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I have a difficult question that you don’t have to respond to if that’s your choice. And I ask this sincerely. How does a trans woman plan for middle age and thereafter? As challenging as it must be for a young person to be trans, it strikes me that biological male bodies age very distinctly. It must be a whole different set of challenges. I know I have a bit of a beer belly myself. And while I’m fortunate to have my hair, I suspect most males have to worry about going bald. Ear hair was nonexistent until I hit 40. It seems like a something that is challenging under the best of conditions becomes completely insurmountable.
That’s actually a very good question - the answer is that with feminising HRT, you won’t age as a male at all. Estrogen gives you a feminine fat distribution - hips, breasts and bum instead of a beer belly - along with softer skin. Female-level testosterone means body hair is substantially reduced (although I’m still getting laser to be sure), masculinisation of the face and body is halted, and low DHT ensures you don’t go bald (although you won’t magically recover your hairline if it’s already gone).
My fear of aging as a male was part of my motivations for transitioning, and I’m essentially safe from that now. And past a certain age, both men and women kinda start looking the same anyway, outside of hair loss and facial hair. Men’s testosterone naturally lowers with age, and women are far removed from menopause. Trans woman might even age better than cis women as they don’t go through the latter and can maintain appropriate levels of estrogen indefinitely.
I think females would also maintain higher levels of estrogen indefinitely if they were supplementing with synthetic hormones?
Yes, in fact post-menopausal women are the biggest consumers of hormone replacement therapy. However it's very tricky and has many potential side effects and risk of some cancers if not adequately managed - I've read studies where it was suggested that the benefits did not outweigh the risk unless it was started before menopause.
So what data do we have on the use of these hormones by males? Facially it's not obvious why these side effects would be sex dependent.
The side effects aren't side effects of HRT, per se, but rather effects of lifetime estrogen exposure. For example, women who start menopause later than average have a higher risk of breast cancer than women who don't - and so do women who go on HRT after menopause. In both cases, the risk comes from an extra X years of exposure to estrogen.
And indeed, those risks exist for trans women too. But someone who transitions as an adult will almost certainly have less lifetime exposure to estrogen than the average cis woman.
What about someone who has their puberty blocked and starts taking the hormones as soon as legally possible?
They'd basically be in the same boat as a cis girl who starts puberty around that time, and if they maintain that same hormone level into old age, they'd be in the same boat as a cis woman who starts HRT at menopause.
Isn't the hormone use going to be mandatory for the rest of their life? (unless they 'detransition' or otherwise change their approach)
This is quite different from women, most of whom don't do HRT after menopause. (and can discontinue it if it's causing issues, without the side effect of changing their gender)
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