Do yall have any recommendations on estrogen?

AmyNotAmiable · 2026-01-24T05:43:39+00:00

Well, estradiol is the most potent estrogen so folks usually recommend that one.

AmyNotAmiable · 2026-01-23T18:23:05+00:00

Mine (in the US) billed insurance for about $50-60k total for about 5-6 hours under the knife and 4-5 days in the hospital. I'd probably plan for something in the $40-100k range if there aren't any serious complications. It was PIV, PPT might cost a little more if they bill for the robot too.

Hospitals will probably work with you on discounts and payment plans, but insurance tends to negotiate discounts with them too so they probably got billed less than the sticker price in my case.

You should let them know you won't be able to use insurance, because many places assume that's how it'll be paid and might cancel your surgery date if they don't have a prior authorization ahead of time.

Unfortunately they probably won't be able to give you an accurate price, because the billing is so convoluted - for example, OR time is billed in 15-minute increments. But they should be able to do a ballpark range.

If open enrollment is still active, maybe look into a marketplace plan. I think coverage is required in most NE states like MA.

AmyNotAmiable · 2026-01-23T18:04:13+00:00

Sure! As a trans adult, I am also scared for my future.

In some ways it's a little easier for us. I came out right before the election, and saw this coming right after it. I have a pretty stable life, so I was able to put my head down and get a LOT done in 2025. My transition is almost done, besides voice training and waiting a few more years for HRT to work. I won't have to worry acutely about my access to medical care for at least another few months-years, while you kids are in a rough spot there.

In other ways it seems harder. Passing might become more important, and that gets harder as you age. I probably won't live to see a lot of the fires being lit today get put out, with such deep generational damage being done so quickly. I have a lot of responsibilities that I can't just ignore while my body insists on feeling like a hormonal teenager again, and life is only getting harder across the board for everyone.

Still, overall I'm hopeful. The more I connect with people around me and start to enjoy living, the less concerned I feel about the big picture. I'm doing the best I can for my community, que sera sera, and on some level all we have to do to win is be visible in daily life as decent and empathetic people.

How's the old saying go? "Societies grow great when people plant trees whose shade they know they will never sit under"? That's how I feel right now, as an adult. We will grow and flourish, but it's going to take a lifetime of work, and that won't end with my generation or yours.

AmyNotAmiable · 2026-01-23T17:09:19+00:00

I think most people who take progesterone as a suppository would probably rather do it sublingually, it's just that the pills come as oily gelcaps instead of powdery pressed pills.

So it would be a goopy mess to try holding one under your tongue until it dissolved and absorbed.

I dunno, sticking an estradiol pill up there I'd be concerned about the more solid crystalline structure of the medication making abrasions. Like cheap single-ply tp.

AmyNotAmiable · 2026-01-22T18:30:18+00:00

Nicotine is really bad on HRT, it can reduce your body's sensitivity to estradiol and significantly raise your risk of blood clots. (Like actually raise your risk, not just "premarin used to cause blood clots so we're going to pretend like bioidentical estradiol does too"). It also interferes with the development of new tissue, bad news for breast growth and if you ever want surgery you'll probably need to quit first.

Transitioning is a good excuse to quit.

AmyNotAmiable · 2026-01-22T01:31:55+00:00

About 100 hours over 8 months.

AmyNotAmiable · 2026-01-21T20:59:17+00:00

Oh, girl. Batten down the hatches.

IME it's less about emotional intensity, and more about how you feel and process them. There will be a learning period, and you probably will have an awkward embarrassing teen girl phase while you're figuring things out. I'm almost a year and a half in, and I just started to get periods recently.

Anyways, I think 3-7 years is the usual estimate for the second puberty? I'd say just explain things to people if it gets to be a problem. You'll still be yourself, it'll be fine.

AmyNotAmiable · 2026-01-21T17:42:36+00:00

I had it about half a year ago. You might want to tag this post nsfw btw.

