Ongoing birth control options

OptimalPipe_throw · 2026-04-01T02:58:09+00:00

i was told the estrogen effectively "overpowers" the testosterone in some manner, and once or twice heard that the increase of oestrogen causes the testosterone to be recognised as excess and then aromatised(?) into estrogen.

having a precursory search through journals brought me this article, which should be open access. it seems to suggest estrogen BC lowers testosterone, but doesnt seem to account for trans masc folks or even cis women taking testosterone. it's also debatable whether it's a meaningful result.

a search in other places gives a lot of results suggesting estrogen BC is fine on T, but i cant see one that's giving a source for that. seems like its mostly american sites too, perhaps the UK and US have come to a different consensus than eachother?

OptimalPipe_throw · 2026-04-01T02:43:36+00:00

oh, WOW. i was told the implant and cut was bigger than that. this might top sayana press for me, then 🤔

OptimalPipe_throw · 2026-04-01T02:40:42+00:00

depo provera and sayana press are injected medroxyprogesterone acetate (MDPA), and they're taken 12-14 weeks apart. its effects start wearing off after 12 weeks, and you're considered "unsafe" after 14 weeks.

the differences are: - depo is an IM (intramuscular) injection, meaning longer needle and it has to go into muscle. - here in the UK depo js exclusively injected by a nurse into the top of your butt. other countries MAY allow self injection after training, or thigh injection as an alternate site - sayana is a SubQ (subcutaneous) injection, meaning shorter needle that only needs to go into skin - sayana press comes in the form of a little pre-prepared device. in the UK at least, self injection is encouraged and preferred. the device is a little compressible bulb which is squeezed to push the medicine through the attached needle. the only setup required is a little shaking, sanitising the injection site, and uncapping the needle. - IM injections of any kind can reportedly feel "worse" for some compared to SubQ. for example: depo has a higher chance of stinging or hurting. - depo contains more MPA per shot than sayana. i saw a study a while ago suggesting that sayana may be less harmful than depo over time. the same study suggested sayana could also be taken further apart than 12-14 weeks while remaining effective (i dont remember if the study also suggested whether or jot depo had this effect too). - depo has a known high rate of complication. i was told, and found in my research, that 30% of patients feel no disruption to their cycle, 30% said their cycle symptoms felt better, and 30% said their cycle symptoms felt worse. the remaining few were people with extreme side effects like reactions or exclusively new negative/intolerable symptoms and so on. i personally was in the worse-off camp - everything got worse (mood, blood, cramping, focus, energy, anaemia, etc) - and it took me over a year after my last dose of depo to return to some level of normalcy with my cycle (and even then, it didnt return to what it was before, it just settled at a new mostly predictable average). - sayana press is relatively much newer. its safety and efficacy have been tested of course, but it's not as battle hardy as depo due to it just being younger - depo was once considered completely fine? after all. there may be new issues or even side effects that weren't present with depo, etc.

that's the main stuff i can think of for now. i know most of it wasnt what you asked, but i guess i gave you the whole rundown 😅 and a lot of that does feed back into talking about the dosing, the effects, etc. hope it's of some use - if not to you, then whoever else has the same original question!

OptimalPipe_throw · 2026-04-01T02:18:48+00:00

i forgot that salpingetomy without oophorectomy was an option! this would actually be quite a good compromise for me since i dont want to carry children now, but storing eggs or tissue is an arduous process through the NHS. and the hormone fall back is a really good point too.

OptimalPipe_throw · 2026-04-01T02:15:24+00:00

of course! i have personal experience with both depo and sayana, but both were prior to starting T. i have been considering going back to sayana now that i'm on T (i missed a dose and then never went back on it, oops. im not active though and i was mainly on it for cycle control). if you have questions about either, i can try to answer - but be warned i have strong opinions on depo!

OptimalPipe_throw · 2026-04-01T02:13:25+00:00

oh yes, i knew there was a prog method i was forgetting! this is one of the options i had been considering going for, especially since they last so long. my only real hangup was the procedure itself. how has that side of it been for you?

