I read that it is important to keep a journal to log down emotions, thoughts, bodily changes and other details throughout HRT, so I've started this post to record them all down. It is on the longer side with bits that might not flow as smoothly, since they were written at different months of my transition.

Unintended, but my first day on the journey to womanhood happens to be the unofficial Star Wars Day. I just started, so there aren't any expected changes, other than a mixed bag of emotions that I've felt for a while now; a great sense of hope for the future but also significant trepidation of the challenges to come, now that I've set myself down the path of transitioning. If anything, popping the anti-androgen and estrogen pills for the first time felt extremely anti-climatic, as though my fear of HRT's risks were irrational and unfounded. But the best (and worst) is yet to come. So let's see how this goes. 

May the Force (4th) be with me. 

It's still early days so there are no visible physical changes. Some transwomen report experiencing a greater sense of calm, while others felt they were more in touch with their emotions and less numb. Well...I felt neither 😅 I did feel more light headed in the initial days and my baseline heartrate seems to have gone up. Hope that is just a temporary phenomenon. I also felt a bit more tired, but it could have been due to the general lack of sleep.

Libido took a near immediate hit within a few days of popping the pills. Little fella down below seems to be less inclined to stand. A bit of a downer because I'm not too bothered by my male appendage. My desire to dress as a woman also went down a lot (linked to libido it seems) and I also found myself uninterested in posting photos on Instagram. 

Around the 2nd week my nipples started to feel a bit tender, with a feeling of soreness when they are pressed directly. By the 3rd week, it felt like there was a small, hard marble behind each nipple, and they were perkier than before. The other observation was an increased sensitivity in my nipples. I've had zero sensitivity previously, but now when I gently rub them it seems to stir something down below? Interesting sensation and definitely welcome. 

Emotionally I've still not felt much ups and downs that some may have reported when on estrogen. My brain did occasionally catastrophise my decision to transition, such as worrying that I will never be convincing and passable, that HRT changes will be minimal and I will end up looking like a guy with teenage girl's boobs. But I successfully shoved these thoughts under the carpet by ignoring them. After all, it is still early days and nothing is irreversible. I guess years of compartmentalising has it's benefits 😅

As the changes due to HRT are very gradual and will take around 2 years to be more visible, the journey to womanhood feels like a really long one. For those who are dying to have their bodies become womanly and live as one ASAP, it's best to tamper those expectations significantly. I did a comparison with photos I took on Day 0 and there were no differences except for slightly perkier nipples.

Some fat has been building behind the nipple, causing them to push out a bit more prominently. While I am nowhere at risk of being outed, they are a reminder that in X months time, it is going to be quite hard to hide them. Nipples are also permanently sensitive and sore, which is ok until I bump them into something by accident and it's ouchie. 

I noticed that I was putting on a bit of weight since my baseline appears to have shifted from around 55.5kg to around 57kg. As there hasn't been any changes to my exercise, diet or lifestyle, HRT is definitely the cause. If I want to keep my figure I had better watch my diet more closely.

It also appears that muscle strength has dropped quite significantly. I casually went up to a chin-up bar and to my surprise I could only do 7; which was a big drop from my usual 11 (without any gym training). I also struggled to do more than 30 sit-ups, when just a few months back I could very easily do a burst of 40 sit-up. While I was aware reduced strength was an effect of being on HRT, I was quite shocked at how quickly loss of strength took place.

I had an annoying headache that lasted for 4 days and refused to go away. While a continued lack of sleep was likely a contributing factor, the doctor also said that it was likely due to higher or fluctuating oestrogen levels in the body. Fortunately it went away after a good long rest over the weekend, but it is something to monitor. The recent CNA documentary about increasing kidney failure rates scared me into reading about HRT more seriously, since popping pills apparently places a high load on the kidney as well. 

<Correction: Popping pills increases load on the Liver, not the Kidneys>

My weight has also been slowly creeping up. For the first time in a long while, I hit the 58kg mark, and my work pants occasionally feels too tight at the waist. Although estrogen HRT weight gain is widely reported (due to drop muscle mass and corresponding calorie burn), it is a bit disturbing. I've been cutting my rice intake, but more needs to be done to match the new baseline calorie burn.

