u/Crazy_Assistant_1604

So as of last month, I hit two years of HRT. I feel like I was supposed to be happy about that and proud of myself, but I really just haven't been able to. My results have been pretty poor for that amount of time, and while friends and family who know who I am respect who I am and tell me I look feminine, I run into pretty much zero people in daily life who do that. It makes it hard to feel like I've really made much progress. These things used to not bother me because I could just say "I'm only 3/6/9/12 months in, so it takes time!" but at two years I really look like I did at 1 year with longer hair. Its been really getting to me since I just feel like I sacrificed a lot to end up with nothing. I started at 33, so I wasn't expecting the world, but where I'm at now was my worst-case nightmare scenario, and it's been awful.

But on the flip side, those 2 years have not really been consistent with HRT. My first doc was a moron who measured total estrogens instead of estradiol for the first three months until I switched to injections, so I was never even in the triple digits for estrogen levels, and my T wasn't suppressed at all. Then I was crazy overdosed with 12mg a week of EV which made my moods a roller coaster. I finally got them to test my SHBG cause I was worried the dose was stopping progress, and it was over 200 at the one-year mark. We tried lowering my dose over the next few months but couldn't get my E2 levels or SHBG under control at all. T was finally gone though.

So then I switched docs and she had me try pills again. Felt awful and E2 was in the low 100s with still high SHBG. I switched to Estradiol Cypionate since I wanted to stop the roller coaster of EV so I did a low dose since even 4mg EV had me at 500pg/ml E2 after 7 days so we figured I was a strong responder. Felt level but kinda crappy for 3 more months then I finally get another test and my SHBG is finally under control but my E2 is back to double digits! Turns out I can't tolerate EV injections, which my doc and any search I've done shows I might be the only person who metabolizes it strangely. Increased to a normal dose of EC and gonna see how that goes now.

So I spent 3 months underdosed and with high T, then 18 months at insanely high levels and high SHBG, then another 4 months underdosed again. I guess what I'm asking is I don't know how I should consider what my actual timeline has been. If I just think about it like I'm at year 2 of HRT, I'm depressed because it's going awful for that timeframe, but when I think about it, I don't really know how long I've been on effective HRT!

Maybe someone could help me reframe this in a way that makes me less depressed about it, since I'm trying, but I just keep feeling awful that things have gone so poorly. I feel like my social transition has been making huge progress, and I worked hard at that, but my body has just let me down at every opportunity, so it's been hard to keep myself motivated to do all of it.

Hey all! I have a beautiful 340i xDrive I've had since it came off the first owner's lease at 18k miles back in 2021. I am approaching 100k miles on it and wanted to make sure I do whatever I can to make it last even longer.

I do oil every 10k and last did spark plugs at around 60k. Brake fluid was done last year at around 75k miles and coolant was done a few years ago but just checked out at still good as of today. I pretty much just drive it to school and work so its a lot of highway commutes and traffic with not as much spirited driving as I used to since I just don't have time. The suspension mods really just made it really good at being a touring car. No error codes or anything and somehow this has been one of the most reliable cars I've owned so far.

Mods:

VAC monoball upper control arms

KW V1 coilovers installed at 26k miles in 2022

xHP transmission tune stage 3 around 50k miles

Extensive coding to get the digital instrument cluster to stop freaking dimming during the day

I'm wondering if there are any big standouts I need to do to make sure it stays running well for a while, since I won't be able to buy anything else for a bit until after school and I get work that actually pays me. I know the water pump is a big one and maybe spark plugs again but any others I should look for?

Also has anyone had their KW coilovers revalved? I technically have a lifetime warranty when these are worn out, which is soon, but it seems like it'll have my car out of commission for weeks. I'd consider something softer, but all the suspension parts cost double what they did when I first did the work so a set of Eibach springs and Koni Special Active dampers cost what my KW V1 did back then

So right now I am a 35 year old trans woman and approaching 2 years of HRT with...mixed results. I've had some feminization but nowhere near what I'd like and I'm getting the typical responses of being too old to expect much or just how it goes or a list of sugeons I can't afford handed to me since in the US doesn't care about how HRT actually turns out.

Recently I switched to estradiol cypionate 3mg/7days since I am incredibly sensitive to the effects of estrogen and meds in general but I'll list the results I had when I was taking 2mg EV every 3.5 days. Also on 200mg progesterone orally and 0.5mg dutasteride along with 100mg spiro all daily. I tried prog rectally for a few months and it was an emotional ride to hell so I went back to oral. I am waiting on the results of a blood test after switching to cypionate but I added DHT to the list (after a month of arguing for it to my endo) so its taking a bit.

E2: 532pg/ml

T: 10ng/dl

SHBG: 133 nmol/L (was around 190 when taking 4mg/7 days. my body doesn't like hormone fluctuations at all)

TSH: 0.777uIU/mL

I know this isnt the full panel you'd like to see but considering the battle to have my endo include DHT I'm doing my best. It took forever to convince them to test SHBG as well and then they immediately changed my dose when it came back expectedly high lol.

Overall my breast growth has been really low, body/face hair seems to darken and lighten at random but mostly stay dark especially as my SHBG has lowered. No real fat redistribution after the first year and I'm just not sure whats going on.

I would be thinking its prog to DHT backdoor except im already on dutasteride and have been for the whole time I've been on HRT along with progesterone. I lost all the mental affects of prog around 4-6 months in so I assumed that its not going to allopregnalone anymore therefore cant be becoming DHT but when I tried stopping for a few weeks I felt mentally worse and when I took it rectally it felt totally different.

So I'm wondering if I could still be having some sort of androgenic activity I can't see in the background, even though my T is super low and I am on dutasteride. I guess its also important to note that DHT is STRONG in my family and all the men are totally bald and I was losing my own hair in my teens, though the sides and middle peak held on I have pretty bad recession at the temples. Anxiously awaiting my DHT results but I know they can be super innacurate and my endo wont care.

Is it possible that dut is not enough to block this in some people? Or is there another rare androgen source thats still open?