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<head>
<meta content="text/html; charset=utf-8" http-equiv="content-type"/>
<title>A PRACTICAL GUIDE TO FEMINIZING HRT</title>
<!--Generated on Tue Oct 14 22:40:07 2025 by LaTeXML (version 0.8.8) http://dlmf.nist.gov/LaTeXML/.-->
<!--Document created on October 14, 2025.-->
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@@ -17,7 +17,7 @@
<link href="pghrtcss.css" rel="stylesheet" type="text/css"/>
<script defer="true" src="pghrtjs.js" type="text/javascript"></script>
</head>
<body><div id="snackbar">Link Copied!</div><div class="header"><button id="menu" onclick="document.getElementById('sidebar').classList.toggle('show')">☰</button></div><nav class="ltx_TOC ltx_list_toc ltx_toc_toc" id="sidebar"><h6 class="ltx_title ltx_title_contents">Contents</h6>
<body><div id="snackbar">Link Copied!</div><div class="togglebuttons"><button id="theme-toggle">☀</button><button id="font-toggle">Aa</button></div><div class="header"><button id="menu" onclick="document.getElementById('sidebar').classList.toggle('show')">☰</button></div><nav class="ltx_TOC ltx_list_toc ltx_toc_toc" id="sidebar"><h6 class="ltx_title ltx_title_contents">Contents</h6>
<ol class="ltx_toclist">
<li class="ltx_tocentry ltx_tocentry_section"><a class="ltx_ref" href="#S0" title="In A PRACTICAL GUIDE TO FEMINIZING HRT"><span class="ltx_text ltx_ref_title"><span class="ltx_tag ltx_tag_ref">0 </span>FOREWORD</span></a></li>
<li class="ltx_tocentry ltx_tocentry_section"><a class="ltx_ref" href="#Sx1" title="In A PRACTICAL GUIDE TO FEMINIZING HRT"><span class="ltx_text ltx_ref_title">DEDICATION</span></a></li>
@@ -321,7 +321,7 @@
<span class="ltx_personname"><a class="ltx_ref ltx_href" href="https://katea.gay/" title="">Katie Tightpussy</a>
</span></span>
</div>
<div class="ltx_dates">(October 14, 2025)</div>
<div class="ltx_dates">(October 17, 2025)</div>
<div class="ltx_abstract">
<h6 class="ltx_title ltx_title_abstract">DISCLAIMER</h6>
<p class="ltx_p">I am not a doctor. I do not work in medicine. I am not a medical professional in any capacity. I am a layperson offering lay opinions based on the extent of my own education and experiences. All information and assertions below should be treated accordingly as mere opinion rather than statement of fact or medical advice. This guide prioritizes community moral truth where scientific research falters. Basically, don’t get mad at me.</p>
@@ -607,7 +607,7 @@
<h3 class="ltx_title ltx_title_subsection">
<span class="ltx_tag ltx_tag_subsection">2.3 </span>How does monotherapy work?<a class="ltx_ref chain" href="#S2.SS3" onclick="copyURI(event)" title="Click to copy a link here"> 🔗</a></h3>
<div class="ltx_para" id="S2.SS3.p1">
<p class="ltx_p">In simple terms, the brain does not care which hormone it has, just as long as it has enough. If there are consistently enough hormones in your body, it stops producing more. The “consistent” part is what injections are capable of that other administration routes struggle with. Trying to do sufficient monotherapy on pills, for instance, is very likely impossible in most situations. In more specific terms regarding the HPG axis, <span class="ltx_text ltx_font_italic">luteinizing hormone</span> (LH) and <span class="ltx_text ltx_font_italic">follicle-stimulating hormone</span> (FSH) are suppressed by increased serum <span class="ltx_text ltx_font_italic">estradiol</span> levels, thus inhibiting GnRH production and by extension testosterone production in the testes.</p>
<p class="ltx_p">In simple terms, the brain does not care which hormone it has, just as long as it has enough. If there are consistently enough hormones in your body, it stops producing more. The “consistent” part is what injections are capable of that other administration routes struggle with. Trying to do sufficient monotherapy on pills, for instance, is very likely impossible in most situations. In more specific terms regarding <a class="ltx_ref ltx_href" href="https://en.wikipedia.org/wiki/Hypothalamic-pituitary-gonadal_axis" title="">the HPG axis</a>, <span class="ltx_text ltx_font_italic">luteinizing hormone</span> (LH) and <span class="ltx_text ltx_font_italic">follicle-stimulating hormone</span> (FSH) are suppressed by increased serum <span class="ltx_text ltx_font_italic">estradiol</span> levels, thus inhibiting GnRH production and by extension testosterone production in the testes.</p>
