Starting the new HRT section

public/hrt/fem/antiandrogens.md

@@ -0,0 +1,102 @@
+---
+date: "2020-01-26T20:41:55.827Z"
+title: "Transfeminine HRT - Anti-Androgens"
+description: "This is how we block the T."
+classes:
+  - hrt
+siblings:
+  prev: /hrt/fem/
+  next: /hrt/fem/estrogens
+  nextCaption: Estrogens
+---
+
+# Transfeminine HRT: Suppressing Testosterone
+
+Androgens consist of the three anabolic steroid hormones, testosterone, dihydrotestosterone (DHT), and androstenedione (A4). Anti-Androgens (AAs) are medications which either prevent the production of these hormones or prevent the body from using them. A4 is largely only involved in metabolizing other hormones, and isn’t something to be concerned about for HRT. DHT is more troublesome, however, as it is the primary cause of male pattern baldness, but DHT is metabolized from testosterone, so if you reduce T production, you reduce DHT production as well.
+
+{!{ <div class="gutter d-md-block d-sm-none"><div class="card"><div class="card-body"><h4 class="card-title">Note, it is not always necessary to use an Anti-Androgen</h4> }!}
+
+Due to the way the body’s own regulation system works, if you put enough sex hormones into the body, be they androgens, estrogens or progestins, the body stops producing its own, and this can be a very effective way to shutdown testicle function.
+
+Unfortunately, it is not very common for this to be possible with the cis female ranges that many doctors target, and typically requires a larger than cis normal blood level to achieve total testicular deactivation. Thus, the use of an AA may be needed depending on what your doctor is willing to do.
+
+{!{ </div></div></div> }!}
+
+The three most common anti-androgens are **Spironolactone**, **Cyproterone Acetate** and **Bicalutamide**. A fourth method often used is a Gonadotropin-Releasing Hormone (GnRH) argonist, such as **Leuprolide** (Lupron) or **Goserelin** (Zoladex) which works by overloading GnRH receptors until they stop responding.
+
+### Spironolactone (Brand Name: Aldactone):
+
+Spironolactone (commonly shortened to "spiro") is the most commonly used AA in the United States, largely because it is extremely cheap, is manufactured by a lot of companies, and because Cypro isn’t available in the US due to an FDA ban. The official on-label use for spiro is as a potassium-sparing diuretic; spiro causes your body to release more water, washing away sodium and other minerals, but keeping potassium. In short, the drug makes you pee… a lot. It’s meant to be used to treat high blood pressure and cirrhosis of the liver. [The fact that it suppresses testosterone production is considered a side-effect](https://howwegettonext.com/how-the-worst-blood-pressure-medication-became-the-best-testosterone-blocker-9afec005ede0). Spiro is often also prescribed for severe androgen related acne, heart conditions, and is given to cis women with PCOS.
+
+How does spiro work? Well if receptors are locks, spiro is a master key. It fits into a bunch of steroid receptors, androgen, progesterone, and cortisol. For some it binds exceptionally well (aldosterone and dexamethasone), and some just ok (testosterone). For aldosterone it functions as a powerful antagonist, preventing the kidneys from receiving aldosterone from the adrenal glands. Aldosterone slows down kidney function so that body retains water, and spiro blocks that message, causing them to release the water instead.
+
+In androgen and progesterone receptors it is a partial argonist, turning the key just a little bit, just enough to make the radio turn on, but not strongly activating the cell’s response to those chemicals. It is only enough to tell the hypothalamus that there are androgens and progestins present in the blood stream, so it slows down testosterone production.
+
+The other way that spiro works is that it prevents the formation of various enzymes that the body needs in order to produce testosterone. Without these enzymes, the testes and adrenal glands literally cannot form testosterone molecules.
+
+Both of these functions are very weak, however, and require pretty large doses of spiro to be effective (relative to the diuretic affect). Spiro only actually works well as an anti-androgen in about 20% of subjects, and doesn’t work at all in another 20%.
+
+I mentioned above that the third receptor spiro fits into is the cortisol receptor (technically, the glucocorticoid receptor), and it fits in REALLY well, binding 3x better than actual cortisol. Cortisol is released by the adrenal glands in response to stress. It causes your body to raise its blood sugar, suppresses the immune system, and increases the metabolism of glucose and lipids (fat). The problem is, spiro doesn’t *activate* the cortisol receptor, [it blocks it](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4277847/), preventing your body from receiving the cortisone it produces.