I touched the back of my hand, which felt softer and less oily than I remembered, which was nice. I wonder if my skin would soften a bit further as the days progress. Sadly, I still have rather large pores and acne scars on my face, so the flawless skin that I see in so many other transwomen are likely a pipedream, even if I blow cash on laser and subcision treatments. 

I've been feeling sleepier than usual, which isn't helped by regular overtime and late nights. Fighting off the post-lunch sleep monster to concentrate on work was quite a challenge and I found myself consuming more cups of coffee than usual. It seems like a lack of the "get shit done" hormone has been putting my energy levels on a roller coaster. Hopefully this goes away at some point in the future. 

It might be my mind playing tricks on me, but there are some baby hairs sprouting in my bald spots. It still looks bare in photographs (which is a bummer), but it does give a bit of hope that the combination of finesteride, anti-androgens and estrogen is bringing some of my hair back. 

There were moments where reading a funny remark made me chuckle involuntarily. It was subtle, but a marked difference from how I would have reacted...which was no reaction other than registering: "This is funny". I don't recall ever having this involuntary reaction. When I shared it with other transwomen, they told me they had the same experience. One described emotions on HRT as accelerating faster and hitting a higher top speed. Sounds about right. I also noticed that I was less patient and more vocal about issues in the work place, although that could partially be attributed to stress. 

Recently I've been having more occasions where I feel more tired and down than usual. I'm not sure if it is due to regular lack of sleep or just the whole hormone imbalance causing lethargy. The "xian-ness" isn't due to one single factor; it is partly work related, but i can't say brainworms aren't getting the better of me. I've been fighting off thoughts that I'm gonna fall short of the expected goals of transition and I've already been managing my lowered expectations consistently (not setting an impossible goal of looking like a Kpop star, like some young transwomen do). Yet I feels like i'm gonna be a failure to myself and everyone around me.

Objectively, nothing much has changed, nor will it in the next few months. People from outside might see that I've got my shit together, doing alright at my job and life. But the brainworms remain. I saw an attractive middle aged cis-woman at Tiong Bahru plaza on 2 September in a long white dress whose whole look was exactly what I strived to be. But my brain immediately told me that as much as I hope, I will never come close to being like her.

I finally went for my first endocrinologist appointment at NUH on 19 September, after 4 months of waiting. If I had not sourced for my pills via the private route, this would have been day 1. The doctor I saw was an experienced looking man with a head of white hair. Entering into the room, he asked in a serious tone a bunch of background questions; when did my gender dysphoria begin, NS PES status and vocation, my age, whether I was married with kids, etc. He then proceeded to caution about transitioning in Singapore, that while there are some successful cases, he did encounter unsuccessful cases, including a transwoman 1 year older than me who had SRS, but was asking to detransition because the wife and children could not accept her transition. But then he called himself a hormone peddler, saying that with the psychiatrist's diagnosis, he will give me the anti-androgens and estrogen, as long as I am aware of the risks. After some discussion about the different types of pills available, he gave a presciption for Cyproterone and Estradiol Valerate (Progynova).

The endocrinologist ended off the session again with the warning that transitioning for middle aged adults in Singapore isn't easy, and that I will have to deal with all the social issues faced by transgender persons.

It's been half a year since I have been on female hormones. Popping pills in the morning and evenings have become quite routine, though it makes me feel like a 60 year old man eating his high blood pressure medicine. I've switched to Cyproterone and Progynova in early Oct. Some of the experienced transwomen I met suggested that I reduce the Cyproterone dosage I was prescribed (25mg per day), since long term use increases the risk of meningioma, which is a brain tumour (Sigh). Generally, anti-androgens used for suppressing testosterone aren't great if taken in the long term, so I plan to cut my dosages further and monitor.

Emotionally, I don't think the switch in medicines resulted in much changes, so I guess it is ok? My energy levels feel a bit less nuked, which was something I felt regularly when I was on Spironolactone.  

In terms of physical changes, other than regrowth of hair on my head, I noticed that my waist has gotten a tad bit thicker (especially the lower tummy), but a bit of fat has also distributed to my butt and hips. Let's hope the latter continues. My brain might be playing tricks on me again, but I think my cheek apples also do look a bit more pronounced due to the subtle fat distribution.  

