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9 Questions to Ask When You’re Ready to Start Gender-Affirming Estrogen with Plume

By: Plume Community Member

Are you ready to begin gender-affirming estrogen therapy? Taking the first steps towards estrogen therapy can be overwhelming, but Plume is here to help. Plume is a gender-affirming health care home that provides information and support for transgender and nonbinary people considering gender-affirming hormone therapy. 

In this article, you will find the key questions you need to ask about taking estrogen, including what questions to ask before you start. Some of these questions are questions your Care Team will ask during your first appointment. Some of them are questions you might have for us when you become a Member! All of them will help you and your Care Team understand your transition goals and how we can support you as you become your most authentic self.

What is gender-affirming estrogen therapy?

Estrogen is a type of gender-affirming hormone therapy (GAHT, sometimes also called HRT or hormone replacement therapy) for transgender and nonbinary people. This medication can help bring balance to your body’s hormones, creating physical changes that align with your gender identity. Using estrogen for gender-affirming hormone therapy can help reduce body hair, create softer skin, and shift your body fat to change your body’s curves and facial features. Estrogen can also reduce the body’s natural production of testosterone, which can cause gender dysphoria and discomfort.

For many transgender and nonbinary people, taking estrogen is a crucial part of their gender transition. Estrogen can help create physical changes that can make them feel more comfortable in their body and align with their gender identity.

What is Plume?

Plume is a gender-affirming health care home that provides comprehensive health care and hormone therapy services to transgender and nonbinary people. Plume was founded by Dr. Jerrica Kirkley (she/her), a trans woman doctor. We are passionate about providing quality, compassionate care to the transgender and nonbinary community. Plume offers gender-affirming hormone therapy services and comprehensive care including peer-led support groups, gender-affirming hormone therapy (GAHT, sometimes also called HRT or hormone replacement therapy), and other supports.

At Plume, you will be taken care of by a Care Team of experts who understand your individual needs. Your Care Team will be with you every step of the way, providing support and guidance as you transition. Plume also offers a variety of resources to help you make informed decisions about your health, from understanding what changes to expect to understanding the risks of medication.

What questions should you ask before starting estrogen gender-affirming hormone therapy?

If you’re considering taking estrogen, there are a few questions you should ask yourself and your Care Team before starting. You can bring any questions you have to your first Plume appointment.

These questions are important because they let your Care Team know what you are thinking. Understanding these things about you and your experience can help Plume’s experts recommend the best treatment for you and create a customized health care plan for your unique transition goals.

Questions are an important part of any medical consultation – and that’s especially true when it comes to starting a hormone therapy like estrogen. If you’re considering estrogen treatment at Plume, it’s important to take the time to ask your Care Team the right questions. This will help ensure that you have all the information you need to make an informed decision about your treatment. Here are some of the key questions you should ask your Care Team before starting estrogen at Plume.

If you have more questions after starting estrogen, simply reach out to your Care Team to schedule an appointment.

What is my gender?

Gender is a complex term. Your gender is your internal sense of being male, female, or something else. For example, a person who identifies as female has a female gender, while a person who identifies as male has a male gender. People who don’t identify as either male or female may identify as nonbinary or transgender. You may also have a preferred, or desired, gender. Your gender may be the same as your assigned or assumed gender (e.g., male), or it may be different (e.g., you were assumed to be male when you were born, but you’re actually female). When you start estrogen, your Care Team will work with you to develop a plan that helps you align your gender presentation (that is, the way you show your gender identity) with your gender identity (that is, the way you feel about yourself).

2. What is my gender identity?

Your gender identity is your personal definition of what being male, female, or nonbinary means. Gender identity is different from sexual orientation: Some people with nonbinary gender identities are also LGBTQ, while others aren’t. Like all aspects of your transition, your care team will help you determine the best path towards your gender identity.

3. What is my sexual orientation?

Sexual orientation is your personal definition of who you are attracted to. Your sexual orientation may or may not be the same as your gender identity. While your sexual orientation doesn’t necessarily define your gender transition, it is helpful to share this information with your Care Team. That way, they can understand you as a whole person and offer the best health care support possible.

4. What are my chosen pronouns?

Coming out, disclosing your gender identity, or aligning your gender presentation with your gender identity can be challenging and can take time. In the meantime, many people start to use different pronouns to reflect their transition. Using the right pronouns is an important part of showing respect for your pronouns. Your Care Team will work with you to offer support. When you interact with your Care Team, we’ll always use your correct name and pronouns, even if you haven’t changed them on your legal documents.

