Estrogen HRT and LDL Cholesterol

The HRT regimen that my health car professional has suggested is a combination of Spironolactone (“spiro”) and Estrogen. This fits well with what I’ve read on the subject.

Before either of these were prescribed, I was sent to a lab for blood tests. The tests show that I’m in fine shape as to starting Spironolactone, and so this was prescribed. As to Estrogen, the LDL ratio in my blood was too high, and so taking Estrogen would be unsafe.

LDL is an acronym for low-density lipoproteins a.k.a. “bad cholesterol” even though technically LDL isn’t actually cholesterol, according to Wikipedia. LDL basically builds up plaque in the arteries, which (estrogen or no estrogen) is a serious health risk. Violence and car crashes aside, the high ratio of LDL is the largest risk to my health.

I resolved to eat better and exercise more, and I did. I focused on ab and butt exercises, plus various belly dancing routines. I ate more fiber, including more peas, beans and oatmeal, and I also ate more nuts, salmon and olive oil. Two months later, the results of the next blood test showed no improvement. In fact, the LDL ratio had actually gotten worse. So, no estrogen for me, any time soon.  Besides, the numbers were so bad that I needed to pursue a correction aggressively.

My mom is a dietician so I asked her advice. She explained that I was on the right track but needed to remove cheddar cheese from my diet (I was eating a lot of that) and get more sleep. And, she advise that I focus on more yet of all the good things that I was already doing. My mom reminded me that all my muscle-building exercises were no substitute for some intense cardio, and that I needed to exercise intensely enough to get my heart rate up and keep it there for a while.

My mom had had a client with a similar dilemma, and my mom has looked into the medication that her client was considering, as prescribed by her physician. The side effects were so problematic that my mom, no stranger to side effects herself, suggested making that medication a last resort only after diet and exercise had been optimized. She gave me the same advice. Ironically, this conversation occurred the evening before Thanksgiving, November 26th.

For many in the US, Thanksgiving Day is the one day of the year when they eat too much. For me, it would be the first day of eating exceptionally well, and exercising intensely too. And so it was.

A few years ago, I made some custom software that tracks what I eat, and here is a screen-shot of what yesterday looked like until about 11 p.m. after which I had three more cups of coffee, two glasses of water and a square of dark chocolate.


A key principle that helps me is to consider every calorie to be precious and to use every one wisely, for maximum fiber, protein, Omega-3 and the good sort of fat (unsaturated fat). And, with all the protein I’m eating plus being on Spiro, I need to drink A LOT of water. So, I did. By bedtime I’d had 25 eight-ounce glasses of water, either pure or in coffee or milk.

Here’s an example of my reasoning, in case it helps you: HDL is an acronym for high-density lipoproteins a.k.a. “good cholesterol” even though technically HDL isn’t actually cholesterol, according to Wikipedia. HDL basically removes plaque build-up from the arteries, which is a very good thing. Niacin (Vitamin B3) can play a role in increased HDL, so making sure I get enough of that would be good. That’s why I eat wholewheat bread. But, I just read the label carefully. A 120-calorie slice provides only 6% of the Niacin I need. I’d have to eat an entire loaf of bread per day to get enough Niacin from bread, and then I’d have used up my calorie quota for the day with all sorts of important nutrients having been neglected. So, then I read that peanut butter is a good source of niacin, as are eggs (because these contain Tryptophan, which breaks down as Niacin). And since I already eat decent amounts of peanut butter and eggs, I can stop being concerned about my Niacin even if I reduce the amount of bread in my diet.

As to exercise, I had decided on dancing, and so I huffed and puffed while refining my dance moves.

After two months of this, we’ll see that the next blood test shows.

Photographing and Presenting Well

Before I came out as a t-girl I felt ugly and was only grudgingly willing to be in photographs, typically less than half a dozen per year. I was overweight, unhealthy and unhappy.

Now that I know I’m a girl and I live as such, I’m in shape, healthy and almost giddily happy. The camera is my new friend and some days I take several dozen pictures — and throw away all but the best few. I know some girls Photoshop their pictures and I avoid that. Ask me why if you like.

