Why the Hell Would I Go There?!
“Didn’t I tell you that to get a male body, you need male hormone injections? But hormones are the problem?”
Minsia looked at me with utter confusion. She had every right to. I’d said hormone replacement therapy was essential before gender reassignment surgery, and now I was calling it a problem from the start.
“You’d need one shot a week before surgery, one every two to three weeks after, and starting in your forties up to age sixty, just once a month.”
“Then I won’t need them. My age this year—”
“Of course, we’re basing it on your current rejuvenated age, not your original one, Matriarch. Judging by your appearance now, you’ll need those injections for at least the next forty years.”
“Even if the hormone shots are painful, that’s no issue. Fifty years, sixty, even longer—I don’t care. As long as I can return to my original body.”
Minsia seemed to think the shots were some miracle cure that would fully transform her into a man.
“It varies by patient, but most experience throbbing pain at the injection site. But the dangers I’m talking about go far beyond just the pain of the needle.”
Hormone injections, which you’d essentially need for life, suppress secondary sex characteristics by flooding the body with the opposite hormones. They cause a laundry list of problems.
“Hyperlipidemia, cardiovascular issues, hypertension, liver toxicity, sleep apnea, and more.”
Beyond that, insulin resistance leading to diabetes, acne, hair loss, ovarian tissue damage, elevated triglycerides—the side effects are endless. The same goes for male-to-female transitions with estrogen shots. MTF patients face blood clotting disorders, hypertension, cardiovascular problems, vomiting, migraines, depression, loss of appetite, glucose intolerance and hyperglycemia, gallstones, elevated liver enzymes, weight gain, triglycerides, prolactin surges—you name it.
Sometimes ordinary women say they want estrogen shots because their skin improves and their figure gets curvier.
But that’s dangerously misguided. Even oral estrogen raises breast cancer risk, especially with a family history. And MTF patients can develop it too, so screening is mandatory before starting hormones.
“Even though your body was altered by magic—”
“Not magic—black magic.”
“……Yes, black magic. Anyway, we’d need precise tests, but based on your build, voice, skeleton—you have the body of a full twenty-something woman. Injecting male hormones won’t change your sex chromosomes to male.”
“Sex chromosomes?”
“The chromosomes that determine male or female.”
I gave her a quick explanation of chromosomes, then got back to the point.
“Your biological makeup stays the same; only the appearance changes. That leads to massive mental and physical side effects.”
“Hm…… So if I skip the hormones after surgery, problem solved?”
I shook my head at Minsia, who stroked her nonexistent chin beard.
“It’s not that simple. Stop after a full hysterectomy, and you risk menopausal symptoms. Skip the hysterectomy and just do top surgery, and you might start menstruating.”
FTM patients want to live as men—thicker beards, more body hair, the works. Many are happy with hormones alone. But beyond what I’d already mentioned, some suffer extreme skin conditions that flip their flesh inside out, unbearable itching, rare horrors like that—or severe mental breakdowns.
“In short, to fully maintain a male appearance post-surgery, you need the hormones. But starting, stopping, or skipping them all bring serious side effects. That’s why I can’t do the surgery.”
“Hm……”
Minsia let out a deep groan, but I held her gaze with unwavering resolve. Even the world’s top gender surgeons wouldn’t disagree. Every doctor knows primum non nocere from the Hippocratic Oath: “First, do no harm.”
I can craft double eyelids, enlarge eyes, raise nose bridges—but I always weigh harm to body and mind. No matter how I crunch it, gender reassignment has more cons than pros. The side effects aren’t like dry eyes after blepharoplasty; they’re lifelong torment.
“No way exists to minimize the side effects of my surgery. Even if you offered a fortune—or held a knife to my throat—I won’t do it.”
“Is that truly your stance?”
Her eyes sharpened like daggers, sending my heart into an earthquake.
“Yes.”
Of course, if she whipped out a razor-sharp sword and pressed it to my neck, I’d cave……
But I stared back firmly, making my refusal crystal clear. Beyond hormones and physical fallout, patients suffer profound psychological shocks. I don’t do transitions as a rule. Except once.
The patient who called herself ‘Karol.’
I learned later it’s slang among trans folks for catastrophic mental illness after full transition.
That one FTM case? Originally male.
But she thought she was trans, got MTF elsewhere, then came to me wanting to go back to male.
She’d transitioned male-to-female, hated it, sought FTM from me. I assumed anyone pursuing this had ironclad identity conviction.
Wrong. Plenty regret and reverse.
Bottom line: Karol loved makeup and men. High school identity crisis, legal adult—bam, surgery. Then more confusion.
‘Living as a woman showed me it wasn’t what I imagined,’ she said.
Later research: Many struggle with trans life or family backlash, seek reversals. Hers? No hormones, straight to Thailand post-majority. Confused homosexuality with trans, spiraled into psychosis.
Data showed eight in ten MTF patients like her. Her words still haunt me: “All my past depression feels like excuses now. This anxiety is soul-crushing.”
Sigh…… No more like her.
I did the FTM for severe Karol, but MTF had mangled her body beyond repair.
And that’s another reason I stick to reversals. Even perfect surgery can’t fix identity confusion once it hits. Side effects seal the deal.
I’m treated like Hua Tuo, Heo Jun, Hippocrates here—but some surgeries defy even me. Functional full restoration of the lost? Impossible in either world.
After deep thought, I gave Minsia my careful answer.
“To return to your original form, Matriarch, track down the black mage who cursed you with black magic. Surgery has clear limits.”
“Yes…… That should do it.”
To my surprise, she agreed readily.
“Smart choice! Then let’s hurry to the South Continent to restore you and find your granddaughter—”
“Yes, and I’ll take you along.”
“Yup…… Wait, me? Why?”
Her absurd words dizzied me for a split second. Seizing it, Minsia bared her fangs with a piercing quip.
“For defacing the North Duke with trash tattoos, insulting me and House Hoblood. That’ll suffice as payback.”
No, you madwoman. Why the hell would I go there?!