</div>
</section>
<section class="ltx_subsection" id="S2.SS4">
@@ -1761,7 +1761,7 @@
<h3 class="ltx_title ltx_title_subsection">
<span class="ltx_tag ltx_tag_subsection">7.8 </span>Some of the fluid leaked out. Was my injection wasted and/or will I die?<a class="ltx_ref chain" href="#S7.SS8" onclick="copyURI(event)" title="Click to copy a link here"> 🔗</a></h3>
<div class="ltx_para" id="S7.SS8.p1">
<p class="ltx_p">No. Leakage can happen for any number of reasons and is rarely enough to make a difference, so you do not need to do another injection. For the future, make sure to leave the needle in for 5-10 seconds before retracting and then apply pressure afterwards. You might consider using the air lock technique mentioned above if you are particularly concerned about leakage.</p>
<p class="ltx_p">No. Leakage can happen for any number of reasons and is rarely enough to make a difference, so you do not need to do another injection. For the future, make sure to leave the needle in for 5-10 seconds before retracting and then apply pressure afterwards. You might consider using the air lock technique mentioned above or <a class="ltx_ref ltx_href" href="https://www.nurse.com/nursing-resources/definitions/what-is-z-track-method/" title="">the Z-track method</a> if you are particularly concerned about leakage.</p>
</div>
</section>
<section class="ltx_subsection" id="S7.SS9">
@@ -2442,7 +2442,7 @@
<h3 class="ltx_title ltx_title_subsection">
<span class="ltx_tag ltx_tag_subsection">11.42 </span>How does HRT affect fertility?<a class="ltx_ref chain" href="#S11.SS42" onclick="copyURI(event)" title="Click to copy a link here"> 🔗</a></h3>
<div class="ltx_para" id="S11.SS42.p1">
<p class="ltx_p">It is important to understand that this is extremely understudied so exact figures cannot be stated, and given the seriousness of pregnancy, I urge you to practice safe sex and lean on the side of caution where possible. HRT itself can, and likely will, make you infertile eventually, but only through full suppression of the HPG axis (See Question <a class="ltx_ref" href="#S2.SS3" title="2.3 How does monotherapy work? ‣ 2 WHY INJECTIONS ‣ A PRACTICAL GUIDE TO FEMINIZING HRT"><span class="ltx_text ltx_ref_tag">2.3</span></a>) over a long time span. In other words, if you haven’t had bottom surgery of any kind and you are on an HRT regimen that is less capable of HPG axis suppression (such as pills), then this is more of a consideration.</p>
<p class="ltx_p">It is important to understand that this is extremely understudied so exact figures cannot be stated, and given the seriousness of pregnancy, I urge you to practice safe sex and lean on the side of caution where possible. HRT itself can, and likely will, make you infertile eventually, but only through full suppression of <a class="ltx_ref ltx_href" href="https://en.wikipedia.org/wiki/Hypothalamic-pituitary-gonadal_axis" title="">the HPG axis</a> (See Question <a class="ltx_ref" href="#S2.SS3" title="2.3 How does monotherapy work? ‣ 2 WHY INJECTIONS ‣ A PRACTICAL GUIDE TO FEMINIZING HRT"><span class="ltx_text ltx_ref_tag">2.3</span></a>) over a long time span. In other words, if you haven’t had bottom surgery of any kind and you are on an HRT regimen that is less capable of HPG axis suppression (such as pills), then this is more of a consideration.</p>
</div>
<div class="ltx_para" id="S11.SS42.p2">