+
+Without cortisol, the body resists releasing fats for consumption, it just retains it. This not only makes it easier to put weight on, and harder to lose the weight you have, but it hinders fat redistribution for feminization. New fats go on in estrogenic ways, but the old masculine fats struggle to release. For late transitioners this can result in the dreaded “grandma” effect, where the combined masculine and feminine fats make one look much older than they are. There is also a community term “spiro belly” which refers to the way the drug causes fats to pool in the abdomen.
+
+Reduced cortisol function also affects working memory within the brain, causing one to be more distracted and have greater difficulty working on tasks. This is effectively the same as ADHD symptoms, and some transfemmes notice their ADHD getting much worse on the drug. Personally I found the drug made it harder to drive a vehicle, I could tell my road awareness was hindered. Many people report coming off of spiro to feel like walking out of a mental fog.
+
+Spironolactone is typically prescribed in doses of 100 or 200mg for HRT, and can be taken as high as 400mg, but is not recommended due to all the other side-effects. The drug can also be very hard on the liver and kidneys in high doses, and dehydration is a common risk. Potassium overdose is also a possibility, and it is recommended that you avoid eating foods rich with potassium like bananas, avocados and even potatoes.
+
+Also, again, spiro makes you pee. A lot. This is both a problem because bathrooms, but also because it makes you pee out all your body’s sodium, which then triggers a salt craving in order replenish lost sodium. The community joke about trans women being obsessed with pickles comes from this effect, as pickles are an excellent source of salt, along with olives, sauerkraut, kimchi, bacon, and many salty snack foods. Unfortunately, without cortisol, your body struggles to absorb sodium, as well, so it takes a lot to fulfill the craving.
+
+Another common sign of low sodium is muscle spasms and leg cramps (charley-horse).
+
+### Cyproterone Acetate (Brand Name: Androcur):
+
+Cyproterone Acetate (commonly shortened to "cypro") is probably the most commonly used transgender anti-androgen outside of the United States, where it was never approved by the FDA for sale to patients. This is mainly because no company has ever found it profitable to undergo the complicated process necessary for FDA approval. Additionally, the the drug has a troublesome history, with early studies finding it connected to high liver cancer risks. It also picked up a stigma of causing blood clots due to its pairing with ethinyl-estradiol in the contraceptive Diane-35.
+
+Cypro works in two ways, first by functioning as a powerful receptor antagonist, competing with testosterone for androgen receptors. Additionally, cypro functions as a mild progesterone argonist with poor transactional ability, just enough to convince the hypothalamus that the body is flush with progesterone and thus reducing hormone production. Unfortunately, this means that cypro competes with progesterone, and can hindering its effectiveness, but it does make it quite affective at lowering testosterone levels in the blood stream.
+
+The common dosage for cypro in trans HRT is 25mg, with a maximum dose of 100mg. Because the drug is so hard on the liver, staying below 50mg is recommended.
+
+
+### Bicalutamide (Brand Name: Casodex):
+
+Bicalutamide (commonly shortened to "bical") is also a receptor antagonist, much like spiro and cypro. It is actually a very good androgen blocker, competing quite strongly for androgen receptors, and does a fantastic job of suspending androgens within the body. However, as bical does not activate the receptors it blocks, and does not activate any other sex hormone receptors, there is no feedback to the body to tell it to halt testosterone production. Quite the opposite, the hypothalamus thinks there is *no* T in the body and cranks up production to compensate.
+
+This makes it extremely difficult to determine if the drug is actually working. Eventually, as estrogen levels rise, T production drops off due to the overall total sex hormones present in the body, but this takes time. It does have one benefit, however, that the high levels of T also mean that some of the testosterone will aromatase into estrogen.