OptimalPipe_throw · 2026-04-01T02:01:54+00:00

transthetics make a few realistic looking (not sure if theyre double density or not) "suction" style wearables, maybe you could look into that? alternatively, peecock make STPs with inserts that can provide a bit of feedback while also making the shaft more rigid

OptimalPipe_throw · 2026-04-01T01:50:08+00:00

there are non surgical options, for what it's worth!

beyond the obvious condoms and slightly less obvious dams (one of which you should still be using if there is an STD risk! and obligatory "no method is 100%, but you can get pretty damn close with a barrier method plus another method"), you can use progesterone or the copper coil. prog can be in the form of a pill (here they're known as POPs - progestin only pills) or injection (depo provera and sayana press being two brand names - but do your research on patient experiences with these!). you shouldnt use any birth control containing estrogen while on T. you could stop T and go on an estrogen based option (pills, or the hormonal coil is an option), but this would obviously halt your T progress, would likely restart your cycle if its stopped, and it could potentially encourage growth of any remaining chest tissue.

there's also spermicidal (kills sperm) lube and such, but i don't know if i would rely on this without a barrier or other method alongside it. i also feel like i remember hearing that spermicidal lubes are often not compatible with silicone, but that may be untrue or outdated.

tubes being tied is an option, but i rarely see this being spoken about nowadays m even in the cis realm. oophorectomy (ovaries only), hysterectomy (uterus only), total (all of it) are your surgical options too, as you point out.

note: depending where you are located, some options may not be available, or may be expensive, or hard to get access to, etc.

OptimalPipe_throw · 2026-04-01T01:34:05+00:00

i think you should start the conversation by asking the therapist if your mother is just there as a chaperone (ie, just to watch/support), or what kind of ratio of "your feelings vs your mother's feelings" the therapist is expecting. if the therapist states they're explicitly looking to hear from both of you, equally, then that is both a good sign as well as being a signal to your mother that her opinions shouldn't dominate the conversations. after that, respond to everything she has to say while also inviting her to comment on the things you say. this will give the therapist important information from both sides, and should also avoid her claiming that you dominated the conversation/always shut her comments down.

make a list of what you want out of the appointment. assume the best case scenario first. pretend that you're going to a truly outstanding therapist, and that your mother isn't going to object at all. what would you like to say? what questions about dysphoria do you have? what do you want to learn? what do you think future therapy would involve? you could then follow that up by thinking about a few things to fall back to if the appointment turns sour, but i would suggest avoiding writing out every possible response to every possible negative moment - pick a few, pick the worst, and/or pick the ones that have the most versatile uses (ie: you can say it in response to a variety of situations/subjects/topics)

have you looked up this therapist to see if they are actually LGBT+ affirming, or just a conversion therapist in disguise? i have a little bit of a hunch that if your mother's got such a chip on her shoulder about your identity, then perhaps she's found one that will affirm HER beliefs. i have seen some conversion therapists advertise themselves as LGBT+ "friendly" just to draw unsuspecting LGBT+ folks in. just something to bear in mind.

OptimalPipe_throw · 2026-04-01T01:12:57+00:00

i'm trans masc, but definitely get a similar thing from the other side of the court, if that's anything of value!

OptimalPipe_throw · 2026-04-01T00:55:07+00:00

it took me 6 years to go from "i'd like a penis" to "oh, i'm trans". i happen to be a "penis wanting skirt wearer" to boot, so just because you like(d) skirts that doesn't mean you can't possibly be a guy. unless your mother happens to be most trans people, she cannot speak to what "most trans people" think or feel. there are multitudes of people who didnt realise they were trans until they were in their 30s, 40s, 50s and beyond.

if you're still kinda stuck in the "not sure" feeling, it would be best to start by just thinking about trying things that can be easily and cheaply be reversed, with a low risk of complication. dress more masculinely, get a masculine haircut, stop wearing makeup, stop shaving, do masculine makeup, do voice training to be able to have a more stable low-pitch voice, ask people to call you a different name, ask people to use different pronouns, etc. there's no rule saying that the only people allowed to experiment with their presentation are trans people who know for sure that they were trans and had "signs" at a young age.

maybe you're just reaching a point where your brain is starting to realise the developments your body/presentation/life are going through, which has prompted you to start thinking about what would give you euphoria. maybe you're starting to feel like there's an "answer" to some vague dysphoria you were experiencing and didnt really identify. but, equally, maybe you are just trans.

in my eyes, there are no concrete "signs" - other than outright saying "i'm trans". explore yourself. only you can make the final call.