My areolas have darkened in colour, as well as expanded from 2cm pre-HRT to around 3.5cm at the six month mark. Chest development wise, my left boob seems to be developing a bit more than the right. They're both conical in shape now, which causes the nipples to poke out of my shirt a bit and makes me look like I'm having mild gynecomastia. No one has commented on them yet, so I guess I don't need to start wearing chest-binders to hide them. Because I live with my parents and wear T-shirts while at home, I do consciously pull the collar of my T-shirts forward so that the extra material helps to hide my developing chest.

One of the best things so far is how soft and smooth my skin feels. I actually like running my hands over my forearms to feel this newfound softness. I also no longer have bad acne, which is amazing. God, why didn't I start HRT earlier. Years of cystic acne and scarring from these massive "volcano eruptions" would not have happened. 

While there hasn't been many visible changes, my emotions this month have been more in-flux. While nothing too dramatic, I've gotten frustrated over situations/people easily, and I also had a few depressive episodes. It could have been due to situation in general though. 

I went for a blood test in early December at NUH. Results wise, it seemed like my Estradiol (E2) levels were quite low despite maintaining the same 4mg dose of estrogen pills. The main change was my switch from Estrofem to Progynova back in October. As blood tests aren't frequent there was no confirmation that this was the cause, but instead of increasing my dose further to 6mg of Progynova, I asked the endocrinologist to put me back on 4mg Estrofem instead which he gladly agreed (since taking a lower dose is generally preferred in the eyes of healthcare professionals).

The other issue was that my progestin levels were really high. I was concerned about this, because persistently high levels could potentially lead to brain tumours in the long term. Strangely, the endocrinologist said it wasn't a big concern, but to be safe, I decided to cut my weekly dose further from 3 x 12.5mg per week to 2 x 12.5mg per week. Hopefully this will help to bring down levels during the next blood test. 

Bodily changes wise, there did not seem to be significant changes. Might just be in my head, but there may have be further growth in the chest department, albeit very gradual. Wearing T-shirts with the soft cotton material (e.g. Army admin tees) are starting to look a teeny bit suspicious.

The further loss of strength and muscle mass is also obvious. Recently I tried to do pull-ups and could only manage 4, down from 7 in the third month and 11 pre-HRT. Muscles does increase metabolism, so lesser muscles meant that my metabolism did go down too. 

Emotionally, I find myself easily irritated during the 1 - 4 hour window after taking estrogen, where I feel a grey cloud over my head and become extra snappy about things. This is worsened if I'm tired and in need of sleep.

It appears that fat distribution due to HRT is starting to give me wider hips. The changes can barely be seen in the mirror, but when I look at the pre-HRT photos, 6 month and 10 month photos, the effects are shockingly obvious. While my body doesn't have the hourglass shape, it's still pretty amazing how hormones can change the body shape. My hair is still quite short so I still pass as a guy without any effort (because I still look like one).  

A comment from my Dad recently took me by surprise. Over breakfast, he suddenly said that my face shape has changed. I acted cool and asked him what he meant. He said that my face looked sharper, probably due to my braces. Whew. While some of it could be due to braces, pretty sure some of it was due to HRT. 

On 18 March, I had a very bad episode of emotional deregulation. While it was triggered by certain conversations, the root cause was being really frustrated that the changes from HRT were taking so damn long. Some transwomen were already looking and presenting female at their 1 year mark, but for me, I still look like a guy. Being able to present female was nowhere in sight. I joke around that being in uncle mode works to my advantage as I do need a bit longer to ease into social transition, but honestly, it kind of sucks. It feels like transitioning is taking forever, and I will never reach my transition goals.

Amazing that I have already been diligently popping AA and Estrogen pills for one whole year now. While my transition journey has been much slower than I had initially hoped, the bodily changes are coming in; I just need to be patient. My bum feels fuller, hips wider than when I started transitioning. My left boob is about the size of a small orange, so with some luck, by end of year two I might just be able to squeeze out a bit of a cleavage with some push-up bras. The right boob does has catching up to do however. Nevertheless, seeing and feeling the changes does give me a great sense of comfort.