Trans feminine tips and tricks
- Hair care
- Other issues
- Recommended hormone values
The voice of trans masculine people will change thanks to testosterone. In trans feminine people, however, this change has already occurred.
There is an irreversible surgery that can bring your voice frequency up, with one important downside - it can sound artificial, people will know you're trans and also because of the mechanical changes you will likely be unable to sing.
Therefore we recommend a more difficult, although better alternative - training. Here you can find a series of guides how to train your voice. It takes a lot of work and you will notice the first results probably after at least a month. If you persist though, your voice will sound very natural and won't prevent you from singing in the future.
Trans masculine people, again, will have their beard and body hair grow and thicken due to testosterone and they don't have to take any other steps. Unfortunately it's the other way around for a trans feminine person - these irreversible changes already occurred. That's why it's necessary to undergo several very painful laser treatments. We have to emphasize just how much it hurts - especially the area above the upper lip. People often compare the pain to being struck by a rubber band or being splashed by scalding hot oil.
Price-wise it is an expensive to extremely expensive treatment, not paid by your medical insurance, and the total price for your beard can be between 10 to 50 thousand Czech crowns for a series of treatments, depending on your choice of a clinic, beard density, hair color and your skin tone.
We have personal experiences with two places. Laser-Centrum-Brno CZ is more affordable. Laser Esthetic CZ is a more expensive alternative based in Prague, and if price is the main issue, it's better to take the train to Brno. On the other hand it's in the center of Prague and their attitude is more professional.
Laser isn't necessarily the best option for everyone and is not as perfect at removing hair as electrolysis. Laser works based on the contrast between hair and skin color, so people with fair skin and light hair or dark skin and dark hair will often run into laser not being very efficient, in the worst cases it may not even work at all for them.
Laser treatment is pretty quick, you pay for the part of your body that you chose, but the treatment itself is relatively fast. When it comes to electrolysis, you don't pay for the part of your body but for the time spent. A lot of treatments are necessary and the sessions may take anywhere from 30 minutes to half a day, depending on what you arrange. Electrolysis is also more expensive.
Electrolysis is done in a way where a thin needle is put into the hair follicle, then an electric current goes through the needle and by heating the follicle it is weakened and can be pulled away with a pair of tweezers. It is much harder and more precise than laser treatment, the hair is removed one by one. Unfortunately hair grows in different phases and it is not possible to get rid of it all in just one session. The entire process takes a long time but results will come eventually. The amount of pain depends on the machine used and on the experience of the person performing it. The frequency can be tuned so the electric signal won't hurt, nevertheless you will feel the needle being stuck into you.
We have personal experience with Apilacare CZ (Ostrava, Brno), they are friendly towards trans people and they always try to find an approach, that will be the best for you (for example combining it with IPL).
At the effectclinic CZ (Brno) clinic electrolysis is performed, however they cannot remove light hair. We don't have more experience.
A common problem of trans feminine people is unfortunately hair loss before transitioning. Simply put: testosterone in the body is converted into dihydrotestosterone (DHT), which among other things causes the weakening of hair follicles at first and then their complete death. This then leads to the classic hair pattern loss: on the crown and temples around the forehead.
After starting HRT and therefore starting a testosterone blocker the levels of testosterone in the body falls down to a level comparable with cis women. In most cases this stops the process of hair loss. In some cases it can also lead to the reversal of that process, however, that's only in the case the follicles haven't died out completely.
For hair growth support one can use over-the-counter products containing Minoxidil, for instance Belohair in the Czech Republic. For trans feminine people it is generally recommended to go with the more potent 5% variant usually targeted at men. Minoxidil causes the blood vessels on the top of the head to dilate, which leads to increased hair growth. However, this products is effective only as long as it is used.
Another alternative is Finasteride, which blocks the process of converting testosterone to DHT. This medication is prescription only though. Similarly to Minoxidil, it only works as long as it is administered.
As a supplement a common recommendation is Biotin, one of the B vitamins, however, any link to increased hair growth is weak. Another option might be multivitamins targeted at hair, nail and skin health, which are commonly available at pharmacies.
Regarding any product that helps with hair growth it is important to keep in mind that it's not completely possible to make them target only one area of the body. The blood vessels will supply follicles on other body parts as well, so there's always a risk that using such products will lead to increased other hair growth and facial hair growth as well. These products may also hinder the progress of laser or electrolysis treatment.