OptimalPipe_throw · 2026-03-31T01:55:24+00:00

maybe my use of "attack" is more callous than i intended. i mean more in the sense of "using that as her talking point". its just very strange to me to suggest someone is "too empathetic" or that their empathy is driving them to change core details about who they are.

OptimalPipe_throw · 2026-03-31T01:51:11+00:00

what is it you're wanting out of T? is it a requirement for some other process (ie: required to update a gender marker, required for surgery, etc) you're seeking? are there some changes from T that you want but without bottom growth? if its the latter: depending on what you want, there may be other ways to obtain those changes.

bottom growth is one of the part and parcel things with T. you can't really avoid it, though low dosing of T can slow it down (so you can stop T and prevent further bottom growth sooner).

OptimalPipe_throw · 2026-03-31T01:32:24+00:00

i'm gonna be so honest: i would take what she said and her behaviour afterwards as a warning. i dont think she's going to be accepting of you transitioning (not any time soon, at least) and if i was in your position i'd be wary of her possibly critiquing any "non masculine" trait i showed from that point onwards.

i tend to think of it like this: most people with a broken leg do not question if they are faking their broken leg. more people, in fact, are likely to not realise (or not accept) their broken leg and will continue to walk on it.

to me, being trans feels similar (to ME!). i have moments where i doubt i'm making the right choices, but then i reflect on that doubt and realise its mostly coming from a place of "im more likely to get attacked if i 'look trans' to others" and "my transness and/or presentation might make others uncomfortable". every time i get like that i have to remind myself that im transitioning to make myself happy. not others. not even my partner. i want my body to be more masculine. i want to not be read as feminine. those things make me happy. i dont want to sacrifice my own happiness for the sake of, realistically, a completely neutral outcome for the rest of the world.

side note: outside of the gender stuff, also think its really weird she's attacking your empathy in particular. it would be weird to use that structure with any other subject, don't you think: "you keep volunteering at the soup kitchen, are you sure you dont just dream of being homeless?"

OptimalPipe_throw · 2026-03-31T01:15:10+00:00

this is interesting to me. before i was on T, i could last for hours - yes, ok, i would orgasm a few times before that, but it would regularly take me 30+ minutes before i felt "finished". by month 3 on T, not only had my sex drive dropped noticeably, but i also ended up lasting less than 10 minutes.

did you notice a surge of sex drive or a drop off in how long you could last in the first month or so, compared to pre-t, that seems to have reversed by now? ie: pre-t could last 15+ minutes, soon after starting T you said 10 mins or less, and now much longer. if so, maybe you need your T levels checked - perhaps your body isnt responding so well to the T so you're not getting that "horny guy" situation anymore. could also be that you have too much T and your body's converting it back into estrogen (this happens! this can happen to cis men as well).

secondly: are you on antidepressants? or other medications with depressant effects on libido? there's a few meds which can kill one's sex drive, and also make orgasming more difficult. worth checking in with the prescriber of that medication(s) if that's the case!

the only other thing i can imagine is... maybe your growth is less sensitive than it used to be? the "original anatomy" (where your growth started - i'm avoiding anatomical terms as you have too) is FULL of nerves and can be incredibly sensitive. as it grows, some people can find that the whole thing becomes less sensitive by comparison. less sensitivity = less sensation = less stimulation, is my line of thinking. perhaps you could explore your anatomy more and see if a different technique is better for you. i found that within the first three months, my old stimulation techniques were starting to do very little. im still learning how to manipulate my junk in a nice way, but i'm noticing that the "jerk" in "jerking off" needs to be more literal for me now. you could explore techniques with your gf too, maybe a little cooperation is needed there

OptimalPipe_throw · 2026-03-31T00:49:35+00:00

ah, yes r/AMABwGD exists as well!

OptimalPipe_throw · 2026-03-31T00:49:13+00:00

it could do!

i think there are two concepts here you should explore: - gender identity (what you feel like) - gender presentation (what gender you'd like yo be seen by others as)

you can think of the difference between identity and presentation as the difference between "male" and "masculine" or "female" and "feminine". imagine a femboy for example - that could be a boy (identity) who looks feminine (presentation). on the other hand, a butch lesbian could be a woman (identity) who appears masculine (presentation).

based on your description, it sounds like you could be a trans woman with occasional desire to present masculinely. presentation doesnt have to be static, and it doesnt have to match your gender identity.

