Anti-Androgens

[Guest]

Ok, since we have some experts online...

I visited perhaps 50 US based TG web-sites. Most, if not all, recommend blood tests, check your hormone levels, blah, blah, ..., and make sure you take anti-androgens as a critical part of your therapy.

Ok, so I go to the #1 doctor in Bumrungrad for hormones. He calls his friend while I'm there, who is the #1 hormone specialist in Thailand. They both say, forget the blood tests, and you don't really need anti-androgens except to help the libido, but not necessary for feminization.

So the concept of anti-androgens is pretty simple and would seem not so bad to take.

My question is, why the dramatic difference in professional views?

My only conclusion so far is that American TGs tend to be older and the need to rapidly stop masculinization encourages the use of anti-androgens. Thai TGs tend to often start at puberty, and thus the need for them is less, except to help libido, and this, I don't technically understand.

As for blood tests, I am guessing US doctors don't know fuck all about feminization, and thus the blood tests not for the patient, but so that the doctor doesn't fuck up.

In Thailand, ALL girls take hormones based on feel. I do not know 1 girl (or doctor) who has used blood tests to determine hormone levels. I am guessing the ambient or conventional knowledge here is so high, that there is little concern for danger.

Comments?

[rxpharm]

I have no definite answer for these differences, but have opinions about the possible reasons why.

I think a major reason for this difference is they type of medicine practiced in western vs: other countries. The practice of medicine has been greatly affected by malpractice lawsuits, especially in the USA.

This has led to changes such as excessive testing (eg. measuring sex hormone levels), more scans, etc, etc. In addition they have changed treatments to reduce risk - such as using anti-androgens to reduce the doses of estrogens necessary for feminization and also reducing the risks of side effects of high dose estrogen if no anti-androgens are prescribed. I think you are also correct in your view that most tgs in the west start hormone therapy much later. Antiandrogens can have a beneficial psychological effect on ts as well.

I am not sure why the Thai endocrinologist say antiandrogens have a stimulating effect on the libido of Thai lbs though. Seems counter intuitive.

[post-op lover]

I've forgotten everything, but I think there were some concerns about liver or kidney functioning. It's probably rare, but I think that one of these organs, especially if subjected to a fair amount of drugs or alcohol, would get more messed up by way of hormones.

I think Rxpharm has the main idea right, though: no harm in more tests, and more money for all the specialists.

POL

[Guest]

if you are interested in the current treatment regimes, attached is a link that will tell you current standards of care in the U.S.

http://www.transgendercare.com/medical....ren.htm

[Guest]

Sorry I made a mistake. The Thais are prescribed estrogen and extremely low doses of PROGESTERONE not anti-androgens, for libido. I do not know any Thai taking anti-androgens.

[dmlbl2001]

I find it very interesting the differences in the Thai vs western approach. I think the Thai approach is more based on anicdontal info than you would find in the west. True most Thai LB's start at a much younger age and thus the estrogen probably gains a stronger foot hold because it has less testosterone to fight or overcome. It may also act to prevent the full devlopment of testosterone porduction. Males and females each produce both testostone and estrogen. The difference is the ratio. So basicly the trick is to modify that ratio. One could do just estrogen to get a female ratio, and this is proably what occurs in LOS, because they start ealier and again the full male level of testosterone is not present. On the other hand most western MTF's seem to start much later and have been under the influence of testosterone longer and proabably have a higher level as well. To counter this it would require faily large doses of estrogen to accomplish the ratio. Larger doses of estrogen can present complications, thus by using anti-androgens the testosterone can be supressed and the amount of estrogen needed can be reduced. Just my two cents worth. Also I think that testing for blood levels of each is pretty important to see if you are reaching that balance.

[Guest]

I think what you said is right, except the testosterone levels. I was under the impression that testosterone hits its lifetime high at puberty. Most girls take estrogen about 12-15 is my observation, i.e., when testosterone is at an all time high, so I think it's actually fighting a bigger enemy (testosterone). The west start estrogen often in 30s, when testosterone is not quite starting to drop, but does start in the 40s.

Nevertheless, I think there might be some merit in your logic.

On the blood tests, I don't know what value they will really show. Isn't 'how you feel' a blood test manifested?

Am I right?

[dmlbl2001]

Point well taken regarding the testosterone levels being high in the younger years. But I think that taking estrogen at a younger age certainly blocks the effect of it. Also it may be that the body is more able to absorb the estrogen in that age range too. No real knowledge regarding that part. I think the purpose of blood tests beside watching for liver function and potasium levels (from anti andorgen spironolactone). you can try and balance out the range of hormone balance. For example is the estrogen level close to that of a gentic female, and the same with testosterone. I think the goal is to get these as close to female levels as possible. By doing blood levels you can adjust the dosages of anti androgens and estrogen. In regards to how one feels, one of the very first effects of estrogen is on the brain. within a matter of 2-4 months the brain actualy chages in both structure and function. The brain actualy shrinks in size slighly and certain areas become more active and others less active. Interestingly enough the opposite is true for F2M's they take testoterone and their brains actualy grow a bit and have changes in function as well. All of this is realy facinating and surely something that is not completely understood.

[Guest]

All I can say is this...

Ladyboys in Thailand are georgeous and feminine. The same cannot be said of most western Ladyboys.

So if I were to place my bets, I'd bet on Thai practices as creating the better outcome, albeit, less scientific!

I have asked about 3 dermatologists and 2 dentists if early estrogen causes problems with skin and teeth. I've gotten mixed answers, but they tended towards 'no'. However, my personal observation is that many Ladyboys have bad skin and crooked teeth, more so that women. That is why I asked the question in the first place of course.

For example, look at LBs and women before makeup. By far, LBs have more skin problems. Likewise, take a look at LB teeth. I think 80% of the time they have 'crowding' issues. Only 1 dentist confessed that taking estrogen, which greatly impacts bone growth, can result in abnormal jaw and teeth movement...possibly resulting in crowding.

I've spent several days in the past looking for good studies on PubMed and other medical sites, and it is frightening how littel this topic is studied and how 13yr old LBs continue to take medicine designed for 60 yr old menopausal women! Think about that for a second!

[post-op lover]

And think about how the medicine for the 60 year olds is from pregnant horses that are merely 6-10 years old! And pregnant with a baby that'll weigh twice as much as a LB! Strange medicines indeed!

POL