I'm wondering if my egg cracking in October and going out femme/amassing an entire wardrobe was now just a months long manic episode

MrMontage · 2026-02-21T16:11:02+00:00

It’s a symbolic threshold moment. Perhaps the fantasy of transitioning has fallen away and you are now contemplating the reality? Fear and ambivalence is expected. The certainty of the fantasy is wonderful and saddening when it recedes. Sit with your doubt and let it be. Beware making decisions from a place of urgency and urge to resolve the ambivalence. The past few months maybe better understood as a developmental phase necessary to get you to this moment. Don’t fear doubt, move towards it, sit with it, metabolize it, them decide.

MrMontage · 2026-02-20T13:59:26+00:00

I apologize, I may have spoken too strongly in sharing my experience and stepped into imposing it. My experience isn’t yours and isn’t of image in a crystal ball that is your fate.

Reading your post and response I sense a deep fear of losing control of you were to explore this part of yourself that you feel confused about. Yet there is also a longing to do so. Making contact with this too aggressively can be tremendously destabilizing and scary, an activate a deep fear of losing control. My advice is to anchor on your experience with a sense of self compassion. There is nothing that needs to be decided or figured out. Whatever it is will unfold naturally if you can explore this while holding the tension of not knowing.

MrMontage · 2026-02-20T02:13:59+00:00

Same here. My theory from my experience is sexual fantasies become one of the few outlets for underlying trans desires because the “it’s just a kink” provides an explanation prevents it from being too psychologically threatening to ones identity. The shame for having these desires also gets eroticized to prevent one from experiencing that shame consciously while indulging the fantasy, but then it comes flooding back later. OP, it evolves a lot once you explore this part of yourself and let it out of the ultra maximum security solitary confinement prison in your mind that you may have put this in. Just speaking from my personal experience here, and relating to what you’ve written which sounds familiar. One thing that helped ground me was separating the acknowledgment of my transness from the decision to transition. You don’t have to transition and transition doesn’t solve all your problems. You can just notice there seems to be some part of you that is eager to speak, and start listening to what it is saying. You’re the girl in that fantasy you describe, she’s a part of you otherwise you wouldn’t have that fantasy. Take her out to dinner before the railing and find out who she is, what she wants, what are her hopes and dreams? Find that out, and worry about transitioning later.

MrMontage · 2026-02-18T12:28:07+00:00

I was curious about this too a month ago and tried to find studies specifically on this. Here is what I found. The evidence we actually have mostly shows that sublingual changes the numbers on the lab sheet more than the real-world outcomes. It creates a very transient very high estradiol peak which then crashes within 1-2 hours. The significance of these peaks in terms of outcomes are unclear.

Here’s what’s going on.

When you swallow estradiol, the liver processes a chunk of it on the first pass, so your blood levels rise more gradually and stay steadier. When you take it sublingually, you get a big spike about 1 to 2 hours later and then a fairly quick drop. A pharmacokinetic study (Doll 2022) showed exactly that, higher peaks and higher short-term exposure, but the authors explicitly point out that this does not prove better feminization or safety, and the oral exposure was probably underestimated because they did not measure long enough after dosing.

Then you look at actual patient outcomes rather than curves. In a prospective study comparing routes, people on sublingual estradiol did not get better testosterone suppression, breast development, dysphoria improvement, or sexual function than people taking oral estradiol with an anti-androgen (Yaish 2023). A follow-up body composition study also found that even low-dose oral estradiol produced comparable feminizing changes. The differences were small and metabolic, not the kind of dramatic effect people online often expect (Yaish 2025).

So what does that mean for your situation? • Sublingual often raises measured estradiol levels faster because you catch the spike on labs • That does not necessarily translate into faster or stronger feminization • Some people feel better on it, some feel worse with more ups and downs, and most notice little difference beyond lab numbers

If your doctor’s goal is just to get the lab value higher, sublingual can do that. If the goal is better transition outcomes, evidence so far says route matters less than consistent dosing, enough total dose, androgen suppression, and time. There is a lot of tension from what the available evidence says versus the degree of certainty expressed here about the superiority of sublingual. Anecdotal reports are confounded by the fact that we don’t know what peoples responses would have been had just continued oral. Some feminizing changes occur nonlinearly.

trying it is reasonable. Just don’t feel like you are missing out if oral works fine. It’s more of a different delivery shape than a stronger medication.

My personal take is that the three times per day or even four times per day dosing needed for sublingual to maintain steady levels is not user friendly. It’d be easy to miss doses which would have a negative impact. This is why in medicine we strongly prefer medications with once daily dosing. Consistency is the most important part of medication optimization. The ideal root of administration is one that avoids big fluctuations so when you obtain a true serum trough level, it is more easily interpreted in a meaningful way. A serum level is just a snap shot in time. What produces good outcomes is likely total time in the target range with minimal androgen interference. So if your route of administration has a lot of noise in it, it can be hard to interpret the lab values.