+
+Bical has the same high liver risks as spiro and cypro, and for this reason many doctors are reluctant to prescribe it, especially in older patients. Aside from this, it has relatively few negative side-effects for transfemmes.
+
+### Finesteride / Dutasteride:
+
+Finesteride (brand name Propecia) and Dutasteride (brand name Avodart) are 5-alpha reductase (5a-R) inhibitors. 5a-R is an enzyme that is critical to the body’s metabolism of androgens and estrogens from other compounds. Note, this is an *inhibitor*, not a blocker. Finesteride does not prevent 5a-R production, it merely lowers the potency of the 5a-R chemical reactions that causes testosterone to convert into DHT.
+
+The on-label use of Finesteride is for fighting prostate cancer and preventing male pattern hair loss. **It does not have any anti-androgenic affects, and should not be prescribed as an AA**. It is, however, useful to prescribe to Transmascs who are concerned about hair loss.
+
+
+### GnRH Argonists (Leuprolide Acetate / Goserelin / Histrelin Acetate):
+
+Gonadotropin-Releasing Hormone (GnRH) is the hormone that the hypothalamus produces in order to control the release of other sex hormones. It releases GnRH in controlled pulses as a sort of morse-code for the pituitary gland, which then reacts to those pulses by secreting either [Luteinizing Hormone](https://en.wikipedia.org/wiki/Luteinizing_hormone) (LH) or [Follicle Stimulating Hormone](https://en.wikipedia.org/wiki/Follicle-stimulating_hormone) (FSH), based upon [the frequency of the pulses](https://web.archive.org/web/20150923190449/http://www.biolreprod.org/content/56/4/1012.full.pdf). The intensity of the pulse tells the pituitary how much to produce.
+
+LH causes the production of testosterone in both the testes and the ovaries, but in the ovaries that testosterone is immediately metabolized into estrogens. LH also induces luteinization of mature ovarian follicles (hence the name), which produces progesterone and even more estrogens, and triggers ovulation.
+
+GnRH Agonists, as the name implies, interface with GnRH receptors on the pituitary gland and trigger a constant stream of LH, which initially causes the testes and ovaries to crank up production. However, because the drug doesn’t pulse, the receptors eventually become overloaded and stop listening, causing LH levels to plummet, and shutting down both testicle and ovarian function.
+
+GnRH Argonists are extremely effective and have very minimal side-effects and are the preferred method for blocking puberty in adolescents of both sexes. Unfortunately, GnRH Argonists are extremely expensive (upwards of $1000 per dose, or more) and are rarely covered by insurance for use in adults.
+
+The three most common GnRH Argonists are Leuprolide Acetate (brand name Lupron), Goserelin (brand name Zoladex), and Histrelin Acetate (brand names Vantas and Supprelin). Leuprolide and Goserelin are a shots delivered every 2-3 months. Histrelin is an annual implant, typically placed under the skin of a forearm.
+
+
+## How do I know if it is working?
+
+In all cases except for bicalutamide, the best way to know if your androgens have been sufficiently suppressed is with a blood test. That will tell you how well suppression is functioning, and if more intervention is needed. Typically one wants to target cis female ranges of 20-50 nm/dL (0.7-1.7 nmol/L). Total testicular suppression usually sits around 10-15 nm/dL (0.3-0.7), which is the amount of testosterone produced by the adrenal glands.
+
+One does not want to have a T level below 10 nm/dL for an extended length of time, as the body does need *some* testosterone to function properly.
+
+#### But I can’t get testing.
+
+The second best way to determine if you’ve achieved shutdown is through masturbation. Ejaculate will be very thin and clear, lacking any semen. At this point you are effectively sterile, and your testicles will begin to atrophy.
+
+## Testicle Atrophy
+
+Once shutdown has been achieved the testicles will start to shrink from lack of function, potentially by as much as half their size. This can often be accompanied with pain, which manifests in different ways for different people. Some experience it as a dull throbbing soreness, much like having been kicked in the crotch. Others feel it as quick stabbing pains, like a needle jabbed into the testes. Still others experience it as a sort of lightning quick shock which travels down the perineum and into the anus.
+
+Atrophy pain comes and goes and typically lasts for 6 months to a year (unless they’re removed sooner).

