I have heard that one of the uses of hormone replacement therapy is to see if the individual accepts or rejects the treatment. In your experience (or in other documented sources) where there was a rejection, what are the responses?
First of all, keep in mind that a referral for hormone replacement therapy is made with great caution. Individuals are not only evaluated for severity of gender variance but they are educated to the effect the hormones will have on them. Most of the people I see come in very aware of the effect HRT will have on their secondary sex characteristics but few are aware of the general health risks and the psychological effects they will experience. For example, I explain to all my clients MTF clients that paradoxically taking estrogen will diminish not only their libido, it will diminish their need to crossdress. I know that is counterintuitive but it is a fact.
I also warn them that getting on estrogen can result in a sense of well being that leads to a strong desire to continue taking it. They had better be prepared for that consequence. A similar feeling of well being is reported by FTMs on testosterone.
I am not aware of any documented study of people rejecting HRT but an informal review of four of my colleagues show that out of the 1500 plus people we have collectively seen over the last 20 plus years, there have only been a handful of people who have stopped HRT once they have started. Two of us had patients who stopped because they complained that it reduced their libido and it decreased their desire to crossdress. Two of us report where a client has been frightened off after their breasts began to develop. One of my clients eventually had an orchiectomy and had his small breast development removed surgically and continues to live in the male gender role. One of my colleagues reports a similar experience with his client also having a double mastectomy.Read More