Basically, working in a feedback loop is very effective as to learning which styles and poses work best. I have a webcam on me almost all the time even though I’m the only person who sees the picture. That way I can see “oooh, I’m slouching” or “wow, that angle downplays my too-masculine brow” etc. So, the best tips are those you figure out yourself. And, the poses help you away from the camera too.

By keeping your best and unedited pictures around, then on days when you feel fragile (as girls, we tend to go through that) you can get reassurance that, at least sometimes, you can look very good.

Having others comment on your pictures helps too. Typically, we’re our own worst critic and others might like what they see and point out strengths that we didn’t know we had.

If you’re like me, then you might not be all that happy with your facial bone structure, and you don’t have nice boobs and whatever’s in your thong … still makes a bulge. Unlike me, you might even still have an Adam’s apple. When I was unhappy about my frontal view, I focused on my rear view … I lost weight, got svelte, did leg & butt exercises, and grew my hair long. So, at least from the rear, I knew I could look good. Then I focused on more and more other aspects, too — and good pictures helped me gain confidence along the way.

NEW-5Much of looking and being hot has to do with style … posting and grace and attitude. As an example, look at videos of the Ukranian pole dancer Anastasia Sokolova (pictured here).

NEW-10She’s lovely and she exudes sexuality in large part due to how she moves, and her attitude — but her physique is relatively andogynous and not sexpot-curvy like Marilyn Monroe or Sophia Loren.

What helps me is to move and function with more grace than I have looks. In the long run, that helps a lot. I see many cisgirls who could own the room they walked into if they walked sexily as opposed to slouching in.

As t-girls, we’re in the unique position where we don’t take our femininity for granted. We are female, brain-wise, but femininity includes expressing that with style and grace.

Spironolactone and Electrolyte Balance: All Good

The nice professional lady who manages my health issues specific to hormone replacement therapy called today to discuss the findings of my latest blood test, now that I’ve been on spironolactone (“spiro”) for two months, at a mild dosage of 100mg per day.

NOV26_2The main risk of spiro is that … well, let me see if I can explain it in a way that does justice to what my (late) dad explained to me, plus having read up about it on Wikipedia.

The body uses potassium and sodium for muscle function. When a muscle contracts, it’s due to the sodium and potassium interacting in a particular way.  So, the body needs both sodium and potassium for the muscles to function. An imbalance would be bad. Muscles can start to fail. That includes the heart muscle. An extreme imbalance can cause heart failure.  In fact, officially administered lethal injections (as in, capital punishment in the US) kill by inducing an extreme imbalance. Bottom line: maintaining a good potassium-sodium balance is vital.

One of the chemicals in the human body is Aldosterone.  It help the body manage its potassium-sodium balance by causing sodium to be retained while causing potassium to be excreted. A side effect it that: it helps the body retain water too.

Spiro interferes with Aldosterone thus making it less effective.  So, the body excretes more sodium and retains more potassium, basically a double whammy likely to cause a potassium-sodium imbalance.

NOV26_3Being aware of this risk, I modified my eating habits so that I ate fewer bananas, tomatoes and potatoes. I also avoided manufactured items high in potassium. For example, low-sodium V8 vegetable juice is very high in potassium, so I avoid that and I drink the regular V8 vegetable juice.

As to the water that my body now doesn’t retain as well as it normally does, I drink much more water to try to compensate. This doesn’t counteract the effects of spiro but my reasoning is: whatever amount of water the body is willing to retain, I want to ensure that such water is available, i.e., that a lack of water is never a contributing factor as to my body retaining less water than it should.

NOV26_1As it turns out, whatever I’ve been doing is working beautifully. My blood test results show my potassium-sodium balance as being spot-on. So, I seem to have navigated this particular mine-field well. Yay!