public/hrt/fem/estrogens.md

@@ -0,0 +1,15 @@
+---
+date: "2020-01-26T20:41:55.827Z"
+title: "Transfeminine HRT - Estrogens"
+description: Titty Skittles, Stickers and Girl Juice, oh my!
+classes:
+  - hrt
+siblings:
+  prev: /hrt/fem/antiandrogens
+  next: /hrt/fem/progestins
+  nextCaption: Progestins
+---
+
+# Transfeminine HRT: Estrogens
+
+TBD

public/hrt/fem/index.md

@@ -0,0 +1,43 @@
+---
+date: "2020-01-26T20:41:55.827Z"
+title: "Transfeminine HRT - Introduction"
+description: "An introduction to feminizing hormone replacement therapy."
+classes:
+  - hrt
+siblings:
+  next: /hrt/fem/antiandrogens
+  nextCaption: Anti-Androgens
+---
+
+# Transfeminine HRT - Introduction
+
+{!{ <div class="gutter d-md-block d-sm-none"><div class="card"><div class="card-body"><h4 class="card-title">For Your Information</h4> }!}
+
+The term "**Transfeminine**" describes a transgender person whose body either naturally produces testosterone by way of testicles and was likely assigned Male at birth, or an intersex individual who experienced male puberty due to the introduction of testosterone treatment and is now transitioning to estrogen treatment due to a female gender identity.
+
+The term is not synonymous with other transgender terms such as **AMAB** (Assigned Male at Birth) or **MTF** (Male to Female), as it bears no relevance to the cultural factors of ones birth, nor to the gender of the individual. It only describes the direction of the endocrine transition. The term is sometimes abbreviated as transfem or transfemme.
+
+{!{ </div></div></div> }!}
+
+Before I can get into the medication specifics, I need to introduce the concept of a Receptor, because this is central to how all medications work, and understanding this concept will make it easier to understand the differences in these drugs.
+
+### Hormone Receptors
+
+In simplest terms, a receptor is like the keyed lock ignition on a car built prior to 2010 (do new car’s still have keyed ignitions?). Every cell in the body has a set of protein receptors which activate different functions within that cell. They’re like switches which signal to the cell that it should behave a certain way. Each receptor can only accept certain chemical compounds, much like how an ignition can only accept certain keys, and different chemicals have different capabilities at turning the ignition. Some can completely start the car, while others only turn it to Accessory Mode.
+
+The ability for a chemical to fit into a receptor is called *Relational Binding Affinity,* and is measured as how likely a chemical will bind to a receptor compared to another. So, for example, if Hormone B binds only 10% of the time in relation to Hormone A, then it is said to have a 10% affinity. Similarly, the ability for a compound to turn the key is called *Transactional Ability*. Compounds which into a receptor but don’t do anything are called *Antagonists*, compounds which are able to turn the key are called *Argonists*. If it can only turn the key a tiny bit, it’s called a *Partial Argonist*.
+
+You can think of antagonists like bouncers at a club. They stand in the doorway and prevent anything else from getting through, but don’t enter the club themselves. Most antagonists are referred to as Blockers. This is different from an *Inhibitor*, which is a compound that slows a chemical reaction. In receptors, an inhibitor lowers the function of the receptor, causing it to respond less effectively to things that bind to the receptor.
+
+Right, now that we've covered that, lets move on.
+
+**This guide is divided into four parts:**
+
+1. [Anti-Androgens](/hrt/fem/antiandrogens)
+
+2. [Estrogens](/hrt/fem/estrogens)
+
+3. [Progestins](/hrt/fem/progestins)
+
+4. [What to Expect When You're Expecting Boobs](/hrt/fem/what-to-expect)
+

