tech to tell you which method works better. Both fields are chock-full of the kind of propaganda and superstition that's spread around so often, even the pros believe it. The truth, as far as I can tell, is that both methods work, and both have many pros and cons.

As far as effectiveness, laser is more like lobbing grenades, where electrolysis is more like sending in a sniper. The grenades are quicker and easier, but you have to be more careful not to damage the scenery, and there's a lot more luck involved. (Yes, I'm a dork, but it's a good metaphor. =P) Electrolysis also seems to be more dependent on the skill of the technician, for better or worse, while laser is more dependent on the area being treated, the skin type, and how dark the hair is.

Technically speaking, most laser hair removal devices don't actually involve any lasers, but use xenon flashbulbs, which flash high-intensity light at the skin. The skin itself lets most of the light pass through, but the hair's melanin (pigment) absorbs the light. The hair briefly heats up, effectively frying and killing the follicle around it. The hair is then left to eventually fall out on its own.

An average session of laser hair removal for me involves lying down, and being given goggles to protect my eyes from any errant flashes. They then spread clear goo on my face to keep the skin cool. Next, the tech dials in the intensity for my skin type and progress, and presses the small flasher part against my cheek. The machine beeps, I feel a sting, the tech moves the flasher gun about a centimeter, and then repeats.

The pain is semi-intense, but manageable, though I usually forget to breathe until they stop, and it always makes my eyes water when they go over my upper lip. Each monthly session only takes about 15 minutes. When they're finished, they clean the goo off my face, apply lotion, and give me an ice-pack to go. After each of the first few sessions, the room smelled like burning hair, and my face was red and tender for a couple of hours.

Electrolysis, on the other hand, uses a tiny needle-like electrode. The tech inserts the electrode in to each follicle, next to the hair, and zaps it at the root with an electrical current. They then grab the hair with tweezers and pluck it out.

At my first session on Saturday, my electrolysis tech began by joking about how every trans person she's talked to says that electrolysis is the worst part of transition, which got me nice and psyched. =P

She wore medical gloves, and glasses with little telescope-y magnifiers attached. She also dialed in the intensity, starting low to see what I could handle, then raising it a few times as she worked. Though I couldn't see exactly what she was doing, it seems like inserting the electrode stings, but is bearable, since it's being inserted where there's already an opening in the skin. The zapping and plucking hurts much worse. The pain was pretty manageable at first, but as she slowly moved across my face, my skin became more sore, and the stinging became more intense. The only things I can compare it to are laser hair removal, and getting a tattoo on my back, but it easily beats both.

My upper lip has the most hair left, mostly because the laser techs were afraid to zap too close to my lips. While the electrologist progressed across my upper lip, my eyes were watering like crazy; If you've ever plucked your nose hair, it's like that, but more hurty. Thankfully, Erin came with, and at this point I asked to hold her hand. I also had to ask the tech to stop a couple of times, so that I could sneeze and blow my nose.

The session lasted a little over an hour, and she cleared most of the remaining facial hair. Hair grows in cycles, with one set of follicles being dormant while another set grows, so I'll have to have my face done at least a couple more times to clear everything.

Once she was done, she had me hold a metal rod with a cord sticking out, and I started wondering why she wanted to electrocute me. She applied what smelled like VapoRub to my face, then pressed a metal roller to my skin, and I could feel a very mild current as she rolled it around. Apparently this is called cataphoresis or electrophoresis, which reduces redness by causing pores and blood vessels to constrict, and helps transfer medicinal substances into the tissue. Who knew?

She asked me not to touch my face or wear any makeup for a couple of days, to avoid infection. Most of the redness went away after a couple of hours, but my face was sore for the rest of the day, and there are still some tiny red spots and slightly tender areas four days later.

I definitely plan on taking some pain meds before my next appointment on the 18th. Since I normally avoid meds, they're pretty effective when I do take them. That should be enough to get me through the rest of my face work, but I don't know what to do for the genital electrolysis. Some people go as far as using numbing cream, or even local anesthesia. I'm really not looking forward to it. =/

After just one face-clearing session, I wouldn't say that electrolysis is the worst part of my transition, but we'll see if I feel differently about it after the surgery prep work. *knock on wood*

New Doc, New Meds, New Prescription Madness

"You kn-kn-know what I want!
Gimme more. Gimme more.
Pretty please, a prescription!"
-- Mindless Self Indulgence, Prescription

I usually avoid talking very specifically about my body, but this is pretty limiting in a transition blog. Physical changes are a huge part of my transition, and if any place should be safe to talk about them, it should be here... I just worry that I'll make other people uncomfortable. Since I've really got to stop worrying so much about other people, I'm just gonna give you a heads up: I will talk about my boobs. There, I've said it. Whether you know me or not, if you think you might be uncomfortable with me talking about anatomy, nobody will blame you for ducking out. =P