<p class="ltx_p"><span class="ltx_text ltx_font_bold">If the HPG axis is not suppressed then it is fully possible to impregnate someone</span>, and the timeline for sperm maturation is long enough that this is true even after the HPG axis has been initially suppressed for <span class="ltx_text ltx_font_bold">multiple months</span>. Please take this very seriously. Full HPG axis suppression for at minimum six months, perhaps closer to a year out of an abundance of caution, is recommended.</p>
@@ -2704,7 +2704,7 @@
<p class="ltx_p">Though the text is primarily my voice, this document would not be even half as good without the contributions, feedback, and suggestions from others involved at every step along the way. A good reminder as ever that transition is not something best done alone.</p>
</div>
<div class="ltx_para" id="Sx5.p2">
<p class="ltx_p">Many thanks to Q, R, RM, and S in alphabetical order for close review and generally being fun nerds to talk to; love y’all. Special thanks to CB and J for close review that also inspired some very good bits. Thanks to KG for additional intersex information. Thanks to w [sic] for additional injection resources. Thanks to BIR collectively for a plethora of crucial nerd nitpicks. Appreciation for general review from C, JTP, K, S, and V. Thanks to everyone on Bluesky who encouraged me to write this up in the first place, and everyone over the years sharing knowledge. And of course: much appreciation to all HRT nerds, even when we disagree, since we’re all trying to do the best for our community where we’ve otherwise been let down. Keep up the good work everyone.</p>
<p class="ltx_p">Many thanks to Q, R, RM, and S in alphabetical order for close review and generally being fun nerds to talk to; love y’all. Special thanks to CB and J for close review that also inspired some very good bits. Thanks to KG for additional intersex information. Thanks to w [sic] for additional injection resources. Thanks to BIR collectively for a plethora of crucial nerd nitpicks. Appreciation for general review from C, JTP, K, S, and V. Thanks to E for web dev assistance. Thanks to everyone on Bluesky who encouraged me to write this up in the first place, and everyone over the years sharing knowledge. And of course: much appreciation to all HRT nerds, even when we disagree, since we’re all trying to do the best for our community where we’ve otherwise been let down. Keep up the good work everyone.</p>
</div>
<div class="ltx_para" id="Sx5.p3">
<p class="ltx_p">Shout out to my IB Chemistry HL teacher many years ago who quite reasonably doubted my studiousness even though I’m now putting much of that knowledge to use for the art of transsexuality; go figure.</p>
@@ -2716,7 +2716,7 @@
<p class="ltx_p"><a class="ltx_ref ltx_href" href="https://github.com/Juicysteak117/pghrt/" title="">Source code available here on GitHub.</a></p>
</div>
<div class="ltx_para ltx_noindent" id="Sx6.p2">
<p class="ltx_p">Full Compilation Datetime: <span class="undefined">Tue Oct 14 22:40:07 2025</span></p>
<p class="ltx_p">Full Compilation Datetime: <span class="undefined">Fri Oct 17 00:32:11 2025</span></p>
</div>
<div class="ltx_para ltx_noindent" id="Sx6.p3">
<p class="ltx_p">(There aren’t LaTeXML bindings for <span class="ltx_text ltx_font_typewriter">datetime2</span>, <span class="ltx_text ltx_font_typewriter">hanging</span>, or <span class="ltx_text ltx_font_typewriter">hyphenat</span>, so the formatting is slightly ugly. If you’d really like to help me out, please write those bindings!!!)</p>
@@ -2796,11 +2796,14 @@
<div class="ltx_para ltx_noindent" id="Sx6.p28">
<p class="ltx_p">2025-10-14: Reduced the pithiness and expanded the usefulness of Question <a class="ltx_ref" href="#S11.SS25" title="11.25 Should I be on PrEP? ‣ 11 MYTHS AND MISCS ‣ A PRACTICAL GUIDE TO FEMINIZING HRT"><span class="ltx_text ltx_ref_tag">11.25</span></a> per repeat request because I <span class="ltx_text ltx_font_italic">guess</span> there is public health utility to doing so. 19.8k words.</p>
</div>
<div class="ltx_para ltx_noindent" id="Sx6.p29">
<p class="ltx_p">2025-10-17: Dark mode! And a font toggle off. Plus a few links. 19.8 words.</p>
</div>
</section>
</article>