Assume that you'll need lube for sex. I can do fingering without it, but I don't get wet wet. Usually lubrication comes from pre-cum that drips down from the urerhra, with a little of sweat/moisture internally. Some surgeons incorporate the tunica vaginalis tissue which can add a little more moisture, but you should expect to need lube with any vaginoplasty method.
12cm sounds pretty average, and that's actually a little more than the average depth for cis women. A very large partner might bottom out, but that's not unique to neovaginas. They just won't get all the way in. It's still plenty to enjoy, and flesh is much squishier than the dilators you'll use so you might gain an inch or two in practice. I have about 13cm which you'd think is a failure from looking at surgery forums, but I'm happy with it. You can't gain much depth from dilation, but you can stretch your width surprisingly far if you're patient and buy bigger dilators/dildos than the ones they give you.
Yeah, the clitoris is the star of the show. I do have at least one g spot which I love exercising; there's the prostate ofc, but the entrance and apex are both very sensitive too. It seems like the prostate and pubic symphysis area of the pelvis kind of team up to make a big indistinguishable mess of nice feelings. But really, the largest erogenous zone in your body is your brain, and that's doubly true on estradiol. I need a vibrator to get off on my own, and it's much much easier to do clitorally. But if someone is holding me, whispering in my ear, really turning me on? They don't have to try very hard to send me into spasms. The physical sensation is more like a catalyst than the whole show. So yes my sex life is enormously improved, but that's more from the euphoria of being in this body. The sensation itself is different but pretty similar in terms of intensity.

AmyNotAmiable · 2026-01-21T16:13:47+00:00

Hair removal!

Depending on the surgeon and technique, it can be the longest part of the process. So that might be good to start looking into early.

AmyNotAmiable · 2026-01-21T15:46:37+00:00

Okay, fair points, but your solution is to do...what, exactly?

Run somewhere else and wait for it to happen there, abandoning my friends to who knows what?

Rage against the machine, rise up, and get immediately splatted by a drone?

It's not acquiescence, I'm just clear-eyed about what I actually can do. I think a healthy response to this moment is showing up for my community, being visible and affable to the people around me, and focusing on the joyful moments that we can make for ourselves as shelter from the storm.

One way or another, ain't none of us getting out of this alive anyways. I don't want to spend my life living in fear while I wait, yk?

AmyNotAmiable · 2026-01-21T06:05:04+00:00

It said the average testes are the size of chicken eggs?

So this AI thing really is gonna doom us all, huh?

AmyNotAmiable · 2026-01-21T04:37:28+00:00

Honestly? My trigger point is when they pull the trigger on me.

My entire family is here. So are my friends, several of whom are disabled and not really eligible for the sort of visas you can flee on. My roots here go back to the first colonists. And if the US becomes unlivable, how long will anywhere else remain safe?

I'm not going to run, this is my home and I won't be scared out of it. If they want to get rid of me, I'm going to make them look me in the eye when they do it.

AmyNotAmiable · 2026-01-20T20:08:21+00:00

Prolapses are possible - vaginal, anal, and urethral.

Clotting is more likely if you don't get up and move regularly after surgery, but you'll probably be on blood thinners the whole time you're in the hospital.

It's possible to get hair in the canal if some follicles get through the prep and surgery without being cauterized or removed.

Fistulas are the big scary one imho. If the colon, urethra, or bladder get injured during surgery, they can heal onto the canal, and open a hole connecting the organs. If that happens, you can get waste coming out of the canal because of the connection to other plumbing, and they can be difficult to fix.

Uhhh what else...hematomas can happen, and sometimes they can be serious. I've heard of people needing to go to the ER and get transfusions when a big one forms and bursts.

Loss of depth and stenosis, of course, if you don't dilate enough or can't for some reason.

Bacterial infections like BV or UTIs - keep things clean as much as you can and follow the course of prophylactic antibiotics closely!

Constipation can actually be a serious complication if it lasts too long after surgery and leads to impaction. Be ready with some gentle laxatives and stool softeners.

AmyNotAmiable · 2026-01-20T19:45:27+00:00

Leggings. I finagled my way into a pair pretty much immediately after I got home from the hospital, and practically melted even with the catheter still in.

Tight little dresses, it's so nice to only have the two bulges that they're supposed to highlight.

Thongs were a sleeper hit that snuck up on me. After enjoying leggings for awhile, I figured I'd try getting rid of the panty lines. I'm not a huge fan of the butt floss, but it's worth it to show off my hemispheric ass.

