https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8213007/

Here's one of the more recent meta analysis papers on it. When people who detransition are asked, the majority of the cite external factors like the ones here.

I really don't know why some of the more conservative dosing recommendations still give two week dosing schedules for EV. It has a lower half life than cypionate and should be injected more often, assuming you're aiming for stable levels (most people are). A lot of our original recommendations for transfem people were based around studies for populations with prostate cancer and menopause, and it seems like dosing strategies for them have stuck around.

I personally wouldnt ever go over a week long dosing of ev, and would likely switch to twice weekly injections if were I on it. The people over at transfemscience.org put together a neat way to visualize the difference in esters for achieving a steady state dose based on the pharmacokinetics of them all. Basically, at this point if I get a recommendation from a doctor for 14 day dosing of EV, I'm going to assume they're not up to date on current feminizing hrt research and are likely going to also be giving old information about things like IM vs SubQ injections.

Finally, nobody should ever be paywalled from medical information (and it's pretty abhorrent that this research even has to have hoops to jump around to get through). Just as an fyi for anybody else reading this, most articles that aren't brand newwill have a copy of it you can access by its doi number on sci-hub.ru (or another mirrored domain, searching scihub normally gives a list of current working addresses). In the case where it isn't available yet, the journal should provide a way to email them asking for specific articles for patient access.

In general, body hair will reduce slightly on hrt. It's still there, but in particular I saw a lot less growth for chest hair. If laser works for your skin/hair color combos at a practioner near you, I found it very effective and tolerable. Otherwise I use a safety razor for everything else. Once you're good with it, it's a very close and low irritation save.

For facial hair, almost everybody will see no effect with hrt. New growth (as in fully new follicles) should stop, but any existing hair will need to be removed if you want a smooth face all the time. I did laser for some initial clearing and now am doing electrolysis to finish up.

A note for everyone who is interested in injections but doesn't like IM, you can also do subcutaneous injections. My understanding is that estradiol in common preparations is a depot injection where absorption is controlled less by physical factors and more from the lipophilicity of the medicine itself.

Anybody who's interested can look for the article "Comparison of the Subcutaneous and Intramuscular Estradiol Regimens as Part of Gender-Affirming Hormone Therapy" published out of Dr. nippoldts group at Mayo recently.

Anybody dislike the production today even if the race has a great end? It felt like it took so long to see replays of any significant incidents/moves, if we saw them at all.

Plus, it was great to watch the four racing at the end for so long, but why take away the time splits? They just showed like lap times between two drivers at a time for all of it.

Probably not something you can affect, but my biggest issue with trans care is just access to it through insurance. Free clinics and out of pocket payments make it doable, but around me, the offices specializing in trans care don't cover insurances except the few largest.

I've tried to use different types of corn flour, but it's never quite right. The nixtamilization process dramatically changes the texture of the resulting masa. Fresh masa is even better, and can be made yourself if you're up for a project day.

I agree that flour tortillas may be your best bet if you can't find maseca. A wine or round liquor bottle with the label removed makes a great impromptu rolling pin.

The majority of my friends leaving Austin have done so because of state politics. It's hard to feel safe when you're queer in Texas.

The fun part of transitioning is that you'll get both traditional misogyny and new, unique flavors!

Seriously though, joining a group of people that you aren't used to being in will always feel weird, but luckily that goes away with familiarity. I feel like my advice is always the same though, which is to find a therapist informed on gender issues if you can afford one.

Maybe this is the rumored aero stall when drs is on? It seems like there's still some massive aero efficiency differences when the flap opens.

https://genderdysphoria.fyi/

It's a pretty great description of what dysphoria can be like for some people.

I met up with a friend group I haven't seen in a while, and a lot of people made an effort to lump me into 'the girls'.

Plus electrolysis is showing good results, even if that hour a week is slowly killing my soul with pain.