So today I was thinking about HRT, as one does. Diabetes runs in my family, and if you know even a little bit about diabetes, you’d understand that it’s a disorder of the pancreas which is the organ of your body that produces insulin 1 , a hormone that allows your body to make use of glucose for energy. And given that I do eventually want to replace the testosterone in my system with oestrogen, I was wondering what, if any impact feminizing hormone replacement therapy would have on my risk for diabetes or creating complications therewith. That led me to start reading a few academic papers. From what I can tell, the science on this seems to conclude that there’s no proven increase in diabetes risk for trans women using HRT 2 3 , so that’s great!
Apart from that, there was something else that caught my eye. Going through the Results section of this paper 4 , I stumbled across a statistic that really gave me pause.
The median age at start of hormone therapy for trans women was 30 (23-41) years and 23 (20-31) years for trans men
The median age at start of hormone therapy for trans women was 30 years.
When I read that sentence, I stopped in my tracks. Since I’ve come out to myself, my close friends and my mom, I haven’t really done too much in the way of starting to present more feminine or seek out medical intervention to get started on HRT. I’ve often felt that I’m wasting time, or that I’m not really trans or that maybe, just maybe, if I ignore it, deny it, bury it, this feeling will go away. The feeling that I’m too late to transition or that I’m doomed to live my life in a vessel that doesn’t conform to the shape of my spirit often hangs over my head. The temptation to just continue to accept the low-grade misery of waking up every day just to dread the sight of the mirror is something I’ve allowed myself to give into.
But…
The median age at start of hormone therapy for trans women was 30 years.
If you know me, you know that I Saw the TV Glow literally changed my life. There’s a scene in that movie that I come back to again and again. It comes in the third act of the film. Isabel (Owen) has denied Tara’s (Maddy’s) offer to pull her out of the midnight realm and Isabel is flatly giving her monologue over why being stuck in “A prison so sweet you won’t even know you’re dying” really was the right choice. We’re taken through a slow montage of scenes from Isabel’s mundane life as Florist’s Riding Around In The Dark plays in all its airy wistful melancholy, when finally, mercifully, we fade into a shot pointing down Isabel’s street, panning up to reveal a huge fluorescent chalk drawing in blues and pinks and whites, swirling with joy and rebellion and euphoria that reads
there is still time
We see Tara walking away from the drawing, her final attempt to get Isabel to escape the midnight realm, knowing that she can’t force her to and choosing her own life instead of remaining trapped in a hell she escaped once before.
Isabel never mentions this message.
The median age at start of hormone therapy for trans women is 30 years.
There is still time.
These messages remind me that I’m not too late. There is still time. I’ve seen so many utterly gorgeous, joyful trans people who didn’t start transitioning until their 30s and 40s. I know there is still time, but the reminder always manages to quell some of the fear, doubt and resignation. It reminds me that there is hope. It reminds me to keep dreaming and to start planning.
It reminds me to live.
I would be remiss to talk about transition, medical or otherwise, without drawing some attention to the realities that so many trans people are facing right now. In the United States, where I spent the last 7 years of my life, in the United Kingdom, to which the highest officer of my country reports and all over the Caribbean where homophobia and transphobia run rampant, trans people are in danger, be it from our own governments deeming us undesirables in sports, and likening us to a plague to be eradicated from public life or from our own fellow citizens who discriminate against, assault, threaten or outright kill us at astounding rates.
Be it the governments who are trying to legislate us out of existence by banning or effectively criminalizing accessing or providing access to the life-saving treatments that let trans people exist as we wish to.
There are so many forces in the world today that make being trans feel impossible, but it’s important for us to keep going. We’ve been here forever and we will be here forever. No matter how hard it gets, we will keep dreaming and keep moving towards ourselves.
With that, I’d like to take the opportunity to ask you to consider donating to one of the below organizations. The work they do is needed now more than ever and is harder to do now more than ever.
- TransWave Jamaica - A non-governmental organization working to advance the health, welfare and well-being of the transgender community in Jamaica and the Caribbean
- The Trevor Project - A US-based suicide prevention and LGBTQ rights advocacy non-profit aimed at LGBTQ youth
- The ACLU - The American Civil Liberties Union is a US-based rights advocacy group who has their plates exceptionally full with all of the rights violations happening to queer people, immigrants and women and femmes in the United States today
References
- Insulin (Cleveland Clinic, 2024 )
- Gender-affirming Hormone Therapy and Risk of Diabetes in Transgender Persons (Tangpricha, 2022 )
- Is There a Link Between Hormone Use and Diabetes Incidence in Transgender People? Data From the STRONG Cohort (Isalm, Nash, Zhang et al, 2021 )
- Incident Diabetes Risk Is Not Increased in Transgender Individuals Using Hormone Therapy (van Velzen, Wiepjes, Nota, van Raalte, de Mutsert, Simsek, den Heijer, 2021 )