If you want to improve your body shape, there are three main things: Your bones, your muscle, and your fat. Each of these affect the full general shape of your body.

If you are a woman, you are interested in losing mass in most of your upper body, and gaining mass in your breasts and lower body. If you are a man, then you are typically interested in the reverse.

If you are transitioning, one of the levers you can try to control, is to alter where your soft tissue is (and to some limited extent, bones too). This is, influenced by hormones so we can look a bit at the theory of weight cycling as a form of fat and muscle redistribution.

Weight Cycling is the process of repetitively gaining and subsequently losing weight.

The most detailed post I have seen on this topic, is: Mesityl - MTF Weight Cycling, which goes into some methods and supplements, and explains why a large fraction of potential risks of weight cycling are likely correlational, if perhaps not all of them. I will write about similar topics, and attempt to cover more ground

One part of the theory is that human adipocytes turn over slowly, at roughly 10% per year, with half of adipocytes being replaced over about 8.3 years on average. But this is not the whole story, because the lipids stored inside adipocytes turn over faster than the cells themselves.

If you lose weight, then by default, your adipocyte cells do not die. Instead, they simply get smaller. Then, all else being equal, if you gain fat, then typically, your body will try to refill pre-existing adipocyte cells before creating new ones.

Your hormone levels can act as a pressure lever on where the fat tends to get stored. A feminine hormone profile prefers depositing fat in the legs, buttocks, and breasts, while a male hormone profile prefers depositing fat in the abdomen, back, and trunk.

If one tries to model the effects of HRT using adipocyte cell turnover, one finds it misleading, and studies seem to find redistribution effects way earlier than you’d expect if it acted via turnover. There seem to be two parts to this

Part of this may be from people gaining weight upon starting a HRT regimen, and part of this may cause new adipocyte cell growth.

The other part, is that the lipids stored within adipocyte cells get turned over at a faster rate than the cells themselves, with a mean life of ~1.6 years, rather than the estimate of ~8.3 you get for adipocyte cells.

HRT has been shown to be helpful. But the evidence for Weight cycling is weak.

Weight Cycling might help fat redistribution by repeatedly giving hormones chances to bias fat regain multiple times, but scientific evidence is lacking, and it’s unclear how large the effect might be. But there are also potentially other levers one could pull to make the effects more significant too.

Weight-cycling topics to discuss in future posts:

Weight cycling has two aspects to it, weight loss, and weight gain.

For weight loss there are two things to discuss:

• one difficult aspect is in trying to lose weight at all. I will spend some time describing the current landscape on methods for losing weight, including dietary supplements and peptides.

• The other aspect, is that one wants to stimulate the removal of fat from the right places. This can involve methods for trying to directly cause adipocyte cells to die, or can involve stimulating fat to be selectively burned from a specific area. Research here is still limited, but I will try to outline what exists so far

For weight gain, I will probably combine this into one discussion

• Methods for trying to gain weight, and potential supplements. There are methods for trying to prevent fat loss from accumulating in some areas, and encouraging it’s growth in other areas. These are various levels of dubious, but I will list them all anyway.

• I may venture into understanding the current landscape of muscle growth stimulation techniques too, but this is currently not an area I know much about.

Lastly, I will talk about shifting bone structure, through surgical means, as well as some more contentious non-surgical methods, and I will talk about surgical methods for fat redistribution too.

I woke up the next day, and was feeling feeling fine. Checkup was not until 3pm, so had some time to spend.

I had some food back at my hotel. I then took my first set of medications in the morning:

Here is a transcription of the medicines that we were given yesterday:

before breakfast and dinner (2x per day):

• rabeprazole 20mg (30min before breakfast and dinner)

after each breakfast, lunch, and dinner (3x per day):

• synatura syrup (expectorant)

• cough s syrup (expectorant)

• aldosten tab (expectorant)

• mucosol tab (expectorant)

• cefactlor hydrate tab (expectorant)

• rebastat tab (digestion)

• lenox tab (antipyretic analgesiac)

After eating and getting ready, I walked around with my girlfriend.

We got a taxi to get some lunch somewhere, saw some of the things near Seoul Tower. We went to a very cute tea house that is supposedly booked out most of the time, but which was free when we happened to shop up. After our time was up, we then got some cake. Then went to Yeson for the checkup.

We arrived when we were supposed to, and sat in the reception but the waiting time was pretty short.

I went and saw Dr. Kim again. He looked at my vocal cords and said they look fine still, and took another pic of my vocal folds.

We then went out and waited for the next thing, which was the Botox.

The reason the Botox is given, is not only to prevent me from using my vocal folds, but to unlearn the neural connections I had for my old voice. My vocal folds have changed a lot, so I need to re-learn new patterns, which is easier if the old patterns are unlearned this way.

I went in to get Botox.

I sat on the seat, he cleaned my neck with alcohol wipe, put something on my neck (like some microphone I guess).

He took a syringe and needle into vial of Botox, and took it the botox, and inserted the needle into my neck. As he put the needle in, there was some static noise being played, which I guess was trying to measure when the needle is in the right part of the vocal folds or something. Then injected, and pull it out.

He then injected the same into my other vocal fold too, on the other side of my Adam’s Apple.

All was good. It was slightly painful, but like pretty fine. It moreso feels strange to get injected in the neck.

There was some reminder that the botox is likely to wear off in 3-4 months, so if i start getting a horse voice with tremors around that time then it’s likely that, and it’s possible to get a top-up botox after that wherever I live, and told me he would prescribe me something just in case it happens.

I also asked:

Can I use sauna or hot spring ♨️? Can I swim? Or should I wait?

no sauna or hot spring for 1 week. (i think?) No swimming for 1 month

I waited a bit more. I saw the other person who got surgery. Supposedly their throat was still painful and they couldn’t consume anything other than water yet. So perhaps it could be.

I then waited a bit in the room again, and next was the therapy vocal exercises explanation.

My guide then handed me a bag with a notebook of all of the documents that I had, as well as a USB stick with the exercises, and was pretty fine. I asked the question:

Can I get pictures of my vocal folds?

And she said yeah. You can see these later.

We then went to go to see the vocal exercises being demonstrated.

She starting showing lip fraying exercises. but was like no don’t do it now, do it in 2 months please (oops). (wow 2 months is a long time.) (but yeah it’ll be fine.) Also walked through the rest of the exercises.

I was also showed the massaging of the muscles (or whatever) on the neck, and I did have to actually do those.

After showing this all, we went to main reception.

They printed out the pictures of the vocal cords for me again.

Before leaving, I got reminded many times along the way: drink lots of water, no speaking for 2 months, checkup in 3 months.