public/hrt/fem/progestins.md

@@ -0,0 +1,15 @@
+---
+date: "2020-01-26T20:41:55.827Z"
+title: "Transfeminine HRT - Progestins"
+description: From the Bs to the Ds.
+classes:
+  - hrt
+siblings:
+  prev: /hrt/fem/estrogens
+  next: /hrt/fem/what-to-expect
+  nextCaption: What To Expect When You're Expecting Boobs
+---
+
+# Transfeminine HRT: Progestins
+
+TBD

public/hrt/fem/what-to-expect.md

@@ -0,0 +1,207 @@
+---
+date: "2020-01-26T20:41:55.827Z"
+title: "Transfeminine HRT - What to Expect When You're Expecting Boobs"
+description: From the Bs to the Ds.
+classes:
+  - hrt
+siblings:
+  prev: /hrt/fem/progestins
+---
+
+Transfeminine HRT   
+What to Expect When You're Expecting Boobs
+===
+
+This is a compilation of reported medical transition changes collected from testimonials of trans women from various discussion forums and chat rooms. Yes, that means this is all anecdotal, but most of transgender medical care is anecdotal.
+
+**Note that this is a list of _possible_ changes. There is no guarantee that every person on transfeminine hormone replacement therapy will experience all of these. Your age, genetics, medical history, degree of masculinization, and hormone regimen can all have impacts on results, and some things can take years to appear.**
+
+### Changes connected to reduction of Testosterone:
+
+- Reduction in general body odor and change in the smell of ones sweat.
+  - Many report gaining a sweet smell.
+  - Users of Spironolacotone may notice a total cessation of body odor entirely.
+
+- Skin softens and becomes thinner.
+  - Expect varicose veins.
+
+- Reduction in skin oils, causing face and scalp to become drier.
+  - Significant reduction in acne.
+
+- Thinner and softer finger and toe nails.
+
+- Reduced body hair growth, hairs become thinner and shorter.
+  - Do not expect total cessation of body hair, you will still likely need some laser treatments.
+
+- Emotional expansion
+  - Less stoicism and disassociation, and you will regain the ability to cry
+  - You need Estradiol in order to push this to its fullest
+
+- Reduced muscle mass / harder to gain muscle
+  - This contributes massively to feminine shoulder and neck line, as well as the waist line.
+  - Strength diminishes significantly, become unable to open jars.
+
+- Loss of random erections / morning wood
+  - Failure to regularly give oneself erections can result in atrophy of the tissue, leading to shrinkage.
+  - Prolonged atrophy can cause painful erections.
+
+- Loss of sex drive, frequently a total loss of libido.
+  - This returns eventually once the body gets used to running on estrogen, especially with the addition of progesterone, but it will not feel anything like what you're used to.
+
+- Sterility + testicle atrophy
+  - Testicles shrink in size.
+  - Atrophy pain is common in the first year. May present as a dull throbbing or as sharp sparks which travel through the genitals.
+
+- Deepening or changes in eye color
+  - Testosterone causes a fading of iris pigmentation.
+
+- Hairline restoration
+  - Total reversal of baldness is unlikely, but almost everyone regains some hair line.
+
+- Salt/Pickle cravings
+  - This is specific to those on Spironolacotone, which is a diuretic that causes you to pee out all your sodium
+
+### Changes attributed to Estradiol:
+
+- Breast growth
+  - Extreme nipple sensitivity at the onset
+  - Expect aches and pains in the upper chest
+  - Nipples will get larger, areolas become more visible
+
+- Fat redistribution into feminine proportions
+  - Reduction in the waist and upper body, flattening and softening of belly, gains in hips, thighs and upper arms.
+  - Lower center of gravity
+    - This results in a change of gait
+    - Walking with the hips becomes the body's natural movement
+
+- Facial feature changes
+  - Chin and jaw line will thin out.
+  - Cheeks and lips will puff up
+  - Brow and upper eye lids will lift, exposing more of the eyeball.
+  - Eyelashes will grow thicker and longer
+  - This is extremely subtle and slow going and it's easy to think nothing is changing at all. Take selfies to compare.
+  - Changes in tissue around the eye can alter the shape of the eyeball, changing focal depth and altering vision clarity
+
+- Slimmer hands, wrists and feet.
+  - Ring size will drop as fat moves off the hands and the skin thins, making the fingers thinner
+  - Finger length will drop as ligaments thin and shift
+  - Feet shrink both in length and thickness due to ligament and fat changes.
+    - A drop in two or even three shoe sizes is extremely common.
+
+- [Pelvic tilt](http://en.wikipedia.org/wiki/Pelvic_tilt) causing an increase in curvature of the back and an increase in butt protrusion.
+  - Potentially a loss of 1-3 inches in height.
+  - Note: This is NOT the same as the [hip rotation](https://youtu.be/OROoZzoVwfk?t=12) that occurs in AFAB puberty.
+    - However, that can still happen over very long stretches of time. An 80 year old trans woman reported on reddit last year that over the course of her 30 years on HRT, her doctor observed changes in her pelvis consistent with female hip rotation.
