HRT for Older Trans Women

Dear Editor:

Thank you for your wonderfully informative journal. I always look forward to it.

I have a question to ask. I am a 70-ish post-op for 15 years male-to-female transsexual. I am a healthy, active woman. Lately, with the revised medical thinking about hormone replacement therapy (i.e., that HRT may not only be less or even necessary, but may even be harmful), I have been wondering about the implications for me, a MTF woman who has been taking 2mg/daily Estradiol for 16 years now. Specifically, I am wondering if I should have my dosage reduced.

I have talked to my MD about this, but she doesn’t know much about hormones for TSs, except she does say that since I started taking estrogens at a late age, I am at a lower risk than non-TS women who have been accumulating estrogen in their bodies all their lives.

I know you can’t prescribe, but do you know anything about what are usual or minimal dosages for a healthy TS woman of my age? Can you refer me to someone who might know? Perhaps this subject might be good for a future issue of Trans-Health.

Thank you,
Clare

Hi Clare,

Thanks for writing!

I understand why you are concerned about estrogen replacement. The studies that show the risks of HRT are fairly new and have not yet been duplicated, so it is hard to say for sure whether the risk is something to be concerned about or not. In addition, no real studies have been done on the effects of long-term HRT in trans women. In my opinion, women who have had orchidectomy or GRS have removed some of the risks associated with HRT, but certainly not all of them.

In the absence of decent scientific data I think that I would follow my heart and my informed opinion. If you think that it would be safer to reduce your dosages, give it a try.

The idea of looking into this in the next issue of TH intrigues me. I will try to do that and publish my findings.

Take care!
Raverdyke