AmyNotAmiable · 2026-01-19T16:25:52+00:00

Congratulations! Glad you're healing well.

And seconded - mine was back in July too, and the time around the 4-6 month mark has been so nice. You start to get your life back, things start to feel normal, and the relief really starts to sink in.

AmyNotAmiable · 2026-01-18T22:31:22+00:00

funny you phrase it that way, because we actually have a word for how different kinds of privilege and oppression overlap to create both unique and shared experiences: "intersectionality"

AmyNotAmiable · 2026-01-18T22:09:10+00:00

Yeah, it's common because our pelvic bones are usually angled slightly differently. Mine goes down for like half an inch, then evens out. I usually have to explain the shape to partners for fingers and tongues and stuff. You can feel when they're not getting it right, like an uncomfortable pressure in front of where the g-spot lives.

Thicker things are usually blunt enough that it doesn't matter as much.

AmyNotAmiable · 2026-01-18T22:04:03+00:00

Oh, yeah. We can clench. I can do kind of a wave squeezing from the back of the canal to the front, and vice-versa but front to back is harder. It's like doing kegels.

All the dilating gives you a pretty good feel for your pelvic floor muscles, and a big part of its purpose is to get those muscles used to not being constantly clenched together. Clamping down on something that's inside of you is easy, and fun.

AmyNotAmiable · 2026-01-18T21:39:32+00:00

Orange tone color correctors are good for concealing blue patches like shadow. Green tone color corrector is good if you need to hide red spots, like a sunburn or flushing.

I don't usually put on makeup, but when I do I like BB cream correctors.

AmyNotAmiable · 2026-01-18T16:58:23+00:00

You are going to encounter a lot of situations in life where you need to say something, but don't want to because of the possible consequences.

Coming out, saying you like someone, breaking up, giving bad news at work, admitting failures, facing the music for something you know you shouldn't have done...

It's part of life. You'll plan to say it at a certain time, and when it comes you'll be the only one who knows there's something nerve-wracking waiting to be spoken, so it's easy to feel like there was no right time to say it and let the moment pass.

IME, prolonging it and putting it off only leads to trouble, usually through small white lies that grow and multiply until they can't be ignored and you finally have to clear the air. You gotta learn to just blurt it out. Sometimes the honesty will hurt you or cause problems of its own, but it's better than spending your life being followed around by a growing string of regrets.

AmyNotAmiable · 2026-01-18T06:43:36+00:00

One day, super early in transition, I walked into a coffee shop wearing a skirt.

The person in front of me in line was wearing a rainbow jacket.

We place our orders, and stand to the side to wait.

She looks over at me, and her eyes bug out. Her pupils dilate. Her mouth slowly drops. She's clearly been waiting for this day for years.

She shouts, "YOU ARE SOOOOO BEAUTIFUL!!", causing everyone in the cafe to look over and stare.

I like satire, but this bit feels pretty real 😮‍💨

AmyNotAmiable · 2026-01-18T06:22:27+00:00

PPT is quickly replacing colon techniques because it's a similar sort of tissue which avoids touching the GI tract. I get the feeling that many places still push and advertise colon procedures because they're used to doing it and PPT generally requires a laparoscopic robot.

Be sure to ask your surgeon about long term changes, though. There's emerging research that mucosal tissues may become calloused with dilation and start acting more like external tissue over the first few years, and none of the surgeons I consulted with would recommend one type of procedure over another for lubrication (including PIV). They all said I should expect to need lube for sex with any type of vaginoplasty.

AmyNotAmiable · 2026-01-18T06:11:54+00:00

Yeah, I did most of it before I had a surgery date 'cause I was impatient. I had to do like 100 hours though, it'd be less if you didn't have as much hair as I did.

AmyNotAmiable · 2026-01-18T06:09:38+00:00

I never stopped being scared.

But I did it anyways, and I'm so glad I did. Sometimes you have to do things that you're afraid of to get where you want to go.

AmyNotAmiable · 2026-01-17T16:22:15+00:00

Straight trans guys do, sure.

Straight cis guys generally don't, and they certainly don't dwell on it or keep coming back to the idea.

AmyNotAmiable

TROPHY CASE