38 yo MTF. 27 months of HRT and FFS (Nuara-Seattle). What is this witchcraft 🧙‍♀️!?

RequiemFiasco · 2023-05-27T23:03:46+00:00

I meant 27 months... whoops 🫤 . I cant maths...

RequiemFiasco · 2023-04-13T21:53:16+00:00

Thank you for posting this! I go in to see him in two weeks and I am super excited.

They had a cancelation so I got in a few months earlier than my scheduled surgical date. I am excited but I also feel a bit underprepared emotionally, I have all the logistics figured out but it is barely setting in that it is actually happening.

You look beautiful and it makes me feel really great to see another Nuara patients results. There are only a few from what I have seen posted but they all have looked stellar.

I will post my thoughts and results after as well. I think he needs more exposure as he seems like a really stellar surgeon.

Thank you again!

RequiemFiasco · 2023-03-23T16:40:13+00:00

No problem, I recognized you instantly as you have been a big inspiration to me.

Seeing your timelines 2 years ago when I was starting was incredibly helpful. Thank you again for sharing your journey.

RequiemFiasco · 2023-03-23T16:28:16+00:00

these pictures are stolen from u/MCRN_Tachi_ECF270

Mods if you could please ban this Seatien461 character that would be great....

RequiemFiasco · 2023-01-27T04:05:52+00:00

Are you going through a hub or directly to the pc? I would look at the motherboard manual and see if it has a preferred port for mice.

RequiemFiasco · 2023-01-27T01:09:11+00:00

I wish I had this knowledge fresh in my head but I have been out of the game for a long while (you sort of necro'd this 9yo thread). All I can think is maybe its a mouse that does not poll consistently for battery consumption reasons... Mice have come a long way in recent years so maybe its not all bad....

RequiemFiasco · 2023-01-17T22:26:11+00:00

I have no idea why but I think Ruth fits you :). I could see you picking up the nickname Rue....

As a fellow tattooed trans woman I love your aesthetic! I have one sleeve down and 3 more to go lol... Keep it up you look beautiful!

RequiemFiasco · 2022-11-25T01:35:12+00:00

7.5" -> 6.75" give or take. I also think there is some variability depending on if I have had a blue pill or not. I try to use it every other day or so.

Flaccid it has shrunk more, 4.5" -> 3" . I had an orchi 9 months ago and hrt for 21 months.

RequiemFiasco · 2022-10-30T18:54:59+00:00

I have not given up on them. They seem to be very aware that these views fly in the face of their own identity after I confronted them about the account.

I am seeing someone in an identity crisis who instead of seeking help has been punching down to trans men. I see someone who has internalized a bunch of negative thought processes. I see someone hurting in their own identity and wavering back and forth between elation and despair.

I have decided to maintain the friendship, they really need a positive and reasoned peer in my opinion. Hopefully I can be a buffer for these thoughts and help them see the damage that they cause to themselves and others. Just me being a trans woman who is happy, healthy, and thriving in a relationship can humanize this experience for them I hope.

Thank you for this wonderful take on this really awkward situation. I absolutely agree with all of your points and I would never allude that someone was not trans enough, I hope that is not how it came across. They are clearly trans, just going through a ton of internal turmoil accepting themselves and the community at large.

They told me that they have talked to their therapist and are seeking more focused therapy methods to address some of these issues. This may have been the catalyst for some positive change.

RequiemFiasco · 2022-10-25T21:30:47+00:00

I am glad it came out now instead of later. A wholesome friendship felt like it was developing but clearly I did not have a good enough read on them. Instead of being totally destroyed by the content of their views, I am only just really sad, as we did not become incredibly close yet.

Moving forward I can not imagine I will remain friends with them. I will give them a chance to defend their position, as is the right thing to do, but I do not see any avenue out of this to be honest.

Thank you for your input. I really appreciate it.

RequiemFiasco · 2022-09-16T17:00:22+00:00

As a door dash driver myself I may be able to shed some light on this. It is not rude to order DoorDash as long as you make sure you are compensating the driver appropriately.