I was also handed a prescription document and supply of Clemazopam 0.5mg, that i may or may not need to take starting 3 months in, depending on how good the vocal recordings are.

and that was it.

we said goodbye, and left Yeson for the last time.

Pictures of my vocal folds before

I woke up like 7 am. my mind was kinda swirling like “omg i can’t miss it! omg i can’t miss it!”, a bit like before an early morning flight. I didn’t sleep amazingly.

I got dressed in comfortable clothes, took my tote bag, then we went to the clinic.

We arrived slightly early, by around 10 minutes, and waited for the clinic to open. They arrived, opened just after the time we were told to arrive, and let us in.

They brought me to my room, and gave me pajamas to get changed into. So I put down the blinds, took off my clothes, my watch, my catears, and even the red string i had tied on my wrist for way too long now. I then went to the bathroom briefly.

For a few minutes it felt like nothing was happening. Then it started happening all at once.

Dr. Kim arrived and explained the risks of surgery, like 4 main things that i didn’t have any elevated risk for. These were [better explained by Claude as my notes here were messy] as such:

• Bleeding / hemorrhage — During or after surgery on the vocal folds, there’s a small risk of significant bleeding (submucosal hemorrhage). In a worst case, this could temporarily compromise the airway and require a tracheotomy (a temporary opening in the throat to breathe through). Very rare, and temporary if it happens.

• Tongue bruising — The surgery involves placing a laryngoscope through the mouth to access the vocal folds, and the tongue can get compressed or bruised in the process. Uncomfortable but heals on its own.

• C-HNP (cervical herniated disc) — During intubation and surgery, the neck is extended backward for access. In rare cases this positioning can aggravate a cervical disc. Also temporary.

• Voice change — The inherent risk that the pitch outcome isn’t exactly as expected — either too high, too low, or the voice quality changes in unintended ways. This is essentially the core trade-off of the surgery itself.

[Author note: The surgery did bruise my tongue somewhat, though not visibly. For a few weeks it felt like I had recently burnt my tongue. It was fine though.]

Then also explained again that healing my vocal folds takes time. There is a period of 4 weeks where I am not to speak at all. then another 4 weeks where I am to speak at most 2 words per day, but the recommendation is to not speak at all. Then after that to voice train, and to provide a sample at the 3 month period.

He showed that pitch increase is a bell curve, usually in the range of 70± 30Hz. I asked how much risk there is of much higher pitch, but he said he will make sure it’s not unnatural.

I signed away on the form.

After I signed, the nurse came in. She put in my IV drip into my left hand, and injected me with both some anti-inflammation thing and some anti-mucosal thing, meanwhile another nurse patch-tested my other arm with an antibiotic. The nurse then tied my hair back in pigtails and put on the hairnet.

I was guided to walk into the operating room with my IV drip.

I briefly asked Dr. Kim another question and lay down on the bed.

I had a mask put onto me and was told to breathe into it, and simultaneously I Could feel my arm getting cold from being injected with something else. I then lost consciousness at this point pretty suddenly.

Supposedly after the surgery, they brought me out, and all stood over and watched me until I woke up. My girlfriend commented that I eventually did wake up, and innocently waved my hand in front of my face, before falling back asleep. But I don’t remember this part.

I then kinda woke up later and was kinda fine.

My throat pretty sore. I kinda needed to pee. I mostly felt like I both really didn’t want to sleep rn, but also was not able to do anything. I listen to some progression fantasy audiobook for a while. It was fine, but my throat was getting to me, but was also manageable. When asked, I rated it like 4 or 5 pain. It was pretty bad but also not that bad.

The nurse asked if I wanted painkillers, but I was unsure, and since the pain was relatively minor she preferred to wait for Dr Kim to finish the other surgery which was still on-going before giving me anything.

(Supposedly the other person getting surgery was more difficult for some reason, though it also did go fine.)

Eventually, around 2 hours after the surgery, I was allowed to get up and could go pee also. I was a bit more relaxed after that, and the brief walk cleared my head a bit. It was a bit too warm in the room, like 24C or 25C, so my friend fiddled with some buttons somewhere.

The nurse asked if I still wanted, painkillers, and was like “maybe”, which I said with real words, my gf noticed and told me I was not to speak. Oops.

I asked for the painkillers, and she came back, and put some into my IV drip. It felt cold in my arm again.

After this, then then brought me a (vegan) watermelon ice lollipop. It was pretty nice. I enjoyed it. The cold did help make my throat feel a bit better too. (Though this may have been the pain killers in part too). At some point they stopped listening to my heartbeat too.

I then listened to some more audiobook, but I was tired so lay there, and I did fall asleep a bit for some time, or at least borderline asleep. I did go to the bathroom a couple of times between naps.

I then woke up and there were more things. I went to go to have a consult with Dr. Kim again. He checked on my throat with the same spray-my-nose-and-insert-a-tube method from the day before. It looks fine and still has the stitches.

He then showed me some images. One of my vocal folds from before, another of my vocal fold having the membrane removed and looking kind of ripped. And a last one of my vocal folds again, with the suture in place. yayyy.

I asked like a couple questions. My notes from my phone when asking dr kim:

Is there any thing i should do for food?

[avoid spicy food, caffeine, alcohol, nicotine] is fine for me

eg: minimum protein? sugar?

eg: better maintain weight and better to gain weight than to lose weight?

eg: supplements i should take? or ones i should avoid?

how much should I do walking? is there too little? too much?

Should i get a humidifer for my room?

Tommorow is eating normal?

No need to take a break from food before meeting at 3pm?

He was mostly ambivalent, and told me not to worry too much. Do avoid caffeine/alcohol/smoking as instructed before. Try not to lose weight. They will give me medications. Walking is good. The air in Korea was kind of dry, but probably not warranting to get a humidifier. And yeah eating as normal tomorrow.

He said that healing takes time, but in general you should just like, not use your voice, not strain yourself too much in ways that make you breath heavily, to make sure to drink lots of water and stay very well hydrated (by avoiding caffeine and such)

Before leaving, they gave me a few things too.

For the first day they gave me more pumpkin soup to eat in the evening, no solid food today, then mostly normal-ish food starting the next day.

I was then given all of the medications for the first week, starting tomorrow. They gave a little white bag full of things, with instructions on what they are and which to take. I am supposed to take one set of medication twice per day before breakfast and dinner, and the remaining sets of medication 3 times per day, after breakfast, lunch, and dinner. The medications were neatly packaged in small plastic bags.

Walking is apparently good, even early on, as it prevents blood clotting. We were suggested it’s better walk back to the hotel like 10min instead of getting a taxi.