Almost every trans femme person practices some form of tucking - placing the penis and testicles in your underwear in a way to hide it as much as you can. It is also important to mention that you can hide the testicles inside of your body. If you want to know more, search "inguinal canals". Besides the manual strategy which is free and requires only good fitting underwear, there are also products which aim to make this process easier and achieve better results. From our personal experience, if you are not very well endowed, it is usually sufficient to just use well fitting panties. But there are some trans femme people or specific situations which require better tucking and assurance - like ballet and swimming. There is very little information about it on the Czech internet and even fewer available products.
We don't have any experience with products for tucking and therefore can't recommend any, but it's our duty to mention their existence. One of the finished products is Unclockable Tuck Kit, whose price and shipping here make it a really expensive endeavor - 3500 CZK for 30 pieces. Another is Tuck Yourself Tucking Kit with a total price of 2000 CZK including shipping. On the Czech internet there is also Tuck páska / Trans tape for 500 CZK, which at the time of writing this article was sold out and lacks sufficient information about the product itself. Besides already finished products you could also use a more common kind of medical tape, but it must be fit for use on sensitive skin. Here we really recommend following the safety guidelines, otherwise you could hurt your body permanently.
Makeup is a very strong crutch for trans femme people. This topic is different for everyone, some may want to feminize their face, some may want to add the final details and some may not want to use it at all. It is a very subjective matter and there is no correct approach. We will go over a style that is mostly natural and helps with feminizing your face.
If you have someone who can help you, you may use their help if you want. But expect that they most likely won't have enough experience even if they are using makeup themselves. It is important to mention that techniques to reduce the sharp features of your face exist. If someone is helping you, don't share anything that goes close to your eyes, it is a very common transmission vector of eye infections. You may get inspiration in both the trans and drag queen community, but in the pursuit of remaining natural it is best to not go into the extremes or you may get a lot of unwanted attention.
Makeup can be split into two categories, a neutralizing one, which will make your face softer, hide imperfections and unite your skin color. The second one is decorative, which will add more detail and make you pop. In the next sections we will talk about specific kinds of makeup that you can use, roughly in the order in which they should be used.
- Base/Primer – a transparent substance that you spread around your entire face. It makes applying further products easier and they hold better. If you forget a base it is not a big deal, but the rest of your makeup will wear off quicker and will be harder to apply. We don't recommend oil-based bases.
- Corrector/Concealer – it is a color substance that is used to hide various imperfections. Correctors may have several variants, they may come in a tube (liquid) a stick (solid) or as a powder. Liquid ones are very aggressive and may cause several issues (the face sweats more and by itself it may be more glossy which may look as sweat, a common issue in amateur makeup). The solid variant in a stick is the easiest to use, but the most ideal ones are the powder ones. Which variant you choose is up to you, but try to avoid the liquid one if you have the option to. They may be applied with a brush or a sponge, only a small amount is applied and spread around, if it's not enough just repeat the process. A thick layer is not a solution, it is always necessary to spread around a small layer. Correctors have several kinds so pay attention to its designed use case.
- Green – to cover up red spots.
- Red/orange – to cover up blue or green shades, which are often found under shaved facial hair. They create blue or green shade on your skin depending on your facial hair color. The orange one may also cover up dark circles under your eyes depending on their shade.
- Purple – to cover up yellow spots like bruises.
- Other – we can't list every single color, so we just mention the most common ones. The rule of thumb is that the color that appears on your face can be fixed by an opposite color corrector.
- In your skin tone – you can apply at already corrected spots to make the color more consistent, lighter (can also use a highlighter, however it often comes with glow, which may end up looking unnatural can be used to highlight features of your face. It is commonly applied around the nose, nose holes, cheekbones. Try to avoid places that appear more masculine to you as you may end up highlighting them instead and your face would end up looking more masculine.
- Foundation – what most people call „covering makeup“, it is a liquid substance in the color of your skin tone, which is applied to the entire face. You apply it either with a finger or a small sponge, because a brush would get damaged and leave strands on your face. Foundation makes for a very uniform skin tone but may appear unnatural, it is entirely optional to use it.
- Bronzer – most of the time it is a powder or a liquid substance of a darker color. As a fulfilling alternative you may use a foundation in a darker color (to appear natural, 1-3 shades darker than your skin tone). It can be used to hide masculine features of your face, like your chin or jawline. It is an entirely optional part of the makeup process and requires a lot of experimentation, every face is different and requires a different amount. It is important to start with a small amount and spread it around with a sponge so it creates a smooth gradient to the lighter foundation.
- Powder – a powder that you apply on the products mentioned above. It is used to make your face more matte and to serve as a protective layer for everything under it (most other products make your face more glossy which doesn't look very good in most light conditions). Powder is basically mandatory if you use anything else.