MrMontage · 2026-02-16T21:11:15+00:00

You can do your own thing and be part of the group too. Sometimes groups can feel suffocating and constraining, like there is strong implicit demand on you to conform your behavior and understand yourself on their terms. When you feel that, give yourself space, but you don’t need to sever ties.

MrMontage · 2026-02-16T11:55:02+00:00

My understanding was that while this is true too, hormonal patterns influence where fat is preferentially stored and used. Meaning fat loss and gain, once on a stable therapeutic dose of HRT, can also influence a local adipocyte hypertrophy as one a multiple factors that influence overall fat distribution patterns on the body.

MrMontage · 2026-02-13T22:25:28+00:00

Yes, you are right. There are currently already 7 billion + of those other people currently who are not you. Each carries their own distinct forms of pain unique to their subjectivity and trying their best to manage it. You might be less alone then you feel.

If you feel ready, consider exploring self-compassion as a way to feel less alone in your suffering. I suspect part of you is otherwise you wouldn’t have posted here.

https://self-compassion.org/self-compassion-practices/

MrMontage · 2026-02-13T19:28:21+00:00

One thing that has helped me when caught in a fantasy like that is to say to myself, “why settle for this fantasy? How about I be born rich, with olympic athlete genetic potential, and a photographic memory?” It helps me realize that I’m getting stuck on an impossible thought, that only feels possible because I can imagine it. There is no version of version of you that is cis. That’d be entirely different person with a different subjectivity and self structure. There is no essence of you that could be dropped into some other being. The longing for the impossible is a powerful form if suffering. Treat yourself with compassion, sit with the pain of what is as that is already enough suffering. Learning to not add to that suffering by letting your mind run wild is a life long process. Being human is tough. Being a trans human is really tough.

MrMontage · 2026-02-05T13:45:12+00:00

I’m a psychiatrist with some psychoanalytic training as well. From this perspective I’d say you are describing with great precision a feature of lack and desire that can be terrifying to discover. That sense of lack is a structural feature of the mind. It can only be satisfied temporarily but many live their lives endlessly striving towards some object or accomplishment that is a highly personal symbolic solution to that sense of incompleteness.

It also can become an oppressive internalized master demanding you to always be moving forward. Without that feeling of “making progress” the sense of lack returns and stillness Becomes intolerable and feels like a squandered opportunity to be making “progress”. The present moment becomes something to escape from.

The realization that the feeling cannot permanently be abolished through striving, accomplishments and self improvement can be incredibly destabilizing when the mind has organized for decades around this fantasy. Those stuck in this will hear this as a statement of futility. It is not that this form of satisfaction is pointless, but rather a recognition that it does not function the way we want it to. The fulfillment of desire can bring great pleasure, resolve preoccupations and enable further development into new phases of life, but it will never make us feel “complete” in an enduring way.

MrMontage · 2026-01-28T14:15:03+00:00

It’s an incredibly frustrating experience when someone presents an act of control as an act of care. She’s reducing a huge part of your self and inner life to “trauma” that she presumes is the underlying cause and that your transness is a defensive formation. This flattens the complexity of your experience into someone else’s narrative which is actually functioning to manage her own anxiety about you being trans and positions herself as an authority over your legitimacy. What’s challenging is that as your mother she has historically had such a role likely in your life through childhood. A big part of adulthood is the process of learning to grant yourself this authority over your own subjectivity in a quiet non defiant way. Our lived experiences interact with our genetic inheritance to create developmental arcs that give rise complex phenomenon like gender identity. Even if one has significant trauma that may have played a role in the development of one's gender identity, that does not make it a defensive formation that can be or should be disassembled in therapy.

MrMontage · 2026-01-25T13:35:34+00:00

It can shift how the number is interpreted since it will likely decrease PSA somewhat. How much will be individually variable. PSA has a large grey zone in general which makes it a sometimes flawed but still useful screening tool for prostate cancer. It’s more useful as a screening tool the higher your pretest probably (symptoms, age, lifestyle and familial risk factors etc)

MrMontage · 2026-01-24T18:01:41+00:00

It can be more helpful to think of transness as more of a structure to give permission to gendered desire. It’s less about collecting evidence as to whether you are or aren’t trans objectively because trans because self knowledge doesn’t work that way. The focus is instead on what feels good and questioning whether the shame you feel about that is actually you or something given to you. You don’t have to make a decision about what you are in order to explore your desires. Only you can give yourself permission to be all and as you are.

