Thoughts About HRT — and Human Connection

One of the topics that has often been discussed during the transgender therapy support groups that I’ve managed is the effects of HRT (hormone replacement therapy) — psychologically and physically. It’s often a fascinating discussion.

As the only cisgender person in the room during these discussions, thinking about hormones is really a topic that many of us have to consider when we reach a certain age. What I’m fascinated about is hearing stories from transgender women who love the changes that are happening to their bodies with HRT: softer skin, less muscle mass, less energy, becoming more emotional, redistribution of body fat, and oftentimes, lower sex drive.

For many cisgender women, wanting to obtain muscles or a flat stomach, losing weight, becoming less emotional, less moody, less irritable and stronger seem to be he qualities many women strive for in this culture. Cisgender women take testosterone, hire trainers, diet off and on their whole lives and never seem satisfied with their bodies. This seems no different from many of the transgender women I treat.

This is a generalization, but most men that I treat and most transgender men that I work with don’t talk so much about their bodies but talk more about work, family, goals, disappointments, surgery and dating, etc. Of course, my transmen will talk about top surgery, and whether or not they want bottom surgery, but it seems more like a practicality than anything else. Again, this is a generalization but it’s something that I have observed over the past 20 years.

Perhaps this is too simplistic to state, but the body seems to know what it needs. Is it intuitive? I don’t know the answer. In my groups, I’ve found myself perplexed, at times, by the excitement that participants have about these changes while I, and many other women, want to run away from cellulite, weight gain, lower libido, etc. It makes me think about how screwed up our society really is. Happiness and contentment is so hard to achieve — and it’s an inside job. When other clinicians ask me about the work I do, they seem so fascinated with the stories I tell of courage, heartbreak, discovery, excitement, loss, courage and enlightenment. I forget sometimes about how lucky and fortunate I am to do the work that I do and to be able to help and be inspired by my patients. It humbles me everyday and makes me want to learn and become a better therapist.

What I have also learned from working with these support groups over the years is that people isolate. Because of the internet, many young people tell me that their best friends or inner circle are people they, in fact, have never met on-person. I try to get my head around this and not judge but it does make me sad inside. Psychotherapy is about relationships to ourselves and others. It’s about attachment. I’ve manged therapy groups because I want people to connect, to see each other, to talk to each other and walk away with a phone number, an email address and the feeling that they will see each other next month or next week or connect the next day.

Transitioning can be exciting but many of us want to share our experiences with others and if it can’t be with our family or friends that no longer support us, we need to support each other. As Esther and Jerry Hicks write about it in their book Getting Into The Vortex:

Your body responds to the content of your thoughts:
and right here, right now, your body is benefiting.
Your life is supposed to feel good to you,
and you are meant to feel happiness in your life —
and you are meant to satisfy your dreams.

Until next time, enjoy yourselves and each other.

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