We were discharged, and I walked back to the hotel, and on the way got some more ice-pops in GS25. I mostly ended up using Claude Code again in the evening, and took it pretty chill overall. I had my soup for dinner and went to sleep at a reasonable time, before going to the check-up the next day.

Tomorrow I will describe day 3. I will probably include the various documentations I got from Yeson in another post too.

Here is an extract from my journals following day 1 at Yeson Voice Clinic, before I got my VFSRAC vocal feminization surgery.

I arrive for the consultation, go up to the reception on the 4th floor, they greet me by name.

I fill in some form with name, phone, and some questions about my voice. I make the outstanding payment for the day 3 botox.

After filling in the form, I sit in the waiting area. Apparently i missed a sheet. I then meet my main guide for my stay, the person who translates Korean to English.

She tells me the instructions for tomorrow:

• I am to arrive at 7.50am

• The procedure takes around an hour

• I get discharged at 4pm

• For food there are option of 3 soups. I went with the vegan pumpkin soup, and they said they would get me a vegan ice pop for after surgery too.

• She lets me know that they do 2 surgeries per day, or 8 per week1

She then brings me down to do various test.

I first went get an ECG and blood test. She brought me to the room, I lay on the bed and pulled up my top. The nurse attaches the ECG probes to my chest, as well as some clamps to my wrists and ankles. She read my heart beat. It wasn’t reading correct the first time, so fixed it and did it again. She then ripped the old sheet and binned it, looked at the normal one, and i had the 6 lines of ECG which looked normal.

The nurse then took my blood, put on an elastic band on my upper arm, and told me to clench my wrist. Then, with a relatively large needle, stabbed the inner crease of my arm. It was slightly painful, but manageable. She took 10ml of blood from me, then removed the needle, and put pressure on my stab wound with a cloth, and put a bandage over it.

I then sat in the waiting room again, and could ask more questions.

Second, we went to get my vocal folds examined. The nurse first took a picture of me, then told me to sit on the edge of my seat, and lean forwards, elbows resting on my knees, and head up, and stick tongue out. The nurse then put some cloth on my tongue, and inserted the metallic camera rod thing into my throat through my mouth, and told me to make some sounds: “aaahh” first at normal untrained voice, then at a higher pitch voice, then again at a lower pitch voice. Then the same three sounds again. This was fine, but got slightly uncomfortable toward the end. This was a recording of my vocal folds at normal speed.

Then after this, she did the same, but with another metal rod camera stuck down my throat, and the same sounds needed to be made for a shorter period of time. This was the slow-motion recording of my vocal folds.

We then went out and waited a bit more in the original waiting room.

Thirdly, we went back down and did recordings of me speaking: My name, date of birth, patient number, some different vowel sounds, 2 coughs, sigh, and “hey”. Then I said the rainbow passage with untrained voice, and then repeated it with a trained voice (I hadn’t practiced in a while so it was bad, but that didn’t matter.)

We finished the recording, and had to do more recordings, but this time with an air flow and air pressure monitor in front of my mouth. I had to make an “ahhhhh” sound for as long as i could, and had to repeat it a second time. It was within the normal range when I asked. The screen showed a graph with a bunch of dots and a waveform. With the same mask on my mouth, I then needed to do the grandfather passage. First untrained, then trained. It showed another graph.

I return to the waiting room, wait a while, and get told I will be going for an x-ray.

This involves getting a car ride to another building. I sit with the other person who is getting the surgery the same day as me, who I learn had just arrived. We drive, we go up an elevator, we wait a minute. I am told to go and take off my top and put on a different top. I go to the xray room and stand against some panel, and I rest my chin on some thing against the wall. They press the button, and it’s done after a few seconds. I then return to put normal top back on, and wait a few minutes more, and we get driven back to the main Yeson clinic again.

I then wait in the waiting room a bit more. And I get to see Dr. Kim.

Dr. Kim asks me some questions about my voice. Do i get tremors? Do I have issues with my voice? I say not really, I think it’s mostly worked fine, other than being too masculine, and perhaps being a bit quiet.

He then also gets me to say “ahhh”, sprays my nose with weird advance spray thing, and sticks a camera thing down my nostril, and gets me to say “ahhh” at a normal and high pitch.

We sit and he tells me about things from my voice tests. He first shows a normal voice, then shares with me that my voice is kinda weak and has tremors. The data from the “ahhh” before shows this.

Looking at the airflow and pressure tests, the pressure my voice makes is like 4x higher than it normally needs to be, and the mean aiflow during voicing is like 10x higher than it should be. So my voice is pretty inefficient, and so gets tired when talking too loud. Interesting to have some mechanistic explanation to why my voice would get tired pretty easily, I didn’t know this.

Then went back to sit with my cutest ever wifey and i was soo soo happy because she’s so nice and I’m so lucky to have a nice and cute girlfriend like her <3 <3 <3.

And she likes reading over my shoulder and thinking “you only say that because I’m reading over your shoulder” but i think it’s true anyway >w<

Then we were done. We were told to come promptly the next day at 7.50am for the surgery, not too early but not late either. We left the clinic for the day.

In yesterday’s post, I wrote about the main aspects of voice. Of course voice has many dimensions to it, but the three main physical aspects are: resonance, weight, pitch.

Testosterone during puberty directly causes the expansion of the vocal cords and larynx, and results in a deeper and heavier voice. Taking testosterone as a trans man also causes this to occur, but not everyone reaches the same end point (and much later after natural puberty can affect this), but taking estrogen as a trans woman does not cause the vocal cords and larynx to change back.1

Today I will discuss the main voice surgery types. The standard recommendation is to not get surgery, but if you do get surgery, the standard route is to get a vocal cord shortening procedure.

Surgery Targets

Surgery can affect a few different things.

The first is that it can affect the vocal cords, either by affecting the length of the cords, the tension, or the mass/stiffness of them. This has effects on weight and on pitch.

The second is that it can affect your broader larynx/voice box, and thus alter the size of your pharynx. This is intended to have some effects on resonance.

The last is that it can aesthetically affect the appearance of your Adam’s apple. It is not intended for this to affect voice quality.

You may like to refer to some of the parts of the mouth (not strictly necessary to know):

• Vocal cords = the vocal cords which vibrate when you speak

• larynx = the whole voice box including what is inside

• Glottis = the middle laryngeal region that includes the vocal folds and the opening between them

• pharynx = the throat behind your mouth/nose above your voice box

• thyroid cartilage = the cartilage on the outside of your voice box

Types of Surgery

And there are different surgeries that affect the different aspects, categorized in 5 main ways:

Tracheal shave is the first kind, and is purely cosmetic. A properly done “chondrolaryngoplasty” is meant to be voice-neutral. But overaggressive reduction can destabilize how some things attach, and cause voice problems like lowered pitch or dysphonia

Tension-based procedures are the second kind (eg: ACA, CTA). These just try to “stretch” the vocal cords more tightly, and raise pitch that way. It does not affect vocal weight much, produces results that are strained and falcetto in quality, and also relaxes over time. This is an old type of surgery that has fallen out of favour.

