I started hormone replacement therapy (HRT) three years ago today: one drug to decrease testosterone and one to increase estrogen. Not long ago, getting those drugs would have required psychiatric and medical evaluation that could take months (or years).

But now California has “informed consent” rules or laws, which essentially means you can go to a doctor and say, “I know the risks related to these drugs, and I want to take them,” and if you’re an adult, you can usually get them.

Since I’m in California, that’s how it worked for me. I didn’t have to survive a gamut of different professional “gatekeepers” (and their biases) to start HRT. Soon after I came out, I went to the Desert AIDS Project in Palm Springs, and they assigned me a nurse practitioner (who I still see). He interviewed me and diagnosed me with gender dysphoria, and the prescriptions were waiting at the pharmacy before I got home.

It’s lovely that I have access to a place like Desert AIDS Project (DAP), even if it’s a 70-mile round trip drive to Palm Springs from Joshua Tree. If it wasn’t for them, I don’t know how I would have found a trans-friendly doctor. I certainly wouldn’t have found one up here in the high desert. But Palm Springs is a pretty queer place, so it makes sense that they’d have a joint like DAP.

My DAP NP, Anthony, started me on a minuscule dose of estrogen. He’s very cautious and always does bloodwork, bloodwork, and more bloodwork around any changes. Now, I’m taking six times as much estrogen as when I started. So what does that mean? What did it do for me?

I touched on that in a post about being “out” for three years, talking about increased compassion and emotions (still) being raw. My skin has become much softer, and each time the estrogen dose increases, my boobs are super sensitive for months. But far and away, the biggest, most beautiful thing that HRT has brought me is acceptance of myself.

And that’s kind of difficult to explain adequately.

It’s acceptance, yes. But also realization. Realization of who I am. When you undergo profound changes the way I am, you tend to look back and see if what’s happening now sheds any light on how you saw yourself in the past.

For me, the changes are the dawning of the idea of independence, of autonomy. No more looking to the world to legitimize me or my existence or for approval and not allowing the world or the people in it to dictate what makes me feel good. Knowing that I’m entitled to feel whatever I feel and to be whoever I want to be.

Before I started transitioning, I had a lot of ideas of who I thought I might become or who I wanted to become, but none of them were based on who I am at my core. They were based on feminine stereotypes that I clung to as an expression of my real self before I could actually be my real self. After about a year on HRT, I had a realization that changed all that previous thinking.

How I thought about myself changed. I realized that what I’ve been seeking all my life is not external; it’s internal. When I finally felt that internal change, that inner acceptance, all of the outward trappings instantly felt unimportant. I realized that I had not been honoring who I was regardless of my gender: a scrappy punk iconoclast.

It occurred to me that my femininity wasn’t likely to look like anyone else’s, and however I felt like expressing it on a given day was legitimate and correct. Whether it’s a dress or a motorcycle jacket, both represent who I am.

That realization was liberating. It meant I was good enough as I am, and I didn’t have to strive for anything I didn’t feel was genuine. If HRT gives me nothing else, it gave me that. It gave me my life. My actual, real, 100% genuine life.

Don’t get me wrong, I still care about the exterior, or I wouldn’t be suffering through years of electrolysis. And I still like to look pretty when I feel like looking pretty. I’m just not bound to “pretty” as a rule or an obligation. No shade on my trans sisters who do get glammed up every day. I understand that. The outward trappings aren’t always for our benefit. Sometimes, they can make it easier to move through the world.

But I feel free. That’s what HRT did for me. It introduced me to myself. And we’re getting along pretty well.

WRITTEN BY A HUMAN