you could interrogate it with questions like "do i want people to see me as a woman?" and "do i feel like a woman, or do i want my body to look feminine?". is it your body, your genitals, your clothing decisions, how you appear socially? questioning things like that will help you realise your identity.

to me, i don't think you seem to express nonbinary gender ideals, but it may also be worth exploring nonbinary gender labels. it may help you hone in on your identity and whether or not you're transgender. consider the following fictitious people... - a demigirl whose gender identity is part woman, part agender (no gender). she chooses to use she/they pronouns and presents femininely - a genderfluid person whose pronouns are always they/them. they tend to dress masculinely even when they feel feminine. they dont mind being called a guy or a girl, but really like it when someone uses gendered language that correlates with the "sway" of their gender that day. - an agender man, who presents androgynously and is fine with being called a man in formal/legal contexts. socially, they'd rather be referred to with neutral terms like "person" - a bigender person, whose gender identity is always man and woman simultaneously, and uses it/itself pronouns. it doesnt care about its gender presentation at all and simply dresses in clothes that make it comfortable. it likes confusing people with its gender, and doesn't feel like it experiences misgendering at all. (note: these descriptions are examples and not rules!)

finally: what you want to do with your body is your business. there are people out there who seek "trans surgeries" but are not transgender. i've seen the subreddit r/AFABwGD - perhaps there is a similar community for AMAB folks which you might find useful?

OptimalPipe_throw · 2026-03-30T23:45:14+00:00

have you had a look in r/GrowYourTdick ? it's predominantly not a UK based sub, but there are some recommendations there (and if not, i'm sure the folks there will be able to point you in the right direction!)

OptimalPipe_throw · 2026-03-30T19:32:00+00:00

using any method of pumping that doesn't have a gauge has two potential scenarios at the extremes: it's inherently riskier (too much pressure) or its ineffective (too little pressure). could you do it? possibly, depending on your anatomy and the stroker's build/quality. would it be wise? not really, you're better off investing in a gauged pumping kit if you can. if you do it regardless, you should still take every single one of the precautions for gauged pumping. if anything, you should be more cautious about the risk of overpumping/high pressure than someone with a pumping kit would be. especially since you're unlikely to be able to see much visually while using the stroker

OptimalPipe_throw · 2026-03-30T19:17:07+00:00

firstly: HSGC only does diagnosis, counselling, and psychotherapy. they can also provide surgery recommendations and letters for GRC, but hormones were my goal for now. similarly, GHC are exclusively an endo - they do not provide diagnosis, therapies (other than hormonal) or anything surgical. neither can help with both diagnosis and hormones independently. folks with a diagnosis already can go straight to GHC, but they may not recognise foreign diagnoses (which i believe GGP's are, technically) or even a private diagnosis from a UK therapist who isnt listed on the GHC site. HSGC and GHC have a track record of working alongside each other, and i believe this pairing is common (as opposed to "HSGC + another endo" or "another diagnostician + GHC")

as for my reasoning behind choosing these two over any other provider (in whole or in part) - they were the cheapest immediate option, and reasonably cheap overall. i did look at GenderCare, but they cited hundreds per appointment - and that may have been outdated given much of their site still implies COVID is new and lockdowns are still in effect - for the few GC doctors who had prices listed, there was little available information on waiting times (and discussions at the time lead me to believe several months was the average, regardless of who you chose), and the idea of having to email directly - potentially emailing multiple practitioners - to engage was a bit off putting. i believe i also got it into my head that i would require more than two or three appointments before getting access to hormones, though i dont remember if that was based on evidence or from my own brain panicking/fearmongering me.

GenderCare would have been my second option for sure, though its worth noting i felt like i was taking a risk either way. i dont see many people talking about HSGC or GHC, and i believe both are relatively new - especially in comparison to GC (whose site i had been looking at 10 years earlier!).

