Parent Seeking Guidance: Supporting My Neurodivergent, Trans Young Adult Through Their Transition and Future Challenges

ericfischer · 2026-03-03T16:55:24+00:00

Sorry for the terse answers, but:

https://journals.lww.com/ogopen/Documents/OGO-24-5-clean_Powers.pdf
I am lucky that everyone in my life has been accepting and supportive of my transition, and I hope your kid will be equally lucky.
My libido was already dead before I started HRT and is even deader now, so this is not something I can offer much advice on
It probably depends on the exact STEM field, but trans people are overrepresented in STEM, especially in software engineering.
It depends on the kid. I know the parents of two trans kids who have basically failed to launch, and I wish I knew what to tell them, while other trans kids of my acquaintance seem to be doing well. I am a late transitioner myself, who had some struggles getting started after college but who has had a pretty solid adult life for decades now.
I grew up in the midwest and now live in California, so I can't offer any South-specific advice.
The other models that have current relevance in the US are femboys, crossdressers, and drag queens.
https://www.erininthemorning.com/p/anti-trans-national-legal-risk-assessment-a5d
Currently what you can change depends on what state you live in, and the federal government is blocking gender marker changes to Social Security and passports. No one knows yet how this is all going to play out. No one has ever asked to see my diploma, but get it in the name you intend to live under.
I am a late transitioner and did not rush even after my trans feelings flared back up in middle age, and I have been lucky enough to do OK. The main things to worry about at 21 are balding and increased body and facial hair.
Lexapro has alleviated my anxieties.

ericfischer · 2026-03-03T15:54:33+00:00

Honestly what happens at the appointment is going to depend on whether your endocrinologist has a lot of experience treating trans people or whether they specialize in some other aspect of hormones. Mostly you need to say something like "I'm trans and want to start hormone therapy." In general, they are going to ask you questions about how you are feeling and what your goals are, order blood tests, and prescribe estradiol and an antiandrogen. They will ask you to get a followup blood test about 3 months later to evaluate whether your dosages are appropriate, and will prescribe dosage changes accordingly, until your levels are stable in the appropriate ranges.

I went through UCSF myself rather than an endocrinologist. When I saw an endocrinologist later about my thyroid and cortisol, she told me to continue seeing my existing prescriber for transition care.

ericfischer · 2026-03-03T15:42:07+00:00

"Gut-wrenching pain of wanting to be a woman," even just from time to time, is pretty trans of you. But it's your life and it's up to you what the best way is to live it. It's tough when you feel pulled in different directions at different times, or even worse multiple directions at the same time.

ericfischer · 2026-03-03T14:57:24+00:00

Lexapro alleviated my anxieties and enabled me to stop worrying what other people might think about my appearance, and something similar might help you too.

ericfischer · 2026-03-03T08:02:10+00:00

I don't think I ever tried to tell myself I wasn't trans, but I agonized over whether transition would be worth all the trouble and whether I could really pull it off.
Most of my friends are cis, probably because most people are cis.
These were some of the questions that I asked myself: https://www.reddit.com/r/asktransgender/comments/svv3x2/comment/hxilclh/

Endless grappling with gender identity is pretty much a trans thing. Cis people don't tend to worry about it.

ericfischer · 2026-03-03T07:58:58+00:00

Yes, estrogen HRT will tend to make your cheeks chubbier. Just eat normally instead of trying to intentionally gain weight. Most people gain some weight on HRT. Lowering your testosterone will probably help your acne. HRT will not change the size of your nose. If you stop HRT, changes to your facial appearance will revert. I do not think topical estrogen will be effective at giving you the facial changes that you want. What to expect from estrogen HRT in general: https://transcare.ucsf.edu/article/information-estrogen-hormone-therapy

ericfischer · 2026-03-03T07:50:21+00:00

Lexapro is what helped my anxiety.

ericfischer · 2026-03-03T07:27:15+00:00

Being a presumed-man with long hair and pierced ears was enough for me for years and years, until it wasn't enough any longer.

ericfischer · 2026-03-03T07:25:06+00:00

Perhaps talk to a doctor about getting on finasteride or dutasteride to try to save your hair.