When taking hormones or hormone-affecting chemicals, it’s wise to start modestly and to have the results monitored regularly and professionally — and to increase the intensity only when things are safe. So, now that this particular test has shown such good results, I have the official green light to increase my daily intake to 200mg instead of 100mg. I’m excited!

spiroWith the stakes now higher, this means I have to drink water more diligently yet, and take in more sodium yet, and eat yet fewer potassium-rich foods.  Probably my occasional glass of V-8 vegetable juice will become a daily event instead, and I’ll eat fewer potatoes yet.

The pictures of me, shown here, are all from today.


Busty Me, Two Months Later


No, the above isn’t a picture of me. It’s a statue at Treasure Island resort and casino, Las Vegas. But, curvy, wow.

Below are two pictures of me, with my new fake boobies. They’re not implants. They’re … outplants: bra stuffers. I’m getting used to their shape, size, weight, feel, etc. before I go further.

IMAG1653IMAG1656After two months of this, yesterday was the magical day I’d been waiting for.  Until now, I’ve always been giddily happy with my new boobies, even though (yes, I know) they’re even more fake than implants are.

But, yesterday was different. For the first time, I felt lazy when it was time to put my bra on.  I’d worn my favorite bra for enough days that it was due for laundry day yet again, and so I needed to choose another (and less-comfy) bra.  I chose one from my stash. It looked nice enough. It felt … not bad.  So, more out of routine than sheer delight, I put the bra on. Into it went my pretty boobies and … yay, I’d passed the basic test!  Even when the excitement wore off, did I have the discipline to still go through the process? Yes! It’s almost like these fake boobies are part of me now, like contact lenses might be for someone else.

By the end of the day, my shoulders were hurting. The bra straps had carved into my shoulders, ow. On a hunch, I weighed my fake boobies. They weighed a puny one-and-a-half pounds each. That’s almost nothing.  And yet, there I was, feeling sore.  By contrast, girls like Chelsea Charms have boobies that weigh approximately 30 pounds … each.  Wow.  That really puts things into perspective, for me.

I’ve always fantasized about owning a V-12 BMW 750iL.  And now I do, with all of the glory and the issues, including having to buy two replacement fuel pumps. Until I can get them installed the car is parked in my yard and has been for several months. The reality of the total ownership experience … it’s good to have the entire picture.

This reminds me of two specific friends / acquaintances (they’re right in that “middle ground”). They’re both nice ladies. They also have the same size boobs and they’re about the same age (beyond early 30s). One of the ladies admits freely to not having made bra-wearing a priority.  How do I say this nicely … it shows. Gravity, over time, is not kind. The other lady made bra-wearing a priority, and wow, does it show. Her breasts look perky and gorgeous, and even though she’s personally lovely anyway, boobies or no boobies, her lovely curves certainly add to the overall “wow” look. So, whenever I feel inclined to be lazy about wearing a bra, I think of these two extremes. Conclusion: bra-wearing is a good habit to maintain even if it’s sometimes tedious.

When I’m feeling less-realistic, I fantasize about having huge porn-star style breasts. If I wanted to be cynical, I might say that from then on I wouldn’t even need facial feminization surgery because nobody would look at my face anymore except maybe passport and security officials.

But, it seems to me that if one-and-a-half pounds of weight, times two, can be enough to give me sore shoulders, then I need to buy a better bra, and also be more cautious as to how bigger and heavier boobies would feel.

Although my plans to have  nice curves are congruent with who I am, I do suspect that my enthusiasm for an unusually large size might be: I’m overcompensating for a time when I hated being flat-chested and looking less feminine than I basically am.  Overcompensating is not necessarily a bad thing, as long there is basic self-awareness as to one’s decisions and the underlying elements.

Winning One Battle at a Time


When someone finds out she’s a t-girl, it tends to be a happy realization. Thereafter life is much harder in some ways, and much easier in others. Either way, it’s very different from then on.

Problem is, the image in the mirror. If your journey is like mine, then your aesthetics in the beginning were overwhelmingly masculine and not even pretty by any stretch of the imagination. Personally, when I thought I was a male, I had little interest in maintaining my looks or physique or health. I was on my way to an early heart attack, diabetes or both. Even so, I couldn’t summon the enthusiasm to do anything about it. Intellectually, I’d read and learned much, professionally and personally. But as to my non-cerebral aspects, it was a sad situation. And even as to my mental state, one vital conclusion was still absent.