+
+- Improved flexibility due to ligaments stretching
+
+- Scalp hair becomes thicker and follicles grow stronger, allowing hair to grow to longer lengths.
+  - Hair can also become curlier
+  - Hair may change color
+
+- Emotional expansion
+  - Higher highs and lower lows
+  - Mood swings, random crying
+  - Crying from joy
+
+- Erogenous zone development
+
+- Multiple. Full body. Female. Orgasms.
+  - Pelvic orgasm becomes harder to achieve, but stronger in intensity
+  - Full body orgasm becomes possible, but may be hard to reach without a partner
+
+- Penis and scrotal tissue changes
+  - Increased sensitivity
+  - Skin moistening, change in odor (scrotum and penis begin to smell vaginal)
+  - Coloration changes, particularly along the [perineal raphe](https://en.wikipedia.org/wiki/Perineal_raphe)
+  - Skin along the shaft and glans thins and becomes more prone to tears/bruising during sex
+  - Perineum becomes very soft to the touch, velvet like
+
+- Perspiration distribution changes
+  - Sweating becomes more of a full body experience, less focused on the scalp.
+  - Underboob sweat will become a thing
+
+- Changes in body temperature placement
+  - Reduced tolerance of temperature changes
+  - Women have warmer cores but colder extremities.
+  - Oral and skin thermometers may show a lower temp (~97.6)
+
+- Improved color perception
+
+- Significantly improved sense of smell, especially of other bodies
+  - Will be very intense when it first unlocks but then calms down as your brain gets used to it.
+
+- Changes in taste perception
+  - Many people report cilantro becoming more palatable.
+  - Chocolate addiction _(Only half kidding)_
+
+### Changes attributed to Progesterone:
+
+- Increased appetite, food cravings
+  - Progesterone increases mitochondrial function, boosting metabolic rate. That gives you more energy, but it also means you consume calories faster.
+
+- Increased libido / sex drive
+  - Note, the change in libido may not be immediately obvious, as [estrogenic sex drive feels completely different](https://curvyandtrans.com/p/5BF1EA/libatious-libidos/) from androgenic sex drive..
+
+- Breast fullness and improved breast development
+  - Progesterone is a critical hormone in the maturation of milk ducts. It also encourages the body to favor breast tissue for fat deposit.
+
+- Improvement of impulse control
+
+- Deeper sleep with potential for much more vivid dreams
+
+### Changes that cannot be specifically attributed to a single component of HRT.
+
+Some of these may simply be the brain getting what it finally wants.
+
+- Drastic reduction in depersonalization / derealization symptoms
+
+- Improved clarity of thought (many reports of improved multitasking)
+
+- Increased chattiness and generally more extroverted
+
+- Less likely to engage in arguments or fights, more likely to attempt to defuse or escape heated situations
+
+- Improved balance & spacial awareness (less bumping into walls or kicking doorways)
+
+- A sense of feeling smaller in the world.
+  - This is not just because of physical body changes, your perception shifts and you feel actually smaller.
+
+- Reduced tolerance of caffeine and alcohol
+  - Testosterone increases body mass which increases alcohol tolerance.
+  - Estrogen slows metabolic rate, decreasing the speed at which toxins are processed.
+  - Spironolacotone and oral estradiol strain the liver and hinder metabolism of toxins.
+
+- Changes in ADHD symptoms and/or intensity
+  - For some it improves, for others it gets much worse.
+  - This is much more likely for users of Spironolactone
+
+- Lactation
+  - A few drops is to be expected, especially while nipples are being stimulated, and is merely a sign of milk ducts forming properly.
+  - Significant discharge may be a sign of a dangerous hormone imbalance and should be checked by a doctor.
+
+- Cyclical period symptoms.
+  - [Yes, for real](https://curvyandtrans.com/p/C4BD87/cycle-dynamics/).
+  - No menstruation, because there is no uterus, but all other typical period symptoms can manifest in 26-33 day cycles.
+  - Symptoms vary greatly (just as in cis women) and typically last for 4-5 days. Use of a period tracker can reveal the pattern.
+    - Cramps in the intestine and abdominal muscles
+      - Ranges from a slight flutter in the gut, to strong painful spasms
+    - Bloating, Gas, Diarrhea and other intestinal issues ("period poops")
+    - Emotional instability and irrational thoughts
+      - Heightened depression and dysmorphia
+      - Increased dysphoria
+      - Irritability (PMS)
+    - Muscle and joint aches and pains
+    - Breast engorgement and nipple tenderness
+    - Acne
+    - Fatigue
+    - Appetite changes, spontaneous cravings (see: chocolate addiction)
+    - Spontaneous shifts in libido
+    - Changes in genital odor
+
+- Significant loss of trust in cis men.
+
+- Communism
+
+Ok, those last two might be more social than hormonal...
+