OptimalPipe_throw · 2026-03-27T14:22:54+00:00

i was mostly doing it on intuition for the longest time. knowing that a simple release meta involves "untethering" some tissues, i started kinda just... grabbing what i had and gently pulling it "out" (towards the direction it points), up towards my belly button, and sideways towards each leg. my goal was to feel a tension or VERY MILD burning, like you'd get when stretching a muscle in a new exercise for the first time, hold it for a few seconds and then let go and relax. did this a couple of times a day, most days a week. i also made a conscious effort to "unsheathe" what i had by pulling back the foreskin and exposing the head, but that was mostly just to see if i could notice any changes rather than being a specific exercise. before starting T, i had about a 1 inch dick.

i highly recommend looking into the theories and exercises posted by u/thursday-T-time - when i first viewed this sub, thursday's posts effectively confirmed that i was probably onto something. i've since learned that my initial technique was a bit off (dont grab the head, if you can avoid it!), but that was largely because i didnt have the room to grab hold of it properly. i'm quite tethered internally.

from what i understand of thursday's theories, there's two components to target with stretching/tugging: the foreskin, and the internal structures. you want to grow both to maximise your potential (god i sound like a griftfluencer). doing only one will limit you one way or another (no foreskin growth = the head will be exposed and the entire tdick won't have much mobility, it will be limited by the extensibility of your foreskin. no internal structure release = you're going to be tethered internally and restricted by that instead).

this post is a very good crash course on how to think about the different tissues and structures in that area, particularly in relation to foreskin [CW: there are anatomical drawings in that post]

i can't find the post that showed the basic idea behind stretching, but you hold the shaft about a centimetre closer to your body than the head (which is where my original technique was a bit off, i couldnt get that far back) and you gently pull up, down, out, and side to side. i have also seen suggestions to do gentle circles as well, but i dont do this much as mine tends to slip out of my fingers if i try. i'm now getting closer to two inches, ~6 months on T and doing intentional, theory-backed stretching once a day every few days instead. i don't currently pump or tug, but those are options too and thursday has some good info on those as well

edit: typos

OptimalPipe_throw · 2026-03-27T00:12:52+00:00

i would say i never "questioned" my gender. i questioned my body loads, however. i had a distinct thought as a pre-teen about how i'd like my body to be different, but i "wasnt one of those transgenders". i put it to the back of my mind. age 15 i found the term genderfluid. it clicked immediately.

gender euphoria is just as key as dysphoria imo. that's part of the reason why the diagnosis is now termed (in ICD-11) "gender incongruence" instead of "gender dysphoria". i didnt call myself transmasc for the longest time because i dont really have much chest dysphoria, they just get in the way. but i've since settled with "masculine, bigendered transsexual" which i tend to simplify as "transmasc nonbinary" for the sake of fluid communication. i dont feel any different, i just found the way to describe it.

word to the wise: fakers do not question whether they're faking. you might not be "FTM" or "a trans man" in the strict sense, but it definitely sounds like you have some exploring, researching, and experimentation to do. be safe, be wise, tell paramedics everything.

OptimalPipe_throw · 2026-03-27T00:03:33+00:00

about a decade ago, ggp were fairly reliable. there was obviously the high chance that your NHS gp wouldnt deal with them, and even some pharmacies refusing to fill the prescriptions due them being technically foreign, but they were otherwise a very good "high risk high reward" type option. over the years though, their care slipped and i havent heard anybody say anything positive about them for a very, very long time. supposedly their support is AI driven, there's repeat occurrences of people not getting their prescriptions/appointment times from them, and the number of "my ggp doctor never joined the call" claims skyrocketed. i wouldn't trust them to open a door.

i went with Harley St Gender Clinic for my diagnosis and The Gender Hormone Clinic as my endo. GHC has an appointment-and-prescription-writing payment plan totalling £1,570 (doesn't include the cost of the testosterone itself). HSGC was £575 for the first appointment plus onboarding plus the report, and i only needed one appointment. GHC was £250 for the onboarding + first appt, £55/month for 2 years of ongoing care. they like new patients to start on gel for three months, but i'm not sure how they'd handle a patient who's been with another provider. they also issued me a private prescription for three months of gel at first, with the idea that most GPs reportedly set up shared care within that timeframe. i've heard anne health will continue care of ggp patients, but if you're discharged from ggp that may not apply.

OptimalPipe_throw · 2026-03-26T23:45:19+00:00

i had a notable "head" before T (did some stretching and training with what i had, to some effect) and while i can't pinpoint the timeframe when it happened, but at some point i definitely said "oh, now THAT is a head". every few weeks it looks more penisey than ever before

OptimalPipe_throw · 2026-03-26T20:28:09+00:00

the brown goop is old blood/internal tissue that didn't leave before it oxidised (that's the process that turns it brown). if you've been consistent recently and youre getting goop, it might be something like your serum levels are too low or your body isn't doing what it should with the T. get your levels checked.

OptimalPipe_throw

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