Apparently, today is my two year HRTiversary (anniversary of the day I started hormone replacement therapy). Who knew? I mean, I guess I did in the back of my head, but I completely forgot about it. I only even thought about it today because of a friend who reminded me this morning by wishing me happy HRTiversary.
Trigger warning for talking about suicide
As you can tell by the trigger warning, this post will touch on suicide a bit. I’ve written about this a few times before, but, while I know it won’t be the last time I write about it by any means, I’m always a little hesitant to write about it again. It always seems to raise concern with at least a few people. But, as I have written about before, being able to write about these kinds of things has always been helpful to me.
Two and a half months ago, I had my annual checkup with my doctor for my HRT (hormone replacement therapy). We went over my labs and discussed how things have progressed over my first year. One thing that came up, was my discontent with my breast development. I’ve hardly got anything going on. Since the main reason for transgender women to take progesterone is typically for breast development, I had planned on asking if it was even worth continuing with it, as it is likely partially to blame for my weight gain. Considering the plan was to only take it for a few years while things were developing, I wanted to know if maybe I should just stop taking it since I’m not getting anything out of it anyway. My doctor, instead, suggested doubling down. Literally. She suggested we try doubling my dose. She was confident it would help, but was very clear about the side effects of increased weight gain, depression, and possibly suicidal thoughts. I cautiously decided to at least give it a shot.
After a couple months on my increased dosage, the depression seems to be in full effect. I’ve been really struggling to deal with it at times and it’s around more often than it’s not now. The worst has been dealing with feeling suicidal much more than my normal baseline.
I’m no stranger to the feeling, it’s been a fairly constant background noise my whole life, but things had gotten a lot better for a while. Instead of it being a daily thing, it was maybe a couple times a week. I counted that as a huge win.
Unfortunately, it’s recently been back to every day and been triggered by the smallest things.
That’s sort of the thing about being someone who struggles with feeling suicidal, you really never can leave it completely behind you. Once you’ve been at a place where you’ve accepted it as a legitimate escape, there’s no reversing that. A few weeks back, I wrote a post on Tumblr, but never posted it. It’s been sitting in my drafts since then. This is what I wrote:
The thing most people don’t realize about suicide and feeling suicidal is that it’s rarely about the pain right now. The pain may suck, but, in many cases, you know you’ll get through today. You know tomorrow will be better and if it’s not then maybe next week will be better. You know what you’re feeling now isn’t going to be what you feel every moment of every day going forward. That’s not the problem. The problem is knowing relief from the pain is temporary. You know you’re always going to have to fight through something. You know the pain is immortal and, while it can be knocked down, it can’t be entirely defeated.
Sure, you can fight through today and you can fight through tomorrow, but you’re tired of fighting. Why do you always have to fight? Sometimes, you just want a break from fighting.
People tell you things will get better and they’re right, but things don’t stay better, they get bad again. It’s a cycle and you know all the stages. When you feel good, you know it’s only temporary. The good sometimes feels so fleeting that it often seems entirely pointless to even let yourself feel good at all.
The reason for not wanting to live isn’t what you feel, it’s knowing you’ll never escape what you feel. It’s feeling trapped. Suicide is escape from the trap. It’s freedom from ever feeling the pain again. It’s freedom from ever having to fight again.
It’s not the present that makes you not want to live. It’s the future.
Once this place has been created in your head, there’s no destroying it. It always exists. The worst is that it becomes easier and easier to access. Actually, that’s not even the best way to say it. It’s more like you exist closer and closer to it after each visit. Smaller things will take you there for another visit. A minor tiff with your significant other? Frustration with a coworker? A feel-super-ugly day? All of these things are more than enough.
This has been my reality since somewhere early in high school, so it’s sort of my normal. What’s changed now, though, is that it’s not just what’s in my head that’s taking me there. It’s being assisted by my meds. The very same meds that have freed me from so much other unhappiness in my life. This makes it so much worse. There was never a silver bullet for getting myself out of the darkness, but I had gotten good enough at surviving it until I felt better. Now, just surviving it is getting harder. Each time I’m in that dark place, it seems to be even darker and the way out is more poorly lit than the last time. Not to mention how much more easily I end up in that place now. It’s been multiple times a day. Every day.
Last Friday was probably the darkest it’s been in a very long time. I was at work and a couple things were frustrating me, then I was reminded about a few things that were causing me a lot of dysphoria earlier in the week and how crappily running has been going lately. Somehow, these things all really spiraled out of control and I was in bad shape. All will to live was completely taken from me. It wasn’t that I wanted to die, I didn’t, but I just REALLY didn’t want to live anymore. As I’ve mentioned, this is sort of normal for me, but things got to a level much worse than I normally deal with. The point that scared me the most was when I, while sitting at work, opened an incognito Chrome window and Googled “least painful ways to kill yourself.” I’ve never done this before. I even started thinking very seriously about what to write in a suicide note. I started drafting it in my head, but I didn’t quite get to a point where I actually started writing it down.