As soon as I realized that I’m fundamentally a girl, everything changed. I was highly enthused to improve things but didn’t know where to start.

As the above picture suggests, a t-girl’s front is the most problematic part of her transition. Typically, that part costs money to improve: Adam’s Apple surgery, breast implants, facial feminization … but even as I saved money to pay for that, I could work on the rest.

I ate healthily, exercised, attended to my skin, grew my hair long, waxed my body and facial hair into oblivion, slept enough, drank enough water, and avoided the obvious vices and dangers. That alone helped me make a lot of progress. And whenever I was glum I could always look at a picture of myself from behind, since that’s where the progress showed sooner than the front.

I know this is a difficult road, but it might help if you realize that your looks don’t define you. If you’re a t-girl, you’re a t-girl due to your brain structure, not due to looking hot or looking feminine to any (key point: ANY) extent.

Yes, aesthetics do matter in the grand scheme of things, but if good looks are the consequence of being radiantly healthy, that’s typically a very good checkpoint along the way to looking better.

A t-girl friend of mine described herself to me as an ugly woman. I sympathize with her aesthetic self-assessment — and wow, do I relate based on how I personally felt for a long time. But, at least she IS a woman and she knows it.

As to the rest, it’s a journey. Once you realize you’re a t-girl, everything else just becomes a change to a matter of degree. You’ve basically won the hardest battle, the conflict within yourself. What remains is the easy part, and there are no further fundamental victories after that. Even if you get Adam’s Apple surgery, or breast implant surgery, or facial feminization surgery, or surgery ‘down there’ … fundamentally, nothing changes.

Everything beyond your basic realization (that you’re a t-girl) is merely a qualitative improvement. It’s just the size of the improvement that varies.

It’s Ok to Guide People As to Gender Pronouns

NOV25Some of my t-girl friends begin their social transitioning by focusing on their looks.  I did the same thing. But, if I could do it over, the first thing I’d focus on would be my voice. And, at a price tag of maybe $50 (for tutorials), it’s the best value for money on the planet, as to transitioning.

There’s no fast track. Voice retraining (and more: speech retraining) takes time and patience … for the t-girl and for those around her.

As t-girls, when we’re transitioning, we sound awkward and we feel awkward. The sooner we get it over with, the better.

Part-way along the transitional path comes a point where we sound not-quite-female and not-quite-male. So, people on the other end of the phone have to guess. Guys tend to get most unpleasant if called “ma’am” and by contrast, girls tend to be more socially gracious — so it’s the safer bet to guess “male” as opposed to “female.”  That happens to me a lot, and when it does, I gently correct the person, and all is well.

Tonight, I needed to call my bank due to some or other oddity in my bank statements. I was transferred multiple times, and whenever I was called “Sir” then I gently said “It’s not Sir” or “It’s more Ma’am than Sir.” The bankers were each most gracious, and the conversation beyond that point continued pleasantly and with me being addressed as “miss” or “ma’am.”

In all fairness to whoever is on the other end of the phone, if I sounded 100% like a girl, they wouldn’t be calling me “Sir” so I certainly have no basis for being indignant.

Before I transitioned, phone calls were just a normal part of life. Nowadays phone calls are an exciting opportunity to sound as good as I possibly can — which is a good premise ANYWAY, t-girl or no t-girl.

Chelsea Charms and her Polypropylene String Implants

I belong to an online community dedicated to raising awareness about elective surgery. The place is normally the paradigm of benevolence and professionalism (although in my opinion, some of the official doctors’ advice doesn’t qualify for either or both of those two adjectives). Normally, the community managers are the keepers of the flame as to the positive spirit of the place. They are genuinely nice people.

