Hormone Replacement Therapy and medications
As mentioned in an earlier post, my second attempt at transitioning to a point of contentment started in 2018. That was strictly getting myself in better shape, healthier. And happier. If that’s even possible. In the summer of 2018 I quit smoking for the umpteenth time, and lost 40 pounds. I had already quit drinking before my first attempt at transitioning in 2008, so this time it was a lot easier. Kinda.
I finally found a family doctor in 2019 who knew a ton about being trans, transitioning and hormone replacement therapy. He already had 11 trans patients, all at various levels and degrees of transitioning and some at varying stages of surgery. Not just young people, he dealt with a wide range of ages looking for a “cure”.
I have always stated that testosterone was toxic to me, if not physically, it was part of my psyche while suffering from gender dysphoria. You can lower the testosterone levels through medication, some or all of the effects reversible.
Cyproterone acetate (CPA) is a competitive inhibitor of the androgen receptor and exerts negative hypothalamic feedback. In layman’s term is inhibits androgen production and androgen is what regulates the production of both estrogen and testosterone. It is often used in combination with estrogens in trans women to achieve feminization.
As an anti-androgen in men it causes a major drop in testosterone, and your body starts to react in various ways physically and mentally. Everyone’s different on how, and where, the effects show up.
It’s also used as a treatment for prostate issues, as using anti-androgens can lower your risk of various conditions, including cancer. It’s legal in Canada, and most of the rest of the world to use CPA for gender dysphoria, but not in the US for some reason.
August 2019 was the start date for going on CPA.
But…there’s always a “but”…Doc failed to mention it can cause severe depression in 5% of the population of men using the drug. Or maybe he did mention it and it went in one ear and out the other. Who can keep track of all the side effects anyway?
So you already guessed the outcome I bet. Come the first of October I started sliding downward and didn’t stop until I was at the bottom. From there it was like sinking in the mud, being sucked down into the gloom. At that time this depression was probably the worst I had ever experienced. My mood was horrible, sleep was non-existent. Suicidal ideation? Yeah, that’s all I’ll comment on that.
October has never been a good month for me when it comes to being depressed. Why? I haven’t figured it out fully, but it seems all my illnesses and worries and problems escalate and reach their peak in October. Probably fueled by the dread of the upcoming winter that was quickly approaching,
By the end of October we made the decision to stop CPA altogether. I originally thought it was the end of my dreams to transition, that I couldn’t even make it past step one! My family doctor knew otherwise, and simply changed his gameplan.
All was not lost, there were other ways to get to the same desired result, and on January 2nd of 2020 we switched to estrogen and progesterone. I’ll write more on that pathway in another post.
The moral of the story? Like all other medications you have to pay attention to the side effects and potential damages they can cause. Of course when they said not to worry, it’s only a 5% chance of severe depression occurring with high doses of CPA, I should have known!
Like EMDR, not all therapies or treatments work for everyone, and some folks will fall into that bottom tier of having negative side effects.
I just wish it wasn’t me every time!
As a side note, my psychotherapist was overly concerned on how totally lost I had become and told me I needed purpose in life, something to keep me going.
So I took her advice, and on a wild spur of the moment went and picked out my purpose. A little bundle of fur, a tiny little puppy with the heart of a lion, who believed he was just as tough as the big dog he was happily chasing through the breeders backyard.
There’s always a silver lining. That purpose arrived.
