Why does the number for E and T go up dramatically with age but not for blockers? Aren't they usually given in conjunction with a blocker or is this showing HRT vs. "blockers only".
Good question. They do not take blockers and E or T at the same time. There are three trajectories:
1) Blockers, then hormones
2) Blockers, then nothing (their puberty will resume as expected)
3) No blockers, and start hormones in late teens or older
The best physical and mental health outcomes are from option 1. For example, trans boys will not develop breasts, so no need for top surgery later. And they will never have menses. And trans girls won’t get facial and body hair, so no need for later hair removal and not get broad shoulders, etc.
(However, if kids do want to preserve eggs or sperm for future use, they will have to at least start puberty before going on hormones. So that means a small period of time with neither blockers nor hormones.)
Should also add that trans women and trans femmes who take E also take androgen blockers to suppress their natural testosterone. This is different than puberty blockers. And if they get orchiectomy (remove testes), they no longer need the androgen blockers.
Trans men and transmasc people don’t need to suppress their natural estrogens, though. The testosterone does enough on its own.
Weird, most non DIY HRT regimens I know of contain Spyro, Cypro or GnRHa in addition to T/E as recommended in WPATH. Is this not standard practice in the US? To my knowledge most endocrinologists are rather reluctant to to monotherapy.
Why does the number for E and T go up dramatically with age but not for blockers? Aren't they usually given in conjunction with a blocker or is this showing HRT vs. "blockers only".
Good question. They do not take blockers and E or T at the same time. There are three trajectories:
1) Blockers, then hormones
2) Blockers, then nothing (their puberty will resume as expected)
3) No blockers, and start hormones in late teens or older
The best physical and mental health outcomes are from option 1. For example, trans boys will not develop breasts, so no need for top surgery later. And they will never have menses. And trans girls won’t get facial and body hair, so no need for later hair removal and not get broad shoulders, etc.
(However, if kids do want to preserve eggs or sperm for future use, they will have to at least start puberty before going on hormones. So that means a small period of time with neither blockers nor hormones.)
Should also add that trans women and trans femmes who take E also take androgen blockers to suppress their natural testosterone. This is different than puberty blockers. And if they get orchiectomy (remove testes), they no longer need the androgen blockers.
Trans men and transmasc people don’t need to suppress their natural estrogens, though. The testosterone does enough on its own.
Thanks for the clarification! Makes total sense then.
Weird, most non DIY HRT regimens I know of contain Spyro, Cypro or GnRHa in addition to T/E as recommended in WPATH. Is this not standard practice in the US? To my knowledge most endocrinologists are rather reluctant to to monotherapy.
Yes! Our comments crossed paths! I’m using “blockers” in the original article to mean GnRHa for pre-teens and teens.