As usual, I've waited far too long to talk about what's going on in my life, and I've got quite a backlog, so let's catch up on hormones. =)

My first endocrinologist sucked, so about four months ago, a month before my hormone prescription ran out, I decided to look for a new doc. I had three goals in mind: find someone who cares, is in my insurance, and prescribes *progesterone. I got a big list of endos and ratings of said endos from various trans friends, then narrowed it down by insurance, and started making calls. The only one within my plan that was taking new patients however, was only accepting referrals from a primary care physician. The good news was that there was a PCP in the same office that works closely with the endo. The bad news? The physician was booked about a month out, and the endo three months. =/

*(Progesterone is a primarily female hormone often prescribed as part of both post-menopausal and transsexual hormone replacement, but many docs are afraid of it, because some synthetics have been known for nasty side-effects, and its full effects on development aren't well known. Progesterone is key in breast development, among other things, but there is still a lot of disagreement as to how much is gained, and which meds, if any, benefit trans-women the most. Part of the problem is that most of the data comes from post-menopausal women, and broad testing with trans-women is virtually non-existent.)

Since I wouldn't see the new endo for a while, I called my old doc to ask for an extension on my prescription, and she told me that she would grant it, but never followed up. Fortunately, my appointment with the new PCP was just a few days after my prescription expired.

The new physician was awesome! She listened, she answered, she genuinely cared. I know, weird, right? She even chatted with me excitedly about my (then) upcoming wedding, and gave me a three month extension to last until I could see the endo. About a month later, when I went through my legal name/gender change, she was also nice enough to write up a letter of recommendation for me to present to the judge.

When I finally saw my new endocrinologist, she was just as cool. She was extremely enthusiastic in getting to know me and explaining things to me in detail. Before I could even bring up the progesterone, she asked, "How's your breast growth?" I explained that I'd had some growth spurts in the beginning, but nothing much since then, and she immediately followed up with "We should get you on progesterone!" =D

Of course, there's always a hitch. To save myself from having to go in at different times for different prescriptions, I waited for my other two to run out before filling the progesterone. When I did, the pharmacy informed me that I could now get three months of the spironolactone and estradiol, but that my insurance would only let me get one month to start on the progesterone. That seemed reasonable, but when I got home, I realized that they only gave me half my normal dose of spiro. It turned out that the new endo had accidentally prescribed it wrong. =/

Unlike with my old endo though, I was actually able to get a hold of one of the new doctor's staff, and they immediately sent a correction. The pharmacy then told me that I should just take the spiro at the correct dosage, and that they'd get it corrected at the 45-day marker when my supply is gone.

Last night, I called in a refill on the progesterone, but when I picked it up, they said they only had enough for 5 days, and that they'll call me in the next few days when the rest is available. I also asked them about the spiro, and they told me that they'll probably just refill for three more months when I run out.

So now, even though I'm getting meds for three months at a time, I had to go in yesterday for the progesterone, I'll have to go back in a few days for more progesterone, then back in two weeks for the spiro, again 45 days later for the estradiol, and repeat. Despite my efforts, my three prescriptions will never be on the same schedule again. *sigh*

Anywho, I've now been on progesterone for one month, and I've definitely noticed a few effects. Like with my first hormone post, I'll just present the evidence, and let you decide what's unrelated/psychosomatic and what's not. =P

• My breasts have been tender and itchy almost constantly for the last month, which indicates growth to me. This is basically what it felt like off-and-on when I first started hormones. Their shape has also rounded out a bit, and they look more natural.
• I've noticed some skin changes, and the weirdest thing, the tattoo on my back sometimes "raises", and I can feel bumps where the lines are; when this happens, it's also itchy.
• My skin is a little more oily, and I've gotten a few more zits than usual.
• My anxiety is back, which is odd, because progesterone is supposed to be calming. Of course, this could easily be due to a lot of other things going on, too. =P

I really haven't experienced any extreme side effects so far; the acne is a little annoying, but hopefully that will fade after a few months, as it did when I first started on hormones. Otherwise, med-related things are going pretty hunky-dory, and still far better than when I had to deal with my old endo. =)

The Magic of Hormones

"And if rain brings winds of change,
Let it rain on us forever.
I have no doubts from what I've seen,
That I have never wanted more."
-- VNV Nation, Solitary

I've been on hormone reassignment therapy (HRT) for about five months now, and I finally decided that I should share what I've experienced as a result. While there are a lot of things hormones can't change, I'm constantly amazed at all the things they can and do change. I currently take two medications, once a day: estrogen, and an anti-androgen, which dramatically slows the effects of testosterone.