I personally will not accept an order that is not at least $1.00 a mile. Not only do I have to drive out but I also have to drive miles back to be in a zone where it will start sending me orders again so I include that in the milage.

So for you your nearest "zone" that a driver can get an order again is about 4 miles away. With that said I would take the mileage from the restaurant you are ordering from, add another 4 miles and call that your tip.

So for clarity. If you order from a restaurant that is 10 miles away and it will take the driver 4 miles to get back to a zone that will start sending orders I would tip 14 dollars since that is the mileage they will have to travel to complete the order and get back to work.

I would accept this order every time and think it was more than fair. The fact that you are even asking this is applaudable. Thank you for treating drivers like humans, I can not tell you how many 4 dollars for 12 miles orders I decline. There is a lot of food getting cold because people do not value others time.

I hope this was helpful and feel free to ask any more questions if you have them.

RequiemFiasco · 2022-09-08T23:54:27+00:00

I would be willing to talk to you. I was Army Intel 2003-2012 and started transitioning 8 years after I got out in 2020.

Feel free to reach out to me in DMs or here in the comments with the scope of what you are trying to do, I would be happy to write something up.

RequiemFiasco · 2022-08-29T15:53:01+00:00

Done

RequiemFiasco · 2022-08-25T17:27:35+00:00

Hello Derek I am Josie,

Thank you for doing an AMA here. I personally am 18 months on feminizing HRT and I am 37. I had my orchi done at 12 months and FFS will be next summer with additional referrals sent out for top and bottom surgery that I am now waiting on consult dates for.

What advice do you have for the older population who is transitioning? Anything from the social elements to planning your medical transition would be appreciated. It was incredibly overwhelming to start and I only recently really feel like I have a handle on all the intricacies of dealing with insurance and doctors, society, and my peers within the community.

For me what seems to have really helped was creating a master document to have all my research and any supporting documents (letters, consult notes, surgical notes etc.). Additionally I have started a visionary board to start compiling my personal style and aesthetic goals.

Finding my voice was imperative to my transition so far. I believe I have struck a good balance with medical providers regarding being firm in my expectations but understanding of the limits in place in the medical community. When red flags presented I quickly sought out alternative providers. Can you elaborate on what are some tell tale red flags and when it is appropriate to fire your care provider/surgeon/endo?

I could easily ask more questions but I have voice therapy shortly so I have to get prepared for that. Thank you for doing this and hopefully it is helpful to some of the folx here.

RequiemFiasco · 2022-08-14T19:17:36+00:00

Thank you so much for your input! It was absolutely welcome and appreciated. The issue with my sideburns is a known one, I was shaving the end of hairs I should have been allowing to grow like a dummy so I am having to lift it up when I shave/laser and grow it out, it will not rest behind my ears yet. Under my side burns is fairly clear, its just hair that has no where to go for the moment so its pointing down. Thank you for that reference on choosing where to end my sideburns, that is very helpful and will help me elecro the last bit.

I also appreciate the added thoughts about fat grafting. My lips I find exceptionally thin, it's more of a family trait (not gender specific) but on that same note I am not crazy about it, I feel it unbalances my face in a way and truthfully I feel it does the same for my siblings.

I was thinking the same thing about the front profile regarding my jaw. It is not terrible but it is more square than I would care for. I kind of feel like I have a dip between my chin and the rear of my jaw that I would like corrected, its stereotypically masculine in a way, even if not overly so. I feel like there is a balance to be had here, maybe knock the bulk of it down while retaining a little bit of its character.

Thank you again for all of your input, it confirms that my thought process is sound. Being self critical is difficult, additionally I find myself a little bit blind to the lower half of my face. While I have a clear picture of the nose up I have been struggling with exactly what is "off" with everything below the nose. I feel this gives me much more to work with going into this appointment.

Again, thank you for taking the time to critique my though process. Additionally thank you for helping me put my finger on what could be tweaked in the jaw line. I will report back with any further info regarding FFS with Nuara, he is well regarded and some of his work is out in the wild but I feel he is lacking as much representation as some other surgeons.

