Some comments on the SoCs

So I live in a shitty Midwestern city and there aren’t a lot of trans-friendly doctors in this joint. I’m lucky enough that my school has a therapist specializing in LGBT issues and he’s pretty good, but as far as hormones go, the only MD we knew of in this hellhole has retired and run away to Florida or some such place. However, the local Planned Parenthood clinic offers trans services, so I’m working with them. Which brings me to the subject of the various Standards of Care.

For the most part, treatment of trans people is guided by the WPATH Standards of Care. These are generally accepted as the best guidelines for the treatment of transfolk. However, Planned Parenthood has its own SoC.

The major difference is the hormone replacement therapy bit. WPATH doesn’t prescribe when trans people should start hormones. For this reason, a lot of people, especially MtFs, like to start hormones first and then transition to living full-time once those hormones have started to do their job. At Planned Parenthood, you have to live full-time for 2-3 months before starting hormones. I think this is the better option.

I feel like a lot of trans people (mainly women and girls) think hormones will be some sort of magic bullet that makes them automatically pass. Passing takes time and effort. I’ve been working for a while to learn to pass, and I’m getting pretty good. Hormones may help with fat redistribution and whatnot, but they won’t magically make you pass. By having some real-life experience before starting hormones, you’re sure that this is what you want to do. Hormones really fuck with your system, and some of the changes can become permanent. Furthermore, estrogen can cause mood swings and depression, so if you have hidden emotional problems that haven’t been dealt with, you could crash hardcore. (My doctor says Premarin is the estrogen that she’s had most problems with in the mood swing area.) For this reason, it is best to live full-time first, then start the hormones once you’ve adjusted. Therefore, I think the WPATH should suggest that a few months of RLE be mandatory for hormone replacement therapy.

Again, I know a lot of trans women think hormones are a magic bullet, but you can’t bank on them. Get some experience passing first.

Laser magic

Just had my first appointment for laser hair removal. It went extremely well. I know a lot of people bash laser and worship electrolysis, and I did try electrolysis first, but then I decided to let my skepticism of all things popular take over and did some research of my own, with the help of the magic of being a student at a major university and having access to all sorts of electronic databases. Here are some scientifically established facts:

Fact 1: Laser hair removal has been proved effective at permanently reducing hair growth. It also makes remaining hair light and finer. Electrolysis does the exact same thing. Studies have shown that laser is just as effective as electrolysis for this, if not more so.

Fact 2: Laser is most effective in people with dark hair and fair skin (like me). If someone says that laser didn’t work for them, look at their skin tone and hair color. If they don’t have dark brown or black hair, this is why. If they are dark-skinned and had a bad reaction, it was their skin tone. Vampires like me are the perfect candidates for this procedure. This has to do with the laser’s effects on pigmentation.

Fact 3: Laser is less painful than electrolysis. I have just verified this for myself. I barely felt the laser. (Don’t take my subjective report as a universal claim; I have a high pain tolerance and even electrolysis was not very painful for me; I just think laser was more painless than electrolysis.) It feels like a rubber band snapping on your skin. Most studies show that subjective ratings for pain are less severe in laser than in electrolysis.

Fact 4: Laser is faster. This one should be a no-brainer: instead of hitting each follicle individually, lasers can hit dozens at the same time.

Strong Possibility 1: I had a hard time finding literature about long-term effectiveness for permanent removal, but what I have read suggests that if continued regularly for more than six months it has some effectiveness for permanent hair removal. Again, this is mostly pertaining to good candidates (vampires like me).

Overall, I’m not holding my breath for anything miraculous, but I just think people should think rationally about these things. For me, the big factor was the fact that electrolysis is $75 every week and laser is $75 every 6-8 weeks, so I’m saving money. If I don’t get permanent removal, I will at least see permanent reduction and can go back to electrolysis for mop-up. I strongly encourage people to do the research themselves. If you want to read the evidence, post a comment and I will point you in the direction of some credible literature. A good place to start is a review of 30 studies by Haedersdal and Wulf from a few years back, which can be found on Ebsco.