Laser-based procedures are the third kind of surgery (eg: LAVA, LRG, VFMR). This tries to alter the the mass/stiffness of the tissue. However, it mostly alters the mass/stiffness of the vocal cords to be lighter, and sometimes tension2, but not length. There is a reduction in vocal weight and increase in pitch, but the effect is relatively small. It also typically causes a moderate reduction in quality and range. It is, however, relatively less invasive and does not require an external excision into the neck.

Shortening procedures are the fourth kind of surgery, (eg: Wendler Glottoplasty, VFSRAC). This primarily changes the length of your vocal cords, and by proxy also changes the mass and the tension in your vocal cords. It does not affect resonance, so still requires some voice training. It is is also less-invasive and does not require an external excision into the neck. Wendler gluttoplasty is the standard good kind of voice surgery people get these days.

The differences between Wendler Gluttoplasty and VFSRAC are notable, but relatively minor in practice. The former only cuts the vocal cords and re-attaches them together to be slightly shorter. The latter makes an additional to better control how mass+length+tension change. (It also makes it so that the tissue below the vocal cords also makes a slightly more “conic” shape rather than being suddenly smaller). There are some theoretical reasons this could be somewhat better, but I don’t fully understand them, and my understanding is that it’s not a huge difference.

Thyrohyoid approximation is the fifth kind of surgery. This involves altering the cartilage of your voice box to be higher up and trimmed to be slightly smaller. This is the only one that affects the pharynx, and so affects resonance. This procedure, alone, does not alter pitch or weight, but is usually paired with shortening procedures. This surgery is particularly invasive and risky.

One notable surgery, is that one can get a FemLar, which is a combination of thyrohyoid approximation + vocal cord shortening + tracheal shave. This is the only method that results in a voice that requires the least amount of voice training in theory (though still requires training), and is also the single riskiest procedure.

One can summarize the results as such:

Surgery Recommendations?

This is more opinionated than the sections before

Ideally, for most people, it is possible to achieve good results through voice-training alone with enough effort. It can be very difficult, but surgery has it’s own risks too. Most voice surgeries trade away some vocal flexibility (especially low range) and some can reduce loudness or alter quality, though the degree varies by procedure.

If you do choose to get surgery, my current top recommendation is to get shortening-surgery. This has the best tradeoff between how good the results are, amount of voice training needed, and how safe the procedure is. I personally went with Dr. Kim at Yeson in Korea, as he has done countless surgeries over the course of years, has published significant amounts of research, and trained many of the other best voice surgeons. But there is not much difference between Wendler Gluttoplasty techniques if they are skilled and reputable, and you may have tradeoffs in cost/insurance coverage/distance.

Getting a tracheal shave is slightly not recommended. But aesthetically, if you have a large Adam’s Apple or feel dysphoric about it, the risks are not that large and you should probably get it done. If you value voice quality above all, it may have some slight effect. It is typically recommended to get it after VFS, but you can get it before too. Either way, let your FFS know the guidance from your VFS surgeon.

If you care only about the best-case-scenario for voice and don’t mind a pretty large risk of things turning out bad, it is possible to get really excellent results through FemLar. I don’t personally think the tradeoffs are worth it, but this is the most comprehensive, but risks damaging your voice more.

In a future post, I will talk about the experience getting Yeson VFSRAC.

If one considers the how to decompose voice, people typically start by considering pitch, as it’s both the easiest to measure and the one people talk about the most.

However, while raw pitch does matter, it’s not quite how humans intuitively distinguish between voices of males and females, so it’s really not what you should start off by optimizing.

There is far too much content on voice training and aspects of passing voice. I won’t provide training instructions directly, but will describe the main aspects of voice that matter and provide links to a list of guides.

Here are a few of the main factors of voice that matter, and I will move on to how to resources for changing them in a later post.

Though it’s worth noting that the language used to describe different aspects of voice other than pitch is extremely inconsistent. But with that said, the main 5 aspects of voice are: Resonance, Weight, Pitch, Speech Pattern, Consistency.

• Resonance is the size/filter of the voice.

• Weight is the “density” of the sound source.

• Pitch is how high or low the voice is.

• Speech patterns are how you change your voice in words and sentences.

• Normalization is making sure you are using your voice consistently.

I will now describe them in more detail. You may find it useful to learn how to read spectrograms. You probably also want to know that the Larynx is the voice box, which is seen as an Adam’s apple.

Resonance

known as: vocal tract size, vocal size, formants, brightness/darkness, small voice/large voice. Controlled not by vocal chords directly but by the space in your mouth.

The most important aspect of voice for passing is “resonance”. This posits that voices can get smaller/brighter or larger/darker This is mostly affected by how much space there is between your larynx/voice box, and your lips. The best descriptive explainer I think is this one: https://scinguistics.com/encyclopedia/vocal-tract-length/

One naturally has some intuitions about this when listening to the echos of a sound in a container with various amounts of liquid in it. Importantly, the main pitch can also change somewhat, but that is not the primary effect.

On a physical level, there is the main frequency F0 which is the vibration of the vocal chords, and is the main source of sound which describes pitch. But between your vocal chords and leaving your mouth, there is your vocal tract.

The other aspects in the mouth and throat that have their own weaker forms of vibration and enhance or reduce different frequencies, which are primarily modifiable by changing the size of the vocal passage. Most obviously this is done by raising the larynx, but there are subtler things one can do too.

In practice, many find it easier to try to listen to examples of resonance and rather than to see it described on a page. One video you can watch is this one by TransVoiceLessons.

Weight

known as: voice quality, source quality, phonation, glottal weight, vocal fold mass, heaviness/lightness, thickness/density, buzziness. Controlled by voice box directly.

Once you learn to control resonance by modifying your vocal tract, the next main aspect is called “weight”. This one is harder to describe than resonance, but is sometimes heard as being more buzzy/heavy/thick vs more soft/light/airy. This involves your voice box directly.

The main thing is trying to understand the pattern of how your vocal chords vibrate.

One aspect of this is vocal fold thickness. Having gone through puberty, your vocal cords get larger and thicker, and have more mass.

The second aspect is how firmly the folds come together (aka: Adduction vs Abduction). Coming together more tense and closely means a voice is buzzier and heavier, as they become harder to vibrate. Coming apart slightly means the voice is more breathy and airy.

