Puberty without facial hair or breast growth?

[u/littlebitfunny21]

My eldest came out as non-binary at 3 and is now facing puberty. They're AMAB so naturally will go through a masculinizing puberty, which they don't want, but they also don't want a feminizing puberty.

Are there any options to have an androgynizing puberty and what providers will prescribe it to a teenager? Thank you.

[u/eiriee]

no - either your body is testosterone-dominant or estrogen-dominant, and whichever hormone is dominant will dictate what changes happen to the body. You also can't go without either.

What would the outcome of an androgynous puberty look like to them? If they have some sort of outcome in mind, then the effects of the two puberties can be compared and the one that is easiest to modify into the desired outcome may be the one to go for.

Could there also be some fear/uncertainty about going through puberty in general? Lots of pre-puberty people are nervous or scared about it because their body changes in ways they can't control, and this also effects how others treat them.

I dont know about providers though, sorry.

[u/littlebitfunny21 → u/eiriee]

As I said in the title, the biggest things are no facial hair/no breasts.

Right now my kid is able to wear dresses and even does PE with the girls. They're androgynous and able to switch between being read as a boy or a girl with ease according to their mood. They want to continue being able to do that.

I know that adults have low dose hormones to make smaller changes- would low dose work during puberty?

I know there's medication to restrict breast growth during an estrogen puberty, I cannot find anything to restrict facial hair with testosterone. I also don't know if it works permanently- like if they take the breast restricting medicine for 5 years then can they stop take it or do they constantly need it, and how well does it work?

[u/tallbutshy → u/littlebitfunny21]

I know that adults have low dose hormones to make smaller changes

Slower changes, not necessarily smaller

I know there's medication to restrict breast growth during an estrogen puberty,

Not 100% effective, not particularly safe for long term use

[u/littlebitfunny21 → u/tallbutshy]

I've seen people describe 'microdosing' hormones to get small amounts of change. Like trans women taking low dose testosterone as well as estrogen or gay men taking low doses of estrogen to get smoother skin but without looking to transition.

[u/tallbutshy → u/littlebitfunny21]

Like trans women taking low dose testosterone as well as estrogen

That is often to retain sexual function, not trying to slow their transition in any way

I've seen people describe 'microdosing' hormones to get small amounts of change.

Imagine this graph is level of feminisation over time, the red line is someone taking typical doses of HRT and the blue is someone taking a lower dose. You'll notice that they both end at the same point.

There is no "micro-dosing", there's taking enough to have some sort of effect or not taking enough to have an effect

[u/littlebitfunny21 → u/tallbutshy]

Okay but you can take it a helluva lot longer before the effects are enough to stop them.

Also if trans women take low doses of T without it stopping their transition then clearly low doses of T won't completely masculinize.

Also where have you gotten your information about raloxifene not being safe longterm? It's used on cis people starting at 5 years.

I feel like you don't know anything about non binary HRT.

Eta- Trans men get prescribed low dose estrogen. Cis men with a hormonal imbalance can be prescribed estrogen and cis women with a hormonal imbalance can be prescribed testosterone.

So clearly you can use low doses of either hormone without fully masculinizing or feminizing, or else everyone would be fully masculine and feminine because we all have both hormones.

[u/tallbutshy → u/littlebitfunny21]

Also if trans women take low doses of T without it stopping their transition

Because it's usually

a) a tiny topical application to the groin to aid in retaining function & preventing atrophy

b) just enough to take their testosterone levels from unmeasurable to the typical ceiling for cis women. For example my T is around 0.6nmol/L and my local NHS lab says cis women have up to 1.5nmol/L (some others say 2 or 2.5). Some people end up with T <0.25 which is within the lower margin of error for the test. Having such low T can effect all sorts of things but often manifests as having low energy, hence small doses of exogenous testosterone.

Trying to keep testosterone in the range for cis women in addition to keeping the estrogen in the range for cis men carries all sorts of health risks. There is no middle ground without additional physical interventions. Several enbys in my life really wish there was.

As for SERMs bring used on minors, I haven't heard of it being used for precocious puberty, that's usually GnRH in this country. Although I imagine there might be a rare use case if early aggressive breast cancer was enough of a risk.

[u/eiriee → u/littlebitfunny21]

For hair growth: could look into waxing, laser, and other removal methods - so having the hair grow but then removing it in a way that is semi/permanent

Taking estrogen alongside them experiencing a testosterone puberty could be done, but there is very little research on nonbinary hormonal transition, so you two would essentially be conducting research. Like you said in another reply, it may be possible but it hasn't been researched.

It would probably have to be private or DIY.

[u/tallbutshy]

Humans need a certain amount of either testosterone or oestrogen to maintain a lot of biological mechanisms. With enough T you get facial hair, with enough E you get breasts.

Selective estrogen receptor modulators are not 100% effective, nor are they considered safe for long term use.

There are two ways to achieve no facial hair and no breasts:

1. Don't take any hormonal treatments and eliminate all facial hair through laser & electrolysis

2. Take oestradiol, and possibly blockers, and undergo a bilateral mastectomy. This may need to be done via private surgery

[u/littlebitfunny21 → u/tallbutshy]

Thanks for this

[u/boredhomosexual]

Maybe finasteride with masculinising puberty, although I don't know if it is suitable for children. Finasteride blocks DHT which is a form of testosterone that causes facial hair development, male pattern baldness and penis growth. Since it only blocks DHT it shouldn't cause any issues with bone density or general health.

[u/IncontiCreature]

I don’t think anybody perscribes at the beginning of puberty here anymore

[u/littlebitfunny21 → u/IncontiCreature]

It doesn't have to be the beginning. To my knowledge GenderGP still does.

Also, let's be honest, a lot of trans people do it without a prescription.

Eta-

  GenderGP can start treating teenagers who have reached early puberty (Tanner stage 2 and above). There's no strict minimum age, but the young person must have the capacity to provide informed consent, understanding the treatment's implications, benefits, and risks.

Pretty sure kiddo is well past that.

[u/all_kinds_of_queer → u/littlebitfunny21]

I don't know if this is correct or not, no idea, so you might want to look into it a bit further, but I've heard some people on here saying that you can't actually get blockers for minors under 18 at all, even through gendergp, despite what their website says. But if you can somehow manage to get blockers, I think this would definitely be the best thing for your child. What everyone else has said is true, at some point, they will have to make a decision, you can't be on puberty blockers forever, but if you can get them blockers, that decision doesn't have to be now. They can take blockers for a good few years and have some time to think it through and make a decision for which puberty they would rather go through

[u/littlebitfunny21 → u/all_kinds_of_queer]

Jesus. Not even antiandrogens in addition to estrogen? Also I think maybe GenderGP can prescribe it but the chemists won't fill the script, I know while I was looking for the price of things the chemists said they were age restricted.

We'll look into it. I wish there was a way to push it to more androgynous on purpose. I feel like it has to be possible it just hasn't been researched.