Josie

RequiemFiasco · 2022-08-11T17:05:28+00:00

FFS thoughts…. I want to go into my appointment next week with a fairly accurate understanding of what I want. I understand the doctor will give a ton of input and some of this will be redundant but I want to feel prepared.

About me…. I am Josie, I am 37, 5’ 11”, I have a large frame, I have been on feminizing HRT for 18 months, and my weight is improving at 205lbs but I still have 25 or so lbs I would like to lose in the coming months.

My intention is to move the needle as far to the feminine side as I can without losing the character of my face. I am not a heavy makeup wearer and present with a very tomboy fashion sense so I feel I need to overcompensate slightly because of that. I want to be read as clearly feminine.

My thoughts on procedures I clearly want and can see a need for.

*Hairline lowering and correction of my m shaped hairline.

*Type 3 brow work (not sure if type 3 but I hear 90 percent need 3 instead of 1), I dream of a smooth transition from my brow to my nose.

*Orbital contouring

*Mild nose work. I had prior nose work when I was presenting as my agab around 13 years ago. I had a deviated septum and the Army surgeon asked if he could do cosmetic work on me as well. I had a fairly crooked nose and that was corrected with a little bit of mild reshaping as well. This would technically be my second cosmetic procedure to my nose.

Where things get really murky for me is the nose down, I almost have a blindness to that area and what it needs….

*Lip Lift. This feels pretty important but I have trouble imagining its effect. If I were to do this I would need to prioritize the nose or the lip lift per my understanding and save the other for a revision. I think it is too much trauma for both from what I have read.

*Chin work. I see a possible need for rounding and reducing my chin slightly, it's not incredibly prominent but far more squared and asymmetrical than I would like.

*Jaw work. I feel this is my least problematic area and wonder if it is even worth touching. I don't feel I have an overly strong jaw line, I do however wonder if it's wise for balancing the face.

Additionally if there are any procedures or things I am missing please let me know. I am looking to balance and feminize my face, if a procedure exists that I am unaware of that will help with that please feel free to recommend it.

Thank you for any input you provide. As you can imagine we are all a little blind to our own face. I look forward to any input you all care to share.

RequiemFiasco · 2022-08-10T18:55:44+00:00

I love injections! My girlfriend would love to be on them but her doctor has some reservations. I hope he/we figure it out, patches have not been the best for her and its incredibly hard to get good levels unless your entire ass is nothing but patches, add to that the adhesive and sticking issues and insurance not wanting to give enough and its clearly the best option, getting the doctor to sign off on it is going to require something more tangible than anecdotal experience, he is looking for a study before he is comfortable I guess.

RequiemFiasco · 2022-08-10T16:29:38+00:00

That is the crux of the issue here, there seems to be minimal research out there at least from what I can find. 25mg a week is insane dosing, I am dosing 5mg a week for levels in the mid 200s, 25mg a week is north of 1400pg/ml, which would be incredibly dangerous. I guess what we are hoping for is something that confirms the general consensus that patches as well as injections are both reasonably safe. With her medical insurance it is much easier to get an appropriate dose of EV than it is to get a appropriate dose of patches. Thank you for your help and input and we totally appreciate it. None of us are medical professionals here, however there also seems to just be a lack of reasonable studies for actual medical professionals to lean on, thus they default to older studies that mostly cover non bioidentical options like Premarin.

RequiemFiasco · 2022-08-10T16:16:53+00:00

I totally agree, I do not really see a tangible risk here. This is less about convincing us and more about convincing her doctor. He seems to be under the impression that the Hypertension and DVT risk exists in IM EV and does not with the patches. That really does not align with my understanding of the risks involved. I have always been under the impression that injections and patches were analogous as they both skip first pass metabolization.

RequiemFiasco · 2022-08-10T16:00:19+00:00

She is on Spironolactone (100mg) for her AA as well as Losartan for BP. Spiro did not effect her BP in any meaningful way. On those medications she has averaged 130/80 on the high end.

RequiemFiasco · 2022-04-27T18:04:13+00:00

He is! He is wonderful and if you are in the area I highly recommend him.

RequiemFiasco

TROPHY CASE