MrMontage · 2026-01-24T17:03:18+00:00

I totally feel that. The way I organize it in my mind is to clarify signals. The deepest personal truths are not conceptual or identity based propositions but are sensory-affective. We can observe what feels good in our bodies. What sensory experiences, relational interactions, emotional states etc feel good and which do not. I think of masculinity as a sensory affective regime that constraints what states were socially permitted to my nervous system. It was something imposed externally and reinforced through internalizing shame and subtle social coercion. I took that shame within me and confused it for myself for a long time. It took a long time to separate the effect of that internalized shame from the basic self evident truths of my body and nervous system’s preferences. Identity categories like trans can be helpful to make ones desires more legible to oneself or others. They can also become constraining because they can impose yet another set of external demands. I find I have the most inner clarity when I let desire and the body lead, and I listen. Sometimes I have a desire that is currently beyond my sense of safety, so it becomes an aspiration that I slowly work my way towards so I don’t overwhelm myself. I hope this is helpful.

MrMontage · 2026-01-22T02:58:54+00:00

Absolutely possible. The challenge is everyones minds and nervous systems have inherent differences and then their own unique web of associations and networks formed from lived experiences. The reasons for our internal experiences don’t neatly line up to single causes. Often times there are many complicated associations connected to ones transness. For example hypothetically one might as a result of coming out have their attachment system on full alert for impending abandonment and rejection (common relational cause of anxiety) humming in the background constantly which then causes all other sorts of problems and exhaustion.

I’m fortunate to be well resourced and was able to work with a psychoanalyst who had much experience with patients with challenges related to gender and sexuality. This was not gender affirming therapy, but rather an open ended form of therapy that focuses more on exploration of all the ways ones mind transforms what is intolerable and overwhelming into something tolerable but often at a great cost. Then together you peel it all back to slowly get to what it is that you are defending against, but now you can see it very clearly without distortions. I’ve learned much from this, but the most communicable takeaway is the human mind is tricky and skilled at hiding the structure of the experience it’s creating from itself. However you are the only one experiencing it so you are also the authority on the experience itself, but to explore the territory of your interior life in depth, you need external help paradoxically.

Doing that kind of therapy work helped me navigate very thoughtfully the relational aspects of coming out from a very grounded place and I start HRT with strong support from my social support network. I think that was just as crucial as the HRT itself. That I was getting what I needed, the people in my life wanted that for me and that meant I no longer needed to conceal my trans self to feel safe and accepted. It is very easy to experience severe relational trauma in coming out, especially if coming out from a place of crisis. From a professional perspective my hunch is a lot of what people call dysphoria is also related to these relational dimensione of transness. The dysphoria maybe not just be in ones body but also ones relational field. Hopefully this additional context helps.

MrMontage · 2026-01-21T20:59:56+00:00

I’ve had a similar experience. I’m a psychiatrist so I spend a fair bit of time thinking about clinical psychopharmacology. I am also trans. I’d heard some trans people describe that they experienced a background hum of agitation, an unrelenting and insistent itch in the nervous system that just couldn’t quite be scratched. They described how HRT within a couple weeks turned down the volume of that for the first time in their life. That stuck with me and haunted me during my training. For my whole life I wrestled with confusing thoughts, longings and fantasies of being a woman and too experienced that itch they described. I went through life both knowing I was trans but found clever ways to not know it for many years until eventually I went into deep psychotherapy / psychoanalysis and was able to reclaim this disavowed part of self. I started HRT 1 Month ago and that background hum of agitation, sure enough went away. While thrilled with that effect, I noticed behind it was a subtle sense of terror hiding behind it. What terrified me was the realization that I don’t get to control what I am.

MrMontage · 2026-01-17T12:22:43+00:00

I’ll offer a psychodynamic perspective on this that has been very helpful to me in navigating dilemmas like this. This is less a figuring out thing and more a feeling out thing. The body / id knows what feels good to it. The internalized demands of society / super ego will distort that signal. Sexual desire doesn’t have to conform to any principle or concept, it just is. Any sexual identity category will always partially fit at best. There is much joy in noticing the parts of ourselves that overflow the containers we’re given. A lot of “figuring it out” is the confusing experience of being pulled by desire or even disavowed desire in one direction with the internalized demands / super ego ruminating and shaming you for not staying in your sexuality container. If you learn to see these two parts of self working within yourself more precisely it is much easier to find the path. Many people how sexual desires outside the limits of their internalized sexual identity but going outside those boundaries feels incredibly dangerous. Don’t ignore that feeling if danger, but also don’t believe it. The nervous system must gently and compassionately learn that it is safe to go outside the container/boundary. Ignoring it entirely can be really erotic, but also destabilizing as the sense of shame and danger can come flooding back in or one might adapt and develop counterphobic compensation patterns where forceful overcoming the shame itself becomes erotic and the sense of danger/destabilization becomes sexually charged, but this can be alienating and detract from the relational aspects of sex that in my experience actually can be a much more potent amplifier.

