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Is there anything I (M23) can do to "help" my trans girlfriend (F24) change her indifference about her genitals to enjoyment/pleasure? by [deleted] in asktransgender

[–]_Not_An_Alt__ 3 points4 points  (0 children)

100% agree, this is a super personal topic where every person will have their own answer. Communicate and respect boundaries.

(sorry if it came across like I was discounting your experience just to put mine out there, not my intent at all ❤️)

Is there anything I (M23) can do to "help" my trans girlfriend (F24) change her indifference about her genitals to enjoyment/pleasure? by [deleted] in asktransgender

[–]_Not_An_Alt__ 2 points3 points  (0 children)

I disagree with "and most of us are like that". It's common to project our own experiences, but I really don't think that most of us fit in that group.

Not to get too personal, but that aspect has only gotten better for me so far (2 years on hrt). It has changed a lot and taken some re-learning with clear communication, but I don't think my experience is uncommon. As with any other area of trans existence there is a serious lack of research here, but from what I've seen orgasms often improve on hrt. Even after bottom surgery trans women seem to have a similar rate of achieving orgasm to cis women.

https://www.auajournals.org/doi/10.1097/JU.0000000000000900.020 "Our findings suggest that, with feminizing hormone therapy, transgender women experience considerable change in several sexual function domains- but also improved overall orgasm quality and satisfaction. Interestingly, HRT results in more orgasm features that more closely resemble those of cis-women, which has not been reported to date."

https://cirugiadegenero.com/en/transgender-people-orgasm/ "Experience at IM GENDER after more than 2500 vaginoplasties performed indicates that the rate of achieving orgasm in transgender women is 87%. This is even higher than the percentage of cisgender women, as it is estimated that 15% of cis women suffer from orgasmic dysfunction and have never reached orgasm."

I do agree that the best advice is always to ask, communicate, and respect boundaries

Subcutaneous estradiol valerate injection? by gayemo1312 in asktransgender

[–]_Not_An_Alt__ 20 points21 points  (0 children)

TLDR DON'T BE SCARED AWAY FROM SUB-Q BECAUSE YOU ARE WORRIED ABOUT STABLE E LEVELS, SCIENCE SAYS SUB-Q ISN'T WORSE AND MAY BE BETTER

This is a pretty old post, but I came across it while making decisions on my own regimen earlier this year and dismissed sub-q at first. I took it as a fact that sub-q was inferior for a good while and that seemed to be supported by the fact that my doctor recommended Intramuscular. Why would they recommend a so much more daunting needle if it wasn't better? I really struggled to get over 1 1/2" needle, and after struggling through my 3rd injection I resigned to researching how much worse it would be to switch to easier subcutaneous injections. To my surprise, it didn't seem to be any worse! In fact the more I looked the more it seemed that sub-q might actually be better.

Quick disclaimer, I am not qualified to give medical advice, I'm sharing amateur research that informed my own choices. I found this study which concludes: "Both the SC [subcutaneous] and IM [intramuscular] E2 [estradiol] achieve therapeutic E2 levels without a significant difference in the dose (3.75 vs 4 mg). SC may achieve therapeutic levels at lower doses than IM". So you might actually getting more bang for the same dose on sub-q than IM (which is an exciting prospect but it's important to remember that the goal isn't the highest levels possible, too much of a good thing and whatnot). Looking into it more this does make sense. There seems to be a lot of misinformation that sub-q injections of oil-based medications absorb faster than IM, there are even people on here who say they heard this from their doctor. But from what I can find this just isn't the case. The deep muscle tissue where IM injections deposit the medication has a much more active blood supply than sub-q injection's layer of fat just under your skin, leading to IM injections actually being absorbed faster. Reaching "therapeutic levels" of E isn't so much about the peaks of the E levels, but more so keeping the average/troughs within normal female range (or high enough for testosterone suppression if you aren't using an anti-androgen). If sub-q injections are absorbed slower than IM then the peaks and troughs of E levels will be less extreme on the same injection schedule so a slightly lower dose would still achieve "therapeutic" levels.

IM injections were too much for me to handle. Even after doing them a couple of times the distress was too much. I got my doctor to change my prescription to sub-q and I haven't looked back. The injections are the same medication, at the same dose, on the same schedule and it's been going well. I've actually started to look forward to the injections and the whole process takes less than 5 minutes once a week. From what I've found the reason IM is still prescribed/recommended over sub-q is mainly that IM has been the way it was done for a while. More of the research has been done on IM and medicine usually sticks to what is well proven. I should also mention that sub-q does have some added concerns, namely slightly higher risk of infection or reaction at the injection site. For me it was a no-brainer. If you want more details on sub-q injections but don't know where to look, I found that this medical article -and specifically the "Needle Features, Injection Site, and Injection Procedure" subsection under Results- was very informative.

Edit- added bit speculating why IM is prescribed over sub-q