public/hrt/index.md

@@ -0,0 +1,25 @@
+---
+date: "2020-01-26T20:41:55.827Z"
+title: "Hormone Replacement Therapy 101"
+description: "An introduction to transgender medical transition."
+classes:
+  - hrt
+
+---
+
+# Hormone Replacement Therapy 101
+
+**Preface**: This post is written for Transfeminine and Transmasculine individuals seeking hormone replacement therapy (HRT). Not every trans person pursues medical treatment for their gender dysphoria, and not all trans people experience physical dysphoria. Additionally, feminisation/masculinization is *not the only reason* to pursue hormone therapy. For those who experience biochemical gender dysphoria, switching hormone profiles significantly improves mental health and mental acuity.
+
+Unfortunately, the reality of being trans is that we often have to be our own self advocates when it comes to our medical care. A *lot* of medical providers have no idea how medical transition works, and even many endocrinologists are woefully out of date on modern treatment plans. It is extremely beneficial to go into your first HRT appointment well informed and well armed. This guide will *attempt* to cover everything you need to know about hormone therapy, and a lot you probably don’t need to know but is good to be aware of.
+
+Note, this is not a guide on how to self-medicate. You should always seek proper and licensed medical professionals to assist you with your transition. In many countries it is possible to find Informed Consent clinics which will assist you with medical transition without the need of a formal diagnoses. [Erin Reed](https://rewire.news/article/2019/10/16/meet-the-woman-making-it-easier-for-trans-people-around-the-country-to-get-hormones/) maintains an excellent [map of all Informed Consent clinics within the United States](https://www.google.com/maps/d/u/0/viewer?mid=1DxyOTw8dI8n96BHFF2JVUMK7bXsRKtzA&ll=42.47025816653197%2C-97.03854516744877&z=4).
+
+<h3 style="justify-content: center; margin-bottom: 1em;">This guide is divided into two parts:</h3>
+<div class="pager">
+  <div></div>
+  <div class="prev"><a href="/hrt/fem" class="btn btn-primary left">Transfeminine HRT (Estrogen)</a></div>
+  <div></div>
+  <div class="next"><a href="/hrt/masc" class="btn btn-primary right">Transmasculine HRT (Testosterone)</a></div>
+  <div></div>
+</div>

scss/_page.scss

@@ -29,7 +29,7 @@ body.post {
   }
 }
 
-body.gdb {
+body.gdb, body.hrt {
 
   #body {
     background-color: $gutter-bg;