The third part is Loudness. A louder sounds requires more subglottal pressure, and requires greater air pressure, and also increases buzziness and heaviness. A softer sound means makes it easier to reduce excess closure.

I will would like to describe and understand it better physically, but a good intuitive video on how it affects voice is in this video by Renée Yoxon.

Pitch

known as: F0, fundamental frequency, speaking pitch, speaking fundamental frequency, pitch floor, pitch range

Everybody knows pitch. I won’t explain it too much. Higher pitch = faster vibrations, lower pitch = slower vibrations. Women have higher pitch (~93–135 Hz for males vs ~162–238 Hz for females). It’s important but should be learned only after you have learned how to control the previous two.

Speech patterns / prosody

known as: prosody, intonation, speech style, phrasing, articulation, pragmatics, communication style.

There are other differences in speaking between men and women. Men tend to have a more monotone voice, while women tend to vary their pitch more. Other things that change are emphasis in a sentence, how long vowels and how sharply consonants are said, etc.

This should be done after being able to land in the correct resonance and weight.

video to watch.

Normalization

known as: knocarryover, habituation, automaticity, generalization, integration, stabilization, default voice, maintenance.

A final aspect that is important, is to be able to hold a voice consistently. Many people can do a passing voice, but end up slipping up some words or sounds and lose consistency that way, in a way that gets clocked. The main way to avoid this is to practice lots (achievable for most), or to get surgery otherwise. (It maybe be possible to get botox on the vocal chords to unlearn some speech patterns too)

video to watch

Overall, there are some aspects of voice that can be split up relatively cleanly if one tries

One common mistake I see people fall pray to, is they want to look a certain way, and conflate “passing” with “attractive”.

Many people think they are trying to pass better, when in fact they are in large part trying to become attractive according to a specific aesthetic ideal. Those are related goals, but they produce different decisions. It’s worth noting this explicitly.

When it comes to wanting to look a certain way, it’s also worth considering how much do you want to explicitly trying to choose between:

• Looking attractive to myself

• Looking attractive to the average person

• Looking attractive to some specific subset of people

If you’re like me, you probably don’t have a single-minded goal to only look a single certain way. You might have phases where you are more conscious about passing, and other times where you are more conscious about looking cute, and perhaps even a rare few moments where you aren’t thinking that much about your looks at all.

And you may have different tradeoffs for different traits that you have. You may have a trait that is “conventionally attractive” that people complement you on, but that is too far in the direction of the gender you don’t want to be. You may have some options for this.

The most obvious case of [passing] vs [looks] is if someone is originally considered attractive by the standards of the gender you were forced to grow up as. One can be an attractive woman but not pass as a man, then transition to passing as a man but not being that attractive as a man. Or one can transition to being attractive but not-quite-passing. Or one can be pretty attractive and passing as the desired gender, but not by a specific subset of aesthetics of the gender you want to look like.

I think the easiest way to hone this point is to look at the list of traits we considered in our previous post “Aspects of Passing: Analysis of the Main Traits”. I try to be neutral and objective, but this is off my personal vibes rather than data, and I do have a feminine-attraction bias.

So here is my analysis on a few of the main traits, and try to categories them based on [important for both passing and aesthetics] that are correlated, vs [ones that trade-off].

By “correlated,” I moving it in that direction usually helps both passing and aesthetics on the margin. It does not always mean that changing that trait indefinitely in one direction is ideal.

passing and aesthetics correlated

for women

Lack of facial hair/shadow is also always good for women, matters for both passing and aesthetics a lot

Softer upper-face features, such as having less pronounces browbone, nose-bridge, orbitals, face planes, is basically always cuter and helps you pass better as a woman

For voice, I think it’s moreso for passing than for aesthetics. I think basically [higher pitch + lower resonance = more feminine], and it is aesthetically true on the margin for basically everyone, but it’s pretty up to personal taste too.

Hairline recession for women makes you pass less and less aesthetic.

Smoother facial skin also is good for both passing and aesthetics.

For head-size, having a smaller head is mostly more towards aesthetics than for passing, but these are correlated. but the effect is not huge.

Chest projection/shape helps you pass better too, and is mostly correlated with aesthetics, though some people do have differing tastes here.

for men

height for men is more attractive and helps pass better ~always.

having a larger upper body is also basically always good for men. It makes them pass better and more attractive, but it’s not as strong as with height.

Same is true for a lower-face features such as a longer-midface, stronger more angular jawline. It can be too extreme but is typically desirable.

Having a deeper voice is usually better for both too i would say, though having a soft but deep voice can be desirable sometimes too.

Passing and aesthetics tradeoff

for women

For women, height is kinda complicated. Being shorter helps you pass better, but doesn’t make you more attractive necessarily. It’s a trait that is correlated in general with being more attractive, but it does make it more difficult to date if you are a particularly tall woman.

Lower-face softness is also mixed. Making your jawline weaker indefinitely would make you pass better, but not necessarily more attractive.

For hip-waist-chest size, has some tradeoffs for women. Getting slimmer has only so much ability to help and is limited by rib-cage skeletal structure. Bone structure can be somewhat modified through surgery and such, but excluding that, the only real option a layer of fat an muscle on top of your skeleton to make a larger silhouette that passes better. (see weight cycling on the wiki or potentially a future posts). Thus you could be “more passing and fat” or “less-passing and slim”.

There are also some procedures like clavicle reduction that can make your shoulders look smaller, but also roll your shoulders forward and make you look more hunched. It does help pass, but it doesn’t always improve looks per-se.

for men

For Facial hair/shadow, I guess I find that it is quite variable. It’s kinda ambiguous, some people like it, some people don’t, but it does make you pass better.

For Hairline recession, generally no recession is seen as more attractive, but for men it does make one pass better if one has hairline recession.

For facial surface roughness, generally smoother skin is seen as more attractive for both men, but rougher skin as a man does help you pass better and be more masculine. People do have differing preferences here.

For upper-face heaviness/hardness, in general I think most people find softer/more-feminine browbone and smaller nose bridge more attractive, even for men up to some point. Heavier upper face features are more masculine, but not necessarily more attractive.

Another consideration I mentioned in a previous post, having a mismatch between how feminine different aspects can also be quite jarring.

Overall, It’s worth somewhat separating out how you care about traits. You may have a perfect body that you want, but basically nobody gets the perfect body that they want. You can have aesthetic preferences, but you should recognize that marginal things that you do might can trade off [passing] vs [personal looks preferences] vs [looks preferences of others] are slightly separate.

Preamble

I don’t think this is a good way of life. It is not that difficult to train yourself into noticing all of these traits, but much harder to train yourself out of it. It is possible to unlearn, but it will never be the same.