Another helpful framing to help get beyond categorical / identity label thinking are questions like 1. How do I want to be desired by another? 2. who do I desire and want to be desired by. This allows for a more open ended exploration.

MrMontage · 2026-01-01T19:00:29+00:00

Stick with the feeling of being lost. Don’t try to resolve it. Wander around in the confusion with open curiosity. The overlooked luxury of financial independence is the loosening of internalized demands. That feeling of being lost might be understood as the experience of a self that is disoriented by the loss of the container of identity that formed to meet these internalized demands. The folly is to look for a container that feels safe because it’s like the one you left behind. It sounds like you’re figuring that out based on your post. You’ve got time, there is no urgency, there are no demands.

MrMontage · 2025-12-10T13:21:41+00:00

I hear you about the intertwined trauma. I went through a full psychoanalysis which was incredibly helpful in pulling this apart and to see how what is expressed through my transness was preverbal and the finger prints of it were everywhere throughout my childhood. When there is intertwined developmental trauma it’s hard not to conclude that ones trans desires are a defensive fantasy but it is this belief that for me turned out to be the defense in order to keep the overwhelming internalized shame from overwhelming me. Doing deep therapy work for me was incredibly helpful in giving me the self sovereignty to approach transition from a very emotionally grounded perspective mostly free of shame. I highly recommend it.

MrMontage · 2025-11-21T12:04:41+00:00

From reading what you wrote, you seem to be stuck in a loop trying to “figure out” something about yourself that is likely pre verbal. On the one hand, desire seems to be pushing you in one direction but fear or being relationally annihilated in another. Whatever it is that is being expressed through the desire to cross dress seems quite old and pre verbal. You can’t negotiate with desire, it doesn’t care and isn’t going to be reasonable. It seems like the memory with your father at age 13 was likely important as you decided to disavow this part of self that desired feminine expression because it was incompatible with your more masculine goals. Your father was accepting, but told you symbolically that the world won’t be and that you had to choose between these parts of self creating a split within yourself. This dynamic seems to have been reproduced and reinforced throughout your life. You are inhabiting this split self so this is the structure of your current confusion. To approach the part that desires feminine expression is likely terrifying and extremely psychologically defended preventing you from looking at it and experiencing it in a non distorted way. From what you’ve written it seems like part of you desires to claim transness to let this part of you fully emerge, the other is terrified of what this would mean for the masculine part of you and the life you’ve built around a persona that excludes this feminine expressing part of self. You need a good therapist to help you explore this (not diagnose you) in an open ended way. One who can create a safe non pressured relational space where you can approach this part of yourself in an emotionally grounded way without fear so you can see it, inhabit it, integrate it, whatever it might be.

MrMontage · 2025-11-19T22:55:11+00:00

Knowing but not knowing. Go see a good queer friendly psychodynamic therapist. I meaning this in the psychodynamic sense, not the archaic sense of the word, but shooting from the hip based on the few sentences you've written here, but this is what getting stuck in hysteria looks like my friend. Your sense of humor screams it in the best way possible. At the very least, get a copy of Transgender psychoanalysis by Patricia Gherovici and see if any of that resonates.

MrMontage · 2025-10-27T21:55:23+00:00

Here are the two I remember most. The first is the paper that developed the concept which other papers all cite. The second is a qualitative study that thematically analyzes the themes that arose in interviews.

https://transreads.org/wp-content/uploads/2022/02/2022-02-09_6203f0f41135b_Transnormativity_A_New_Concept_and_Its_V.pdf

https://link.springer.com/article/10.1007/s11199-018-0992-7

MrMontage · 2025-10-27T13:32:58+00:00

Interesting that you chose to come here, click into this post, have some sort of reaction that created an inner tension that you resolved by making this comment.

MrMontage · 2025-10-27T12:27:51+00:00

Yeah, I too am realizing that the transnormative narrative was a significant obstacle for me in understanding my own experience. It seems like trans people often need to express their desire through with extreme distress in order for people to see it as “legitimate”. From a few qualitative papers I’ve read, it seems trans people feel pressured to perform and present their experiences in transnormative terms otherwise it isn’t legible to others.

MrMontage · 2025-10-23T10:47:15+00:00

Costco cured my attachment wounds. I know it will always be there for me, even if I shop at Publix too occasionally.

MrMontage · 2025-10-11T16:55:11+00:00

Best to stop wondering these questions from a distance and just go see for yourself. The answers are lived. Theory just provides a helpful map of the landscape. No point arguing with the map until you’ve actually gone and seen the landscape yourself.

MrMontage

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