When I began hormone replacement therapy, or HRT, the first change I noticed were my orgasms.

I have experienced gender dysphoria—a discomfort with my assigned sex—for as long as I can remember. But it wasn’t until this year that I committed to medically transitioning.

I found a transgender health clinic that prescribed me estradiol and spironolactone, the standard combination prescribed to most trans women. They produce estrogen and inhibit the production of testosterone. I dreamed about all the changes I was set to experience: breast growth, a more feminine figure, less body hair and a lot more.

Now, eight months later, those things are gradually still happening. But a mere week into my new medication regimen, my orgasms were completely different. Where climaxing was once a quick, concentrated ordeal, now it was something I felt with my whole body. They were longer, more intense and came in great tingling waves. Clearly, I thought, these pills must be doing the job.

But as the weeks went by and the