Quick and generalized biology lesson:

During the first few weeks of fetal development, humans essentially have the potential to develop as either male or female. Usually, the chromosomes will determine gonad differentiation, which causes hormone differentiation, and the presence or lack of *androgens determines the other primary sex characteristics. (*Andro is a Greek prefix meaning "male" or "masculine"; androgens are "masculine" hormones, including testosterone.) Secondary sex characteristics are mostly caused by estrogens and androgens, respectively, during puberty. HRT mainly only affects the secondary sex characteristics, especially those involving skin, fat deposits, and hair, since these are always changing anyway.

Keep in mind that this is from the perspective of a MTF (Male-to-Female). First, let's start with the things HRT won't do:

• HRT won't dramatically change bone structure. Most of the skeletal differences are developed during puberty, though some bones will continue to very slowly change shape or definition over the course of years.
• HRT won't change the voice for MTFs (Male-to-Females). Once a voice is "broken", it can't be "unbroken". For FTMs, taking testosterone causes the voice to break, but MTFs simply have to practice their voices, or learn to live with them.
• HRT won't significantly affect already developed facial hair; laser hair removal or electrolysis are required for that.

And here are the changes I've noticed since being on hormones:

• Within the first few weeks, I got mild hot flashes (mild meaning they weren't painful, but still very strange and obvious). Apparently hot flashes can happen any time there's a quick change of hormones in the body, and some women get them throughout their lives as their natural hormone levels rise and fall. Mine only lasted for a few days, and I haven't noticed any since.
• Also within the first few weeks, I noticed that my skin was much softer and more sensitive to the touch. My skin was already pretty sensitive before, but now, Erin loves to run her hands down my back and watch me writhe.
• My skin is somewhat thinner and lighter in color, especially on my face. Combined with subtle differences in the fat deposits in my face and cheeks, my face looks a lot more feminine now.
• The fat stores on my body have been rearranging themselves. My butt is nearly twice as big as it used to be, I swear.
• Within the first month, I was already noticing some chest growth. This has continued slowly, though sometimes in small growth spurts.
• Within the first two months, I noticed tiny hairs around the corners of my forehead. Since then, even more dormant follicles have been sprouting all over my head, causing annoying fuzzies that are only about an inch or two long. They stick up all over through the rest of my hair, and I can't do anything with them (though my hair stylist was pretty fascinated).
• Body hair growth has slowed down considerably. Some body hair has become lighter and more sparse.
• After a couple of weeks, I started getting noticeable headaches off and on. For the most part these have gone away, but I still get mild headaches slightly more than I used to (which was almost never).
• My finger nails have become a bit more dry and brittle, though they're still stronger than the nails of a lot of girls I know.
• Temperature changes around me are much more noticeable now, both hot and cold. When it's cold, my hands and feet turn into ice sculptures.
• Erin says I now "smell sweeter and more feminine", even without any added scents.
• Recently I've noticed that when I drink alcohol, I feel the effects more and faster. I've always been a "light weight" drinker, which I've been happy with, because drinks are expensive. =P Unfortunately I also seem to sober up more quickly.
• What little upper body strength I had is being slowly but noticeably sapped. I could probably get it back to where it was with a little working out, if I were worried about it.

The psychological effects are harder to define, or pin down as being specifically caused by the HRT, mostly because my mind is already reeling from all the other things going on in my life right now. I'm a skeptic, so I think that most of these can be chalked up to placebo effects, but the below are the mental effects which could be related to HRT. I'll let you make up your own mind:

• I seem to move from one emotion to another more quickly, though the range and intensity of my emotions is about the same.
• I cry a lot more recently. I think this is mostly because I've been under a lot of stress, and because I've been allowing myself to. I used to cry a lot when I was younger.
• If I forget to take my hormones, shortly after the 24 hour mark I get moody, and usually depressed if I'm alone. This happened a few times before I made the connection, but now if I get moody in the evening, it serves as a reminder. This part especially annoys me, because of my control issues.
• Extremely cute things sometimes get to me more. A couple of weeks ago, I giggled uncontrollably at a kitten video on YouTube for about 10 minutes. I've always liked cute things, but what really startled me was the intensity of this experience.
• Sometimes I feel more "cuddly", with a similar intensity. This one's also tough to describe, but when it really hits me, all I want to do is be as near to Erin as possible.

Trans people report a huge variety of other psychological effects, but the above are really all I've noticed. Whether or not these are mostly caused by the hormones, it's likely that genetics and a predisposed mindset play a pretty big role in shaping those effects.

All of the physical effects I've listed are pretty standard, but I feel lucky to experience them all to some degree so quickly. Judging from what I know of other trans peoples' experiences, I'm responding to the hormones really well. It's especially exciting, because the full effects are supposed to take years, meaning I still have plenty to look forward to. =)