In the end, what snapped me out of it was my willingness to allow myself to be snapped out of it. It was actually my reply to a tweet that made me giggle to myself. That smile was just enough to calm myself and I felt everything just melt away.
@ZJemptv I once found my sex in my armpit. I was like "what the hell are you doing over there?!"
— Amelia Gapin (@EntirelyAmelia) July 11, 2014
Without this tweet, I don’t know what would have snapped me out of it. Something would have, but who knows what it would have been. And, this may be the scariest thing from Friday, it took something entirely unrelated and random. What if nothing happened that did the trick? What if the situation was different and I was at home and alone? How dark would things have gotten? What else might I have done?
Sitting here, typing this, I’m completely into the idea of not being dead. I’m in an entirely different headspace. A headspace I prefer a lot more! Typically, I wouldn’t even think twice about a single episode of suicidalness, but Friday was particularly intense and it came on really quick. The one thing that makes me feel okay about it is knowing it almost definitely wouldn’t have happened if not for my increased progesterone dosage. I don’t know how long it’ll be until I reduce my dosage or even stop taking it, but I know this dosage is for a finite timeframe. And, if this happens again, I can choose to stop and things should go back to the way they were.
PS: As I mentioned at the top, this topic often causes people to get worried and stuff. As much as it may seem really bad, I don’t want to worry anyone. My actually posting this should serve as evidence that everything is fine.
When I look back over the past year, it’s almost hard to believe it’s been a year already, but so much has happened and changed that it really does feel like a lifetime. It also took me almost a year after accepting transition before I started hormones so, when it finally happened, it felt like a long time coming.
The changes have been unbelievable. I’ve seen my face develop softer features and more prominent cheekbones. I’ve seen new growth along my hairline. I still hate my hairline, but it’s better than it was. I’ve also noticed my hair strands are slightly thicker. My body hair growth has slowed and almost entirely stopped on my back. I never had oily skin, but it’s definitely even drier than it used to be and I no longer get even the occasional pimple anymore. Obviously, I’ve got boobs now, but they haven’t grown nearly as much as I hoped they would have. They’re still barely there. Though, I have developed a slight bit of a waist. It’s not huge since bone structure doesn’t change, but you can tell it’s there. And finally, one of the most noticeable physical changes has been the reduction in strength and how much of a slower runner I am now.
Taken together, it’s pretty impressive. I look in the mirror now and see the woman I always felt I should see staring back at me. On good days, I even feel pretty.
Most importantly, though, have been the mental changes. Where I used to just feel “off,” like an engine running on the wrong type of fuel, I feel “right” now. My head feels much clearer and 95% of my dysphoria is gone. I feel how I always thought I was supposed to, how everyone else feels.
There have also been a lot of other random changes that I didn’t expect. I started liking most of the foods I used to hate and I fall asleep quicker at night. I’d never heard of either of these things happening before, but I’m not complaining!
The only real negative aspect of HRT I’ve experienced has been my weight. I’m really struggling to keep under control. At first, I lost about five pounds and was nice and steady there. After five months of taking estradiol as a cream I decided to switch to injection. Since making that change, I’ve gained those five pounds back, plus another four. I try to keep better tabs on how much I eat, but it never seems to be enough. It’s a constant worry.
Overall, I don’t think there’s much else to say that I haven’t said already. Transition is a life-changer and hormones are no joke. Next month will be six months live as Me 2.0 (full time out as Amelia), I’ll have more to say specifically about that then. I just felt like this was an occasion I should mark in some way.
I’ve don’t think I’ve given an update on my overall cost of transition in a while, so here’s where it currently stands after 22.5 months since accepting it…
- Hormones: $2,208.73. This includes all my hormones, labs, and doctor’s visits. My doctor simply charges $400/year to cover everything you do though them. My payment for my second year is included in this amount. My Spironolactone (testosterone blocker), Avodart (Dutasteride), and progesterone cost $60/month and my estradiol and syringes cost about $50 for three months.
- Clothes: $3,095.89. This is my entire wardrobe including running clothes and shoes, but not including most accessories. Things purchased with gift cards are included here, but not all gifts I’ve received are (some items my wife purchased for me are, some are not).
- Therapy: $3,083. This is 20 months of therapy at an out-of-network therapist. My last session was in January so this is not currently an ongoing expense. If my count is correct, this is for 27 sessions.
- Laser hair removal: $734 (face) + $448.25 (other). I’ve had 16 laser sessions done on my face and have probably reached the extent of what laser can do there. The rest of the money is for three sessions each on my chest and stomach.
- Freezing and storing sperm: $1535. We’re rather sure we don’t want kids, but just in case we thought it would be a good to make sure we still can. This includes the process of collecting and freezing sperm and two years of storage.
- Legal: $528.03. This is my name change, driver’s license, and new passport (which I needed to pay to be rushed).
- Other: $1,687.76. Everything else. Things like makeup, purses, and accessories, as well as all new snowboarding equipment (board, bindings, jacket, and pants) which I felt like I needed.