If you are mostly happy, and don’t mind how you look, and enjoy your relationship with others, I’d probably recommend against learning to look out for the various aspects that differ between you and others, and between other people too. It feels strictly worse. You have been warned.

But if you have gotten as far as finding this page, you are probably pretty deep, so I guess I will describe what it’s like.

As a starting point, I think it helps to consider two common types of error people make when judging themselves.

Two types of Errors

The memes in trans online spaces often have two memes of how early-stage trans people view themselves, which fall into two categories of error:

1. False Positive: those who think they pass really well, but in actual fact don’t pass

2. False Negative: those that do pass really well, but don’t think they pass at all

I don’t think this is quite true. But it has some predictive power. Both are errors in self-perception, but have different consequences.

This is also not quite a “binary”. One can often have both [false positive] and [false negative] flags on different aspects of their appearance, and perhaps these combine to give a roughly accurate image.

Type 1 Errors - False Positive

The first often leads people to live their lives as if they pass. Wear whatever clothes they want, socialize as if they are the gender they want to be, live their best life. As a cost, there is perhaps some societal judgement, though this depends in some part to where one lives. It is true that many parts of the world can be harsh, but with some confidence and brazenness, it often doesn’t matter in the end.

This often happens when one notices some few subset of the traits that might matter (the good ones), but misses the rest of the traits, and doesn’t combine this into a complete view in how these factors add up.

For the most part, if one lives a life as they wish with directionally false-positive views, this can be a pretty happy life.

One can also be pretty knowledgeable about their shortcomings, but live their life this way anyway. While this may seem cringe, i find it quite admirable.

Type 2 Errors - False Negatives

Type two errors are an error in self-perception too. This often leads one to stay indoors, avoid people, continue to dress as their gender assigned at birth. Often this is coupled with some form of social anxiety and belief that people are judging them harshly, sometimes more harshly than other people really think.

Perhaps related is some discussion on social anxiety, and trying too hard to control how other people who don’t matter respond to you.

There are many very transphobic individuals out there, but for the most part, few have put the effort to understand how all the traits add up to show one’s appearance. And for many (but not all people), it is still sometimes achievable to [use time and effort] and [change how you appear] and thus [alter people’s appearance of you such that you look like a “kinda androgynous” person of the gender you wish to appear as.

But really, the same error is happening in these people too. One notices some few subset of the traits that might matter (the bad ones), and doesn’t combine this into a complete view in how these factors add up.

I think to some extent, i think for people with a similar neurotype to me, who have type-2 errors too, the only way out is through. To learn how to compare all the traits. to look at all various people and try to seriously control your mind:

“Could i see this person as a guy if i try really hard? Could i see this same person as a girl if i try really hard? What are the actual key things that makes the difference?”

One approximate loop is:

• find a trait of yours that you kinda know pretty well (most of them)

• try to look at loads and loads of men and women in the wild. see how it compares.

• What does the distribution look like?

• Are there any men who have that feature the same as you? Are there any women who have that same feature as you?

I made a list of some of the most important traits previously.

Generally, for basically all traits [other than a few, eg, facial hair, extreme chest projection] there is usually some examples in both genders that have it in the wild. It might take a few weeks rather than a few hours, and it is much better to look at a non-homogeneous population.

I personally found that I used to be very insecure about my jawline, but after seeing more and more examples of people, I guess I am not only a bit insecure about it. My guess for other people, is that this could be true for things like height, browbone, nose, shoulders, etc.

I also found, just going into various trans social groups, you can often find a pattern, where there will be 4 trans girls, and each one of them will think that the other 3 people pass but that they, themselves, do not pass.

But again, passing is not a strict binary. Some few people will be able to discern almost anyone. Most trans people can usually kinda tell when someone is trans but not always. Most people are much worse at reading these signals, and many are not paying nearly as much attention as you are.

And to be honest, the thing that makes someone go from [some suspicion] to [probably trans] is voice.

I won’t pretend that traits that are rarely-but-not-never found in cis people are not informative at all, nor that people don’t see your traits that don’t pass. But for many, it’s not as bad as you think.

Many family members or people who have known you for a long time, will remain blind to changes in how you look, to an almost comical level. For most, as you go around life, more people will start seeing you as the opposite gender, while your old friend groups will continue to see you by how you used to look before.

I think this points towards that people really do have pretty strong priors one way or another, and that once that impression is set, they don’t typically change it unless it’s particularly jarring.

And many people have far less ability to discern than you might think.

If I were to rank how well people are able to compare traits, i would say something like: cis men < cis women << trans people. There are exceptions to this of course.

Overall, you can just learn to perceive yourself accurately in relation to other people. As time goes on, and you spend more time on a good dose of HRT, and changing your clothes, and altering your hair and your facial hair, many people get to a pretty good position in terms of visuals. What is typically left is then changing your voice, which is difficult, but is often doable.

I will discuss these a bit more in the next days

In the previous post, I tried to break down “passing” into broad categories: voice, face, body, styling, and behavior.

The point there was mostly to map out the space, and to point out that passing is not one or two signals but a whole cluster of interacting traits. I also said I would leave more detailed analysis until the next post. So this is that post.

Today I want to get more concrete. To see what the traits are, and simply, how much do they vary? I will not yet be focusing too much on which trait matters the most? or which should people optimize first? I think that analysis is a whole post of its own.

So for this post, I want to do something simpler:

• what are the actual sliders?

• what direction do they run in?

• what do rough male and female ranges look like?

• which of these are easy to measure directly, and which are only visible through fuzzier proxies?

The traits

At the highest level, I still think the cleanest breakdown is something like:

Voice + Face + Body + Styling + Behavior

That is still a useful map, but it is too coarse to say very much.

Instead we can look at more fine-grained traits.

More fine-grained traits

I try to write some of the main factors that differ. Instead of always choosing the “easy to measure traits” such as those in the ANSUR or DELSTU datasets, I try to instead choose traits more by vibe to what actually matters.

1. Voice

Voice differs a huge amount between males and females. Looking at pitch, it is extremely distinctive between the two.

Looking at pitch specifically, there is no overlap in normal ranges between male and female voices (~93–135 Hz for males vs ~162–238 Hz for females). For other factors, it is not as strong, but can still be pretty significant.

There is a reasonable meta-analysis on this topic, which found:

The pitch, or fundamental frequency (F0), is the most robust predictor of perceived gender.

Vocal tract resonances, reflected in the spacing and height of formant frequencies (especially F1–F4), also play a significant role

Formant spacing was also related to the perception of gender

Voice quality, particularly breathiness, has shown mixed influences on the perception of gender

other acoustic features have shown links with the perception of gender in the voice. For instance, dynamic changes in intonation and loudness patterns also contribute to gender perception.