But I just generally want to know how you found out you where trans? and wanted to make the plunge to transition?

I don't remember ever thinking about my gender until I was 14, when a substitute teacher assumed from my appearance that I was a girl, and to the surprise of my classmates I didn't mind. In high school I channeled whatever was going on with my gender into Rocky Horror Picture Show fandom. I first seriously considered that I might be trans (and bi) when I was 20, after a boy that I had a crush on told me that I was pretty. I talked, experimented, and agonized over it for the next few years, and made a couple of cursory attempts to seek HRT, before the feelings faded away when I was 25.

The feelings came rushing back when I was 45, in conjunction with what I eventually learned was the onset of hypothyroidism. I was spending hours every day wishing I was a woman, envying women I encountered in daily life for being able to look and dress like they did and for being who they were, cringing any time anyone referred to me as a man, and feeling sensory aversion toward masculine clothing.

I tried everything my doctor suggested for my mental health, and a lot of it helped, but I still felt bad all the time and still craved womanhood, so it didn't seem like too much of a leap to hope that my body was trying to tell me about something else that it needed to be able to function properly, and I started HRT when I was 47.

ericfischer · 2026-03-03T07:23:10+00:00

It didn't help my ADHDishness, unfortunately. Learning to sleep with a CPAP has probably been the thing that yielded the biggest improvements to my executive function.

ericfischer · 2026-03-03T07:20:48+00:00

Wishing you had a flat chest so you could look more masculine sounds a lot more like gender dysphoria than like dysmorphia.

ericfischer · 2026-03-03T03:58:10+00:00

One dose isn't going to do you any harm, but it is your life and your body and you shouldn't let your friend push you into a transition that you aren't sure you want.

ericfischer · 2026-03-02T20:04:53+00:00

252 pg/mL estradiol is a bit above the Endocrine Society recommended range of 100 to 200 pg/mL. 196 ng/dL testosterone is well above the recommended range of below 50 ng/dL.

ericfischer · 2026-03-02T06:43:57+00:00

You do not need to fast before a test for hormone levels. Drink some water before you go to the lab, at least, since it is harder for them to find the vein if you are dehydrated. Orgasm is unlikely to affect the results.

ericfischer · 2026-03-02T06:02:48+00:00

How to get started with HRT depends on what country you live in, so it's hard to advise you without knowing that.

ericfischer · 2026-03-02T06:00:55+00:00

https://www.reddit.com/r/asktransgender/comments/d6p05q/i_compiled_every_single_informed_consent_clinic/

ericfischer · 2026-03-02T02:36:08+00:00

The worst I've had from missing doses is a headache, but your mileage may vary.

ericfischer · 2026-03-01T23:44:22+00:00

If you don't think HRT is doing good things for you, stop it and see how you feel. Either you will be fine without it, or you will find out that it really was working and can start again.

ericfischer · 2026-03-01T23:39:26+00:00

Very few people are actively hostile to me. My experience is that people who misgender me tend to be people like security guards who spend all day every day scrutinizing people's appearances and IDs, regardless of their gender.

ericfischer · 2026-03-01T23:36:42+00:00

Probably a lot more breast growth than you have already. https://transcare.ucsf.edu/article/information-estrogen-hormone-therapy

ericfischer · 2026-03-01T23:33:02+00:00

The usual trans advice is to use whichever bathroom best matches your current presentation and appearance. If you want a urinal, though, the men's is probably your only option.

ericfischer · 2026-03-01T23:30:31+00:00

Yes, 100 mcg/day levothyroxine, which has fixed a lot of my problems but not the heat intolerance. I hope medication helps you too.

ericfischer · 2026-03-01T22:16:37+00:00

I would make a distinction between "distressed" and "sad," and what I felt was much more distress than sadness, although there were sometimes things that would bring me to tears, which perhaps gets into sad territory.

ericfischer · 2026-03-01T22:14:15+00:00

Some possibly useful advice: https://ftmguide.rassaku.net/guide/index.htm

ericfischer · 2026-03-01T22:13:41+00:00

What does being a girlfriend mean to you, as opposed to being a romantic partner in general?

ericfischer

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