By Chelsea_Charms.jpg: J C derivative work: Tabercil (Chelsea_Charms.jpg) CC-BY-SA-2.0, via Wikimedia Commons

By Chelsea_Charms.jpg: J C derivative work: Tabercil (Chelsea_Charms.jpg) CC-BY-SA-2.0 (, via Wikimedia Commons

Anyway, one of the community managers posted an article about Chelsea Charms, a lady who has some really huge implants of the “Polypropylene string” type. The wording of the article was … not very nice.  By now I’ve become used to how other girls make mean comments about girls like Chelsea but some of less-than-nice comments about the article were from community managers themselves. This was oddly out of character. So, I took issue with that, and I wrote a general objection to their comments. Here is what I wrote, quoted below.

I’d like to make a suggestion, and that’s to presume the girl in the story might end up reading your comments, which she might well end up doing since she’s alive and well, lives in the US and probably has an interest in this subject, and is no doubt smart enough to use search engines to look up her own name.

If you think she might get her feelings hurt or that you’re coming across as insensitive, then … well, perhaps you are. Even if you have something really important to say and it’s all bad news, it’s still possible to gift-wrap things nicely. I’m not all that convinced that the comments below are all that rich in what they contribute, but they are certainly lacking in sensitivity. It’s almost as if the theme of the entire thing is “wow, and now look at THIS freak.” I really must object to this.

If I’m misunderstanding what you intended I apologize, but for me the dismay is a little personal because I have exchanged personal private messages with several of the people who’ve made comments on here, or I’ve read what you’ve had to say elsewhere on this site, and you in the past you have delighted me with how thoughtful, nice and sensitive you’ve been in general and towards my own personal struggles in particular.

That’s part of what’s so nice about this community — how positive the community managers are. So please don’t make an exception now, as to Chelsea.

If you watch her video then you’ll notice how, like you normally are, she’s a positive and nice person. She just chose to have huge boobs.

I have spent a lot of time reading about surgery and psychology, and I’m still no expert, but I really like how Carl Jung (a contemporary of Sigmund Freud, though they disagreed on many issues) approached such issues. His basic point is that, as humans, we tend to pathologize that … which we dislike, and often we dislike things due to having a less-than-informed intellectual basis for our opinions. So, to apply this to Chelsea, the undertone I read in some of the comments is that we’re questioning her rationale but the tone would almost suggest that we’re going further and questioning her rationality too. (I might be reading too much between the lines — I actually hope I am).

I’m fortunate to have people in my life who love me very much and wish me only the best and yet it’s sometimes impossibly hard for them to guess what would be best for me given all the complexities of my life. Chelsea deserves no less. She has her reasons, in the context of her own life, why she makes the decision, every day, to have such large breasts when aspirating them is an option and so would be removing or reducing them. I’m hardly in the position in which I can understand her values and her situation well enough for me to go tell her it’s a bad idea to have done what she did. And, even if I could, she’s at most harming herself, not others. So I’d have to first go focus on the hundreds of millions of people who *are* harming others, as being more worthy of my criticism.

Thereafter, I can focus on people who are harming themselves … cigarettes … alcohol … and so on. [And even this is arguable.] By the time I get to the point where Chelsea is at the head of the line of people who might deserve criticism from me, there will have been many, many people ahead of her.

On the positive side, Chelsea is showing how Polypropylene string implants can yield larger breast sizes without any of the capsular contraction, rippling, Anaplastic Large Cell Lymphoma (ALCL) and internal leakage risks that saline and silicone implants have.

Polypropylene string implants are, to use a colloquialism, the red-headed stepchild of the breast implant industry not least due to the popular criticism that’s been personally aimed at their inventor for unrelated reasons. I have been diligently reading about these implants and the amount of unsubstantiated popular misinformation that keeps being parroted (and in bad taste, no less) is saddening, and some of it has even found its way onto Wikipedia. I could by now dedicate an entire website to debunking these fallacies (and come to think of it, perhaps I shall).

Meanwhile, Chelsea is a happy example of how PPP string implants can safely help girls achieve very large breasts, far more safely and viably than they can with traditional implants. If anything, she’s a little pioneer, and a cheerful and positive one at that, in a world where probably most people are mean to her. I’d like this to be one community where we rise above that … please.