At QueerDoc, we believe that there is No One Way to being queer, trans, or gender diverse. This informs how we do gender affirming care: our patients have many different gender, gender expression, and gender presentation goals and we love helping them achieve those goals. This month, we’re going to be focusing on Gettin’ Curvy, the QueerDoc Way. Yep – it’s estrogen, progesterone, SERMs, and curvier and softer bodies. We don’t assume that being femme or feminine are required for taking E.
Our goals are centered on how to achieve your gender goals in accordance with our ethics and your understanding of the processes and risks involved.
A quick aside on gender expression and presentation: we also believe that there is No One Way to express yourself. One of our favorite resources for learning about expression and presentation is the Trans Language Primer, and, specifically, their guided tour on Gender Presentation Terms.
Each week, we’ll concentrate on different aspects of Gettin’ Curvy.
Week One: How We Approach Gender Affirming Care (Right here! Right now!)
Week Two: Gettin’ Nerdy on Gettin’ Curvy:What Estrogen, Progesterone and SERMs Do In The Body
Week Three: Risks and Benefits, Timelines
Week Four: Other Ways to Change Your Body
Why “Gettin’ Curvy” and Not “Feminizing”?
A lot of information on gender affirming care involving estrogen uses the word “feminizing.” At QueerDoc, we work hard not to use terms like “feminizing” or “masculinizing” and try not to conflate gender identity with gender expression. Since “feminine” has a lot of gendered connotations that might not fit with how gender is experienced or expressed by our patients, we like to use words that describe what happens to our bodies when we take exogenous (not made by internal glands) hormones. We use phrases like “getting curvier” to reference how fat distribution changes in estrogen-dominant bodies. We’ll talk about “getting softer” to reference how estrogen impacts skin texture and hair growth. A cultural tendency to use moisturizer more frequently isn’t the only reason soft skin is associated with estrogen-dominant bodies!
Gettin’ Curvy, The Medical Appointment
When you make an appointment to start gender affirming care with us, we’ll ask you about your gender experience and goals for your gender expression and treatment. Some of this will include explicit questions about your body, and your experience of your body. This may be uncomfortable or distressing, and we strive to provide an accepting and affirming environment. We’ll ask you what words you’d like to use for body parts, and if you want to discuss some body parts at all.
Before your appointment, we’ll send you a questionnaire, and ask that you complete it and upload it at least 24 hours before you meet with your provider. These are some of the questions:
“Not everyone experiences dysphoria, but if you do have particular parts of your body that cause you distress related to gender it helps if we know about these. We can make better, more individualized medical recommendations if you share them with us:”
“Is it okay if we talk about your genitals?”
“What are your goals for your gender affirming medical care? What do you want to see change?”
“Are there any specific medical treatments you are really interested in?”
“Are there any specific side effects you are worried about?”
During your medical appointment, your provider will use your questionnaire answers to guide the discussion and gain a fuller understanding of your gender and gender expression goals. From there, they will work with you to come up with a plan that – according to the best clinical information we have, and our understanding of your wants, needs, and overall health – can help you achieve those goals. For people who want to be curvier with softer skin, this plan often includes estrogen. It may also include progesterone, and/or SERMs (selective estrogen receptor modulators.) Progesterone can help achieve fuller breasts. SERMs, (raloxifene, specifically,) can turn off estrogen receptors in breast tissue and discourage breast growth – they might be an option for someone who wants softer skin but doesn’t want breast growth. (If you’re interested, you can read up on progesterone here and SERMs here!)
For the first year of taking hormones, we like to have follow-up appointments every three months. At these, we’ll discuss what’s going on, and ways to change it up if needed or desired. This can include changing dosages, changing formulations, and changing prescriptions.
The science of gender affirming care is ever-evolving, and there are so many more options now than in the past. We love seeing your YOUPHORIA. Credit to mx.deran on TikTok for teaching us this fabulous new word.