- Blush – used to create an illusion of red cheeks/cheekbones, simply apply with a brush to the desired location. Blush is very easy to coordinate with the lip stick, just buy two lipsticks of the same color and apply one to the brush and then onto yourself. The second lipstick is then used on your lips.
- Eye shadows – used to color (most of the time the upper) eye lids. There are a lot of techniques and ways to apply it, it is mostly about what you like. For trans femme people it is possible that they have so called "deep set eyes", which means that your eye shadows may be hidden. We recommend using that phrase when searching for tutorials if that's the case, as it makes everything more complicated.
- Mascara – a stick with which you apply a substance on your eyelashes so they will look darker and thicker, which can make your eyes pop more. Application is simple, just be careful to wait for the mascara to dry and don't apply too much.
- Eyeliner - used to highlight the eyes, most commonly applied to the upper eyelid by going around the eyelashes, or above the eye as a decoration. Application can be difficult, it depends on the kind of eyeliner that you have. Most of the times it's a gel, liquid, a marker or a pencil. The pencil is the easiest but all techniques require a stable hand. It is possible to replace eye shadows with this, while applying with a flat brush to create a soft line, or to fill the gaps between eyelashes and the line.
- Inner eyeliner – inner lines are applied to the skin, which is beyond the eyelashes. This application can be uncomfortable but can also have positive effects. It is most commonly used at the lower eyelid, if you use a white color the eye appears larger which appears more feminine. You may also apply a dark line, but then the eye looks smaller and more tired. We recommend searching for „white waterline eyeliner“ to get an idea about the application.
- Lipstick and lip liner – lipstick is used to give your lips color and is very simple to apply. Just go over it with your lips and them rub them against each other so it covers them properly. Don't apply it in the corners or edges, when you speak and move your mouth it will get smeared and your lips will look unnaturally large. Either before or after applying it you may use a lip liner, which will create a nice sharp line and give your lips contrast.
This is just a simplified overview, the most important part for you will be about neutralization. We recommend looking up guides mainly from trans people, since they know better what works and doesn't for more masculine faces. If you are mainly interested in feminization, „contouring“ will be very important for you.
Besides estradiol and testosterone blockers you may come into contact with other problems that require different medications which a sexologist may prescribe to you. Here it really depends on how you feel and what problems you have and how much you trust your doctor. We don't recommend limiting sexology to just your transition if you see that they value how you feel, they will most likely help you with other questions and problems that may be related to HRT or issues that you had even before.
You may have a very low value of testosterone and a sufficiently high enough value of estradiol (most commonly due to injections). If you are already using a low dose of a testosterone blocker, you may be able to stop taking it entirely. This is not a very common practice as it doesn't work for most people but it may be worth a try. If your testosterone values stay in the proper range, you may be able to not take a testosterone blocker at all.
Low values of testosterone reduce the amounts of erection you have unwillingly (for example when you sleep). They may basically be only limited to your sexual activity. In combination with a low libido this may mean you have either a very low or zero number of erections. If you don't plan to use your genitals you may feel like this is a good thing, but if it's the opposite case (whether you want a vaginoplasty or not), you may have particular issues that may affect you.
Your symptoms may include low sensitivity, anorgasmia or very painful erections. These pains wouldn't stop even in the case of vaginoplasty.
If you are already experiencing this issue, you may talk about it to your sexologist. Regardless the efficient prevention are activities, that cause you to have an erection. We understand that this may cause you dysphoria, that's why some people opt to use a small amount of testosterone gel. This solution is mostly used in the DIY community and we aren't sure how a sexologist would approach this.
High prolactin value
A high value of prolactin is related to a lot of other issues like low libido, infertility, bone thinning, lactation and erectile dysfunction. The reasons for a high prolactin are stress, some medication or a benign tumor on your brain. When your sexologist learns that you have a high prolactin value, you will most likely be referred to magnetic resonance imaging to rule out the possibility of a tumor.
Most trans femme people will have lower libido which is to be expected from blocking testosterone, nevertheless it may lead into a difficult situation that may come with anorgasmia and a low sensitivity on your genitals. If you feel too unsatisfied, don't compare these experiences with people that have a vagina/clitoris. Even though it's true that it's harder to reach an orgasm for them, that's related to the testosterone value which affects sensitivity, nevertheless it is compensated by a lot more nerve endings in the clitoris. If you for example have 0.5 nmol/l testosterone, the same value as a cis woman, you will most likely have lower sensitivity than her.
