I really need to talk about how HRT is making me suicidal
It was sudden. There was no leadup.
The Three Body Problem was playing on our TV. I leapt upright and walked to the window. My partner asked what was wrong. There were bangs and shouts coming from outside, fireworks from Easter Sunday, shocking all the birds from their sleep. I could hear their cawing cries between the whistling shrieks of the pyrotechnics. The neighbour’s kids were laughing.
I told my partner that I was suicidal.
From 9pm that night until 6am the next morning, I cried uncontrollably. I was constantly aware that something had gone wrong but entirely helpless to do anything about it. That was the extent of the pain. I could not breathe. I had various thoughts, most of them were, "how do I tell people I love them?" Somehow, the words kept failing. That night, I made preparations. I uploaded all my works in case I passed away. I wrote letters, unsent, to people I loved.
Eventually, the exhaustion put me to sleep.
To say that I did not have moments of clarity would be a lie. I’ve spoken briefly on the virtues of mindfulness meditation and how it’s akin to a superpower. I’m not trying to oversell it, but the fact that you can just decide to not be angry or sad anymore really is a blessing. It’s nice to notice how you’re feeling, really feel it, and then let it go! I like being able to stop myself from spiralling.
Was I able to do this during my suicidal plunge? Yes. Constantly. I felt that there were multiple moments where I was thinking clearly. In fact, it allowed me to interrogate certain thoughts in my head. Why did I feel that the biggest issue I was facing was “I couldn’t convey to others the extent of my love?” Put simply, that’s a non-problem. Like everyone else, I have my share of regrets in life, but not in my day-to-day. I’m open and honest and I tell everyone how appreciative and grateful I am. “Yeah, that’s just Maddie,” my friends would say. “She tells everyone that she loves them.” You know, of all the things to be stereotyped and joked about, this is probably the best one to have!
What I’m getting at, then, is the sheer extent of the pain—the horror of it all—that I went through. Lucid thoughts could not save me. Logic held no answers. No amount of support from my partner or friends could dissuade my actions. It didn’t matter how privileged my starting point was. I careened off the edge.
The amount of suicide preparation I did that night would terrify if you knew the extent of it. Frankly, it still haunts me.
I wish I could say it was the violences being enacted against us. I wish I could point to societal pressures or the fact that I’m struggling with my doctors or my bills or that I’m barely surviving in this capitalist hellscape or that Twitter actually fucking sucks and the people I follow keep taking the bait and engaging with TERFs and transphobes and it’s wreaking havoc on my mental health. Maybe if I blamed these things enough, I could inspire some amount of positive social action.
The truth is that none of those things crossed my mind. I just wanted the pain to stop.
In the days after, I did some research, by which I meant trawling through forums to read other people’s experiences and reaching out to other transfemmes on discord. This is the nature of "trans research". It's always insufficient data or low sample sizes. Qualitative over quantitative. Your results may vary. In the end, the common thread I found was this:
> Whenever you change your HRT dosage, regardless of going higher or lower, mood swings tend to happen.
This lined up. Two days prior, after spending a significant sum, I had finally found a doctor willing to increase my dosage from 100mcg to 150mcg. (This is still well-within safe levels, and our NZ standards are below other countries to begin with. :unyeah:) An achievement that came with quite a sense of elation. In the days leading up to the night of 31st of March--Easter Sunday, Trans Day of Visibility--whatever you call it, I was perfectly fine.
That I could go off the rails so suddenly—well, I wish I had gotten a warning.
Now, the t-blocker cyproterone acetate does warn you about possible depression symptoms. It’s the one thing they keep pointing out to you before you sign the informed consent sheet. But I don’t think it’s the T-blocker. I’m not a doctor, I can only recount to you my experiences, but I made no change in the amount of cyproterone, nor my diet, nor the timing of when I took my pills.
The only variable that changed was the oestrogen dosage. Is it possible that it's a conjunction of the t-blocker and the change in dosage? Probably.
Far as I can tell, suicidal urges are incredibly uncommon. Nobody I spoke to experienced anything similar. Nor could I find corresponding instances in forum threads. Personal reports simply stated that the severity of the mood swings jumps after a dosage change. They’ll mellow out soon after.
It is now four days since the incident. I’m fine. The mood swings are gone. That’s the best I can tell you.
I hope that writing this helps someone should they go through the same experiences I did.
Fucking hell, I would've loved a warning.