5. What physical changes feel affirming for me?

Before starting estrogen, you and your Care Team will create customized care plan that is as unique as you are. Your care plan will likely include aspects of gender-affirming hormone therapy, medications for your mental health, sexual function support, and anything else that might help you during this exciting time.

Your transition may also include other goals, like having bottom surgery or facial feminization surgery (FFS), or even getting a passport with your new name. Your Care Team will work with you to set realistic, achievable goals for your transition.

6. If I want to take estradiol (estrogen), how do I want to take my medication?

At Plume, we offer a variety of estrogen gender-affirming hormone therapy options to meet your individual needs. We offer estrogen patches, pills, creams, and injections. Each option has its own set of benefits and side effects, so it’s important to talk to your Care Team to find the best option for you. Everyone’s body is different and many people have different transition goals. By sharing your goals and needs with your Care Team, we can help create a unique care plan that will help you achieve your goals and live your best life. There are several forms of estrogen that can be prescribed as a gender-affirming medication. You can read more about estrogen injections, patches, and pills in this article.

7. Do I want to start at a typical starting dose of estrogen or a lower dose?

Finding the right dosage is based on your health and medical needs, and how your body responds to estrogen. Your Care Team will advise on what dosage is best for you. They will also advise you on how often you should have your blood tested.

Some people choose to microdose, which means taking a smaller amount of E. Microdosing is effective and safe and can support people who would like to use estrogen or other E-related medications but do not want the full expression of the hormone.

8. Do I want to take a T-blocker or not? If yes, which one?

T-blockers are hormones that are specifically designed to prevent the production of testosterone in the body. They can be taken in pill or injection form and are designed to be a long-term solution for trans people who want to halt the effects of testosterone production and promote a more female hormone balance. 

There are several types of T-blockers, including spironolactone, cyproterone acetate, and finasteride. T-blockers are often used as an essential part of gender-affirming hormone therapy, especially when transitioning. Trans women, transfeminine people, nonbinary people, and folks who identify as male-to-female (MTF) may all use T-blockers. They are usually prescribed alongside gender-affirming hormone therapy (GAHT, sometimes also called HRT or hormone replacement therapy) like estrogen, another hormone that can be taken in pill or injection form. Blockers are also often used in conjunction with other medications to address potential side effects of T-blockers. You can read more about T-blockers in this article.

9. What are the side effects of estrogen gender-affirming hormone therapy?

All medications come with side effects, including gender-affirming hormone therapies like estrogen. The specific side effects that you experience will depend on your body and your dosage. Some common side effects of starting estrogen include mood changes and changes to your body fat distribution. Some people experience decreased sexual function, while other people experience increased libido. While some of these side effects may be desirable, such as softer skin, others may not be so fun (or even uncomfortable). If any of these side effects concern you, you should discuss them with your Care Team. They can help you understand how to reduce their impact. They’ll also order regular lab work to make sure you stay healthy while you’re taking your medication.

Monitoring hormone levels

Estrogen levels can be checked by blood tests. Blood tests are the most accurate way to measure estrogen levels. They can be done at any time of day. It is your responsibility to get your labs done as directed to keep your Care Team informed of any relevant changes in your hormone levels. This helps them to adjust your dosage if needed.

Working with your Care Team to get the best results

Communication is key in any relationship, but especially when it comes to taking medications. This is especially true when it comes to taking hormones. It is very important to let your Care Team know about any changes that you notice in yourself. This includes both good changes and bad changes. Changes that may be good for you may be bad for another person. For example, you may have more energy than ever after starting hormones, but another person may feel depleted from the same dosage. Let your provider know about any changes that you notice.

Conclusion

If you’re considering taking estrogen, it’s important to take the time to understand the different options and consider what changes you want to see. Estrogen can help bring balance to your body’s hormones, creating physical changes that align with your gender identity. Plume is here to help with your gender-affirming health care needs, from providing hormone therapy services to answering all of your questions. 

Working with your Care Team can help you get the best results from your transition and make the process as smooth and seamless as possible. Your Care Team can provide guidance and advice throughout your transition, as well as a unique care plan customized to your transition goals. With Plume, you can have the peace of mind that you are taking the best steps to safely and effectively transition to your true self. Ready to start? Click here to become a Member today.

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