In the DIY community the most common solution to this problem is to increase testosterone (mostly with a gel or a patch), however this problem may be related to prolactin (the symptoms are similar) and lowering it is a relatively simple deal, so having higher testosterone is not necessary most of the time. One of the options is taking cromocriptine (in Czech Republic sold as Medocriptine), the dose depends on the value of prolactin, most of the time 0.5 to 1 pill 2x a day. The advantage is that if your value goes down to the normal levels it is not a big problem and often another solution is not necessary. The disadvantage is that if you stop taking it you may experience withdrawal symptoms.
If you are suffering from insufficient or hard to reach erection, there are several solutions. Tweaking the values of hormones (prolactin, testosterone) may be enough to solve this even if difficult. In Czech Republic we often come into contact with medications sildenafil (Viagra) and tadalafil (Cialis). Sildenafil works for one day, tadalafil for up to three days. Even if using these medications, stimulation is necessary, they only play a supportive role. When it comes to price, these medications may cost in the range of 300-2000 CZK, depending on the size of the package and the specific mediation (tadalafil is more expensive) and the manufacturer. Always ask the pharmacist about alternatives with the same contents, the prices may differ between different pharmacies but it is possible to save up to 1000 CZK per package if you shop around.
It is understandable that you may be afraid to ask your sexologist about these topics, a lot of them may not have a positive approach towards them. Regardless, these medications don't have a specialization and any doctor may prescribe them. Don't be afraid to ask your general practitioner or other doctor that you trust.
Recommended hormone values
We caution that the reference values of hormones are not the only ones you should keep an eye on. You will most likely have other results in your blood tests which won't fall into the reference intervals. Please inform your other doctors that you are undergoing hormone replacement therapy and to use the reference intervals for cis women.
|Hormone||Reference values (women)||Reference values (men)|
|FSH||1.40–21.50 U/l||1.30–12.40 U/l|
|LH||1.00–95.60 U/l||1.70–8.60 U/l|
|Progesterone||0.18–86.90 nmol/l||0.10–0.47 nmol/l|
|Estradiol||45.4–1828.0 pmol/l||41.4–159.0 pmol/l|
|Prolactin||108.8–557.0 mIU/l||72.7–407.4 mIU/l|
|SHBG||19.00–137.20 nmol/l||14.50–63.80 nmol/l|
|DHEA-S||1.65–11.0 µmol/l||1.91–13.4 µmol/l|
|Cortisole||133–537 nmol/l (68–327 nmol/l in the afternoon)||133–537 nmol/l (68–327 nmol/l in the afternoon)|
|Testosterone||0.30–1.80 nmol/l||8.60–29.00 nmol/l|
|FAI calculation||0.33–4.37 %||26.18–107.07 %|
These values come from the reference values of several laboratories (Fakultní Thomayerova nemocnice CZ, Vaše laboratoře s. r. o. CZ, SPADIA LAB a. s. CZ). The values between the laboratories don't differ too much and it was important to choose those which the doctor will care about, for example for trans femme people it is normal to have values which correspond to any phase of the menstrual cycle (if they feel well), but for example values which correspond to pregnancy may be alarming. We must take care that too high of a testosterone value can cause more masculine features like a beard even for some reference values (some cite values up to 5 nmol/l), which could have a needlessly negative influence if said person didn't go through puberty due to puberty blockers.
These are just reference values (some values are until the age of 50, to better represent the majority of our readers). It's impossible to say if all of your values need to be in these ranges, it's possible it may no be the best for your specific body. Consult any questions and problems with your sexologist.
Doctors should always take into account whether you are currently taking HRT. In most cases the entire blood panel is affected which may result in other kinds of treatment needing to be adjusted to accommodate it (for example trans femme people will have different level of blood clot formation due to HRT and it is important to think about it before any kind of surgery).
Warning: Testosterone is a very important hormone for both cis and trans femme people. Insufficiency may lead to severe health issues, so it's not good to have it in values lower than the reference ones. Generally you should have either a high value of estradiol and low value of testosterone or vice versa. The lack of a hormone will cause issues such as heart disease and osteoporosis. The lack of both hormones (for example due to orchiectomy and not taking any hormones) may eventually even lead to death.
A lot of trans femme people allege, that they are having menstruation or menstruation cycle. This almost always stems from ignorance. In reality these situations shouldn't happen. A real menstrual cycle cannot be simulated by the standard treatment very well, you would have to manipulate your hormone doses that you take, which is only really possible with subdermal pellets, which aren't even that good at it.
If these symptoms appear, you should consult your doctor. These are hormone swings which shouldn't happen. Your doctor will adjust your doses so they are more appropriate for your body. You can have symptoms of PMS or PMDD, which can be dangerous. Please don't consider them a natural part of transitioning.