I started HRT 11 months ago, and I have now been tired for 10 months. Around month 9 I stopped making a lot of plans I would have made otherwise. I don’t go out nearly as much now, because I don’t want to risk going to all the effort of going out just to find that I’m too tired to stand.

I have hope that things will turn around, but I’ve spent a lot of time this year searching for reassurance that others struggle with this past the initial few months. There are a lot of people who quickly got over their fatigue, and report feeling “more energetic than ever before” on E, which I found disheartening as that has not been my experience at all.

Here is my analysis of my energy troughs this year.

2 – 3 months: Initial reduction in testosterone after starting estrogen. It wasn’t a smooth start either. I was using patches at the time. Convinced that my dose was insufficient on the basis of some pretty bullshit reasoning, I self prescribed a second patch. To give me energy! Then I went a little crazy, and decided that the remedy was more estrogen, so I slapped on a third patch. I was basically incapable of sleeping for longer than an hour towards the end of this period, which can be expected of a person with very high estrogen. My endocrinologist eventually saw my insanely high E, I came clean, she told me off, and now I’m a good girl who follows her medical practitioners’ advice to the letter.

5 – 6 months: With the addition of cyproterone, my testosterone nosedived. I believe cyproterone on its own, anti–androgenic effects aside, is kind of a lot for the body to adjust to as well. I was getting up at 7 and going back to bed at 11 some days.

9 – 10 months: Cyproterone stopped working, as cyproterone has been known to do, and I had to increase my dose. So basically my T rose to somewhere between female and male range, then nosedived again. A few weeks later, I was going through the same adjustment as last time, but moreso. This was the point at which I started telling people that I’m staying home for all but the most important events.

11 months: Cyproterone is out because I was getting so upset by the fatigue. Started on progesterone instead and discovered that I am not one of the people who feels happier, less anxious and more rested after sleeping. Nope, I’m an anxious, depressed megabitch on progesterone. My dreams are terrifying, I wake up crying all the time, every sound puts me on edge, and I also weirdly feel emotionally numbed like I did on SSRIs. So we’ll see where this goes, but I feel like I’ve leapt backwards in my transition with this decision, and I am still SO TIRED!

As a bonus, I was diagnosed with POTS recently, which I know I’ve had since my teens, but which only became a problem in need of a solution in the absence of testosterone. This also impacts my sleep and energy.

One positive thing I take away from this is that I must really want this. 'Cause things really suck right now, but never have I ever considered slowing or pausing my transition. A year ago I was all “but what if I’m not really trans”, and now I think I’d sooner get a mobility scooter than stop HRT.

I hope things will be different for you, but I don’t want you to be discouraged if they aren’t, and I don’t want you to feel like something is wrong with you if things still suck 11 months in.