2. Facial hair/shadow (Face)

The lower range of facial hair/shadow is basically androgynous. If one has not facial hair, it can be read as both masculine or feminine, but if one does have facial hair or shadow, it is read as clearly masculine. It’s pretty intuitive to see.

3. Height/Body Scale. (Body)

Body scale differs moderately significantly between males and females.

Height is directly important in some ways, but is part of a larger attribute of “body scale”, such that a tall but narrow person is still in some ways smaller than a slightly less tall but much broader person, which we can somewhat proxy with shoulder width (bideltoid - distance between outer part of both delts).

Considering 5%-95% intervals in the US, we can look at height and bideltoid width:

Height ranges: female 152-174cm, male 165-187cm

Bideltoid ranges: female 41–50 cm, male 46–57 cm

This trait of body scale is not so much a single trait that overrides all, but it acts as an important and visible prior, which alters how much scrutiny is put onto other traits.

4. Hairline recession

This is another trait that is similar to facial hair. For women, the variance is mostly very little. For men, the variance is very high. Having a feminine hairline is mostly just considered androgynous, but having a receding hairline is considered very distinctly masculine. For the most part, nobody really wants hair recession anyway, and it’s pretty preventable for most people.

5. Facial surface roughness

For the most part, at the same age, women tend to have smoother, softer, less rough skin. While men tend to have slightly rougher, less-soft skin.

I don’t really know how to measure this that well, there are some heuristic scales that look at softness, oiliness, pore size, laxity, etc.

This one moderately important for passing, but also more important for looks. if you have extremely soft and smooth skin, this does read as slightly feminine, whereas if you have very rough skin, it does read as moderately masculine.

This is mostly affected by hormones, and is a trait that I feel does start off as not-that-different when young, even in late teens early 20s, but continues to diverge with years of estrogen vs testosterone in the blood. That being said, things like basic skincare (suncream, retinoids) do help a lot here.

6. Head Size

Head size varies a lot between person-to person. The overlap in sizes between men and women is quite high so it’s not overwhelming, but smaller heads read as more feminine, while larger heads tend to read more masculine.

As a proxy, there is head circumference: female 52.7–58.5 cm, versus male 53.5–60.0 cm.

This is something that is slightly correlated with general body size though, and so doesn’t seem to matter that much as an additional factor in practice. It is also not something you can physically change, but it’s perception is affected by hairstyle and other facial components. The next two traits are more overall.

7. Upper-face heaviness/hardness

This is mostly referring to bone-structure features in the upper face. This includes browbone, orbitals, nose bridge, facial width VS cheek fat, “relative eye size”. These factors are more explicitly gendered, but to various degrees.

This is often one of the most important remaining visual aspects people can change to pass better or worse, and getting FFS, especially on browbone + orbitals + nose bridge, can make a significant difference on passing better.

8. Lower-face heaviness/hardness

this cluster i consider to be features such as facial length, chin projection, jaw angularity and width. These are slightly less important than the upper features, but depending on the person can be quite important too. This is generally slightly harder to make larger effects on with FFS, since generally you require more advanced surgeons with additional orthodontic specialty, but the most jarring differences can often be changed.

Additionally, this is one trait that seems to differ a lot ethnically. For example, jawlines of Slavic and Korean women can often be more pronounced than jawlines in other close-by countries, so it’s one that can sometimes be more forgiving, and a minor amount of larger features can sometimes be seen as desirable.

9. hip-waist-chest size

Another aspect that differs greatly is the relative ratio between upper-body/rib-cage, and lower-body/hips. Some most relevant proxy metrics for this are [shoulder-to-hip-ratio] and [underbust-to-hip-ratio]. There is some chance you are in the androgynous zone, in which case it is a pretty good place to be. But there is some reasonable chance you are in a top-heavy or bottom-heavy ratio when you would prefer to be in the other, in which case it becomes more difficult.

The size of these places is driven by aspects like bone underneath, and muscle+fat on top. It is relatively doable to gain/lose fat+muscle, but quite difficult to alter bone.

That being said, this is one that is relatively easy to hide with loose clothing. And for the most part, cis people don’t tend to notice this that closely anyway. So you may personally dislike this aspect of yourself but it probably doesn’t play as large a part in your passing as you think.

Waist indentation also exists here, proxied by [waist-to-hip ratio], but mostly matters for looks rather than for passing.

[Getting reliable metrics for these is a bit annoying and I didn’t have time to get them, I may add them here at a later date]

10. Chest projection

I don’t really like cup-size as a metric, since it doesn’t nicely take into account how different rib-cage sizes can be. But as you know, males tend to fave pretty flat chests (with some larger sizes from trained chest muscles or from gynocomastia), whereas women range from flat to very large. There are additionally differences in shape between male and female chests. I don’t think it’s particularly worth diving into here since it’s mostly obvious.

11. Hand/Foot/Knee etc

Hands and feet can sometimes vary to be smaller [more feminine] or larger [more masculine], but in general these mostly are pretty proportional to body size, and nobody pays much attention to size as much as to general skin texture and such. There are differences in knees that do mean in knee-related surgeries there need to be special accommodations depending on this, but I harp again that nobody cares nor knows how to notice the differences.

In the next days, I will try to give more detailed breakdowns into how much these attributes are modifiable, and some methods for this too.

Before we think about how to optimize things, can we break down the what we want to optimize most? What are the most important aspects of passing?

breaking it down to the 5 senses

Everybody knows the 5 senses: sight, hearing, touch, smell, and taste.

We can break down how important each of these are to people’s perception of you, How much do each of these matter for passing?

By default, people basically assume 100% sight, and don’t think about anything else.

This is partially true for interactions where you don’t interact with people much, and instead only just are seen from the distance or only for a few minutes, or if you are in public spaces. But most important interactions in our lives are not only this.

For any extended interactions with people, people will hear your voice.

And vocal aspects are extremely dimorphic to the point of almost no overlap in range between untrained male and female adult voices.

The other senses: smell, taste, touch, are not given much weight, partially because people don’t get to weigh on them that much, and partially because they are handled by default with hormonal treatment.1

breaking it down more specifically

Let’s break it down further. There are some aspects of yourself that combine sight + hearing in an unclean way, that i will combine to call “behavior”.