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@@ -164,7 +164,7 @@ Generally, no. A properly dosed and spaced injection cycle that provides consist
\subsection{How does monotherapy work?}\label{2-3}
In simple terms, the brain does not care which hormone it has, just as long as it has enough. If there are consistently enough hormones in your body, it stops producing more. The “consistent” part is what injections are capable of that other administration routes struggle with. Trying to do sufficient monotherapy on pills, for instance, is very likely impossible in most situations. In more specific terms regarding \href{https://en.wikipedia.org/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93gonadal_axis}{the HPG axis}, \textit{luteinizing hormone} (LH) and \textit{follicle-stimulating hormone} (FSH) are suppressed by increased serum \textit{estradiol} levels, thus inhibiting GnRH production and by extension testosterone production in the testes.
In simple terms, the brain does not care which hormone it has, just as long as it has enough. If there are consistently enough hormones in your body, it stops producing more. The “consistent” part is what injections are capable of that other administration routes struggle with. Trying to do sufficient monotherapy on pills, for instance, is very likely impossible in most situations. In more specific terms regarding \href{https://en.wikipedia.org/wiki/Hypothalamic-pituitary-gonadal_axis}{the HPG axis}, \textit{luteinizing hormone} (LH) and \textit{follicle-stimulating hormone} (FSH) are suppressed by increased serum \textit{estradiol} levels, thus inhibiting GnRH production and by extension testosterone production in the testes.
\subsection{How are injections safer?}
@@ -1148,7 +1148,7 @@ No. I honestly have no idea where or why this joke started that people now take
\subsection{How does HRT affect fertility?}\label{11-42}
It is important to understand that this is extremely understudied so exact figures cannot be stated, and given the seriousness of pregnancy, I urge you to practice safe sex and lean on the side of caution where possible. HRT itself can, and likely will, make you infertile eventually, but only through full suppression of \href{https://en.wikipedia.org/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93gonadal_axis}{the HPG axis} (See Question \ref{2-3}) over a long time span. In other words, if you haven't had bottom surgery of any kind and you are on an HRT regimen that is less capable of HPG axis suppression (such as pills), then this is more of a consideration.
It is important to understand that this is extremely understudied so exact figures cannot be stated, and given the seriousness of pregnancy, I urge you to practice safe sex and lean on the side of caution where possible. HRT itself can, and likely will, make you infertile eventually, but only through full suppression of \href{https://en.wikipedia.org/wiki/Hypothalamic-pituitary-gonadal_axis}{the HPG axis} (See Question \ref{2-3}) over a long time span. In other words, if you haven't had bottom surgery of any kind and you are on an HRT regimen that is less capable of HPG axis suppression (such as pills), then this is more of a consideration.
\textbf{If the HPG axis is not suppressed then it is fully possible to impregnate someone}, and the timeline for sperm maturation is long enough that this is true even after the HPG axis has been initially suppressed for \textbf{multiple months}. Please take this very seriously. Full HPG axis suppression for at minimum six months, perhaps closer to a year out of an abundance of caution, is recommended.
@@ -1346,4 +1346,6 @@ Shout out to my IB Chemistry HL teacher many years ago who quite reasonably doub
\noindent 2025-10-14: Reduced the pithiness and expanded the usefulness of Question \ref{11-25} per repeat request because I \textit{guess} there is public health utility to doing so. 19.8k words.
\noindent 2025-10-17: Dark mode! And a font toggle off. Plus a few links. 19.8 words.
\end{document}