So, I would probably break it down further as:

• Hearing = voice

• Sight = body + face + styling

• Behavior = motion + speech style + social aspects

Which gets further broken down to:

• Voice = pitch + resonance + prosody + speech style

• Head = hairline/frame + facial hair/shadow + face shape + skin + smaller details

• Body (coarse) = height + overall size + age read + broad silhouette

• Body (finer) = shoulders + ribs + chest + waist/hips + hands/feet + body hair

• Styling = hairstyle + makeup + clothing + accessories

• Behavior = movement + posture + clothing + mannerisms + conversational style + name/social framing + other subtle things

Which is a lot of dials that influence how we are seen. This is too many things to think about at once, but we can try to think about how these things interact with passing.

how do these things interact with passing?

A lot of these traits act pretty differently.

And passing is mostly a continuum.

Some traits act like priors. They don’t fully determine how someone is read, but they set the starting assumption. Height/general body scale is a lot like this.

Some traits act more like vetoes. They can override a lot of otherwise favorable cues. Voice is the clearest example. Facial hair or beard shadow can also work this way.

Some traits mostly act as validators. They make the overall read feel stable and coherent. A lot of face and body traits work like this: clothing, hairline, face shape, facial surface, torso contour, and so on.

And some traits mostly matter once someone is already uncertain. Hands, movement, neck details, knee shape, and so on, work more like tie-breakers for people who are really into the details, than first impressions.

One can think if “passing” as being a scale.

On one end, there are old people who haven’t interacted much with the young ‘uns and think you are a girl if you are young and have long hair. On the other end some will instantly clock you based on the slight difference in shape of your knees.2

passing is not one or two signals

One “mistake” that people often make when they don’t have much knowledge on trans things, is that they maybe think of like a couple most obvious signals that are high sexual dimorphism (for example, breast shape + clothing), and assume that swapping these aspects is sufficient to “pass”.

Upon switching these two properties, one may often find it slightly jarring because other things are still missing.

I personally like to think of the “gendered properties” as being sliders. Most people live on one extreme for all things on the sliders. But if one changes one or a few aspects to one extreme from the other, then it becomes quite jarring. This matches with anecdotes I have heard from people who go out and wear pretty androgynous clothes and pass, but wear gendered clothes and get misgendered.

I think one can apply the axis of “masculine” and “feminine” to basically most attributes, even when the degree to which it matters is quite different. One could consider “kiki” and “bouba” to be more masculine and feminine respectively, but it’s not a strong effect.

some other notes

For some traits, it’s not possible to start on one extreme and end up on the other with current technology. Some hope ends once you start undergoing permanent changes under puberty.

That being said, there is a lot of variation in these traits even among cis people, and technology has gotten quite good, so you may get to a pretty good state even despite some traits. A lot of it is dependent on genetic luck. Some other require a lot of wealth. But for many, doing your best to optimize each of these traits will get you pretty far.

If you want to “fully pass to most people”, I think you kinda need either some combination of:

[mostly passing visual] + [androgynous voice] or [mostly passing voice] + [androgynous visual]

But it’s a sliding scale and depending on who you are interacting with, people may be completely clueless or clued-in.

I leave more detailed analysis until tomorrow’s post

I had been working on https://wikiofdark.art/, a directoy of methods for looksmaxxing your transition. I made a lot of progress on it last summer. However, since then, I’ve kind of had it stuck at 80% and haven’t made as much progress on things as i would like.

For this reason, i will be taking part in Inkhaven to better deep dive into things i don’t understand as much as i like, to describe:

• aspects of looks (aka brainworms)

• standard methods for improving things

• experimental methods for improving things

• surgical methods for improving things, comparing surgeons

• how to do research, best people and communities to learn things from.

• what is actually important to do VS less important?

• which things need more research, and which could be solved with some small amount of funding?

I will be writing every day for the whole month of April.

If you have any specific research threads you think are interesting, I am open to suggestions!

The current version of the wiki follows the current list of topics, with various of them followed in different levels of detail:

• Table of contents

  • Hormone Replacement Therapy (HRT)

    • HRT TL;DR

      • Gamete storage

    • Home-brewing

  • Fat Redistribution and Weight Cycling

    • Downcycle

    • Maintaining a caloric deficit

    • Maintaining a Caloric Deficit

      • Caloric Deficit through Diets

      • Water-soluble fibres

      • GLP-1 Agonists

      • Corset diet.

    • Down cyle - Burning the right fat

      • Aminophylline

      • Glycyrrhetinic acid

      • Topical Caffeine

      • Selective Muscle training

      • Acetyl-l-carnitine (ALCAR)

      • Radiofrequency Electric Field

      • Other things NOT worth considering:

    • The Upcycle - Growing the right fat (and muscle)

      • Excercise

    • Weight gain supplements

      • Thiazolidinediones (TZDs)

        • Pioglitazone

      • Acetyl-Hexapeptide-38 (Adifyline®)

      • Acetyl-Hexapeptide-39 (Silusyne®)

      • Volufiline

      • Leucine and Argenine

      • Growth Hormones and Various Peptides

    • Things to Avoid

      • Alcohol Consumption

  • Bone Altering

    • Waist-to-hip ratio

      • Waist-training

      • Dangerous Darth Method

      • Rib reshaping surgery

      • Rib removal surgery

      • Costal cartilage reduction

    • Shoulders

      • Delt muscle atrophe

      • Surgical Shortening

  • Face

    • Skin

      • Sunscreen

      • Retinoids

      • Matrixyl (palmitoyl peptides)

      • Callogen supplements

      • Niacinamide, Ceramides, Panthenol

      • laser resurfacing

      • microneedling

      • chemical peels

      • Red light therapy

      • Other things

    • Facial Fat Distribution

    • Facial Feminisation Surgery (FFS)

      • Surgery order

      • FFS Surgeons

    • Teeth

      • Non-cavity causing bacteria

  • Body Hair

    • Shaving

    • Waxing

    • Hair Removal Creams

    • Laser Hair Removal

    • Electrolysis

  • Breast Growth

    • Adifyline and Volufiline, Selective Fat Depositing

    • Stop and Go method

    • Progesterone

    • Breast Augmentation

  • Voice

    • Voice Training

    • Vocal Feminisation Surgery (VFS)

      • Cricothyroid Approximation (CTA)

      • Wendler Glottoplasty (Anterior Glottic Web Formation)

      • Feminization Laryngoplasty (FemLar)

  • Hair

    • General care

      • Fringe

    • Prevent loss / regain growth

      • Finasteride / Dutasteride

      • Minoxidil

      • Topical Estrogen (without feminization)

    • PP405

      • Hair Transplant

  • Other chemicals

    • IGF-1, Growth Hormone, and GHRH Agonists

    • CJC-1295

    • ipamorelin

    • tesmorelin

    • igf-1 DES

    • kisspeptin

    • GHK-Cu

    • tb 500

    • Avoiding scarring

      • Inhibiting scar formation

      • Verteporfin

Thanks for reading!