just an example: if you look like a man because you have estrogen insensitivity, buying and taking extra estrogen won’t help at all and you’re wasting money and taking needless risks.

Cis people have more diversity in their bodies and the way they look than most people realize, and cis women are confronted for being “trans” in womens’ restrooms all the time, way more frequently than trans women are, because there are way more cis women who don’t look like the perfect ideal of feminine beauty than there are trans women.

I’m not denying your suffering or distress, but I am saying that it’s entirely possible nothing is medically wrong with you and you are well within the natural diversity of human bodies.

Spironolactone is a pretty weak anti-androgen and will also cause lots of side-effects, some of which can be life-threatening. You should absolutely be monitored by a doctor when taking spiro, it’s not an exaggeration to say you are taking your life into your own hands. Spiro is not a typical part of a DIY regimen for trans women (for lots of reasons, but the medical risks are one of them).

The protocols and treatments designed over a century now for trans women are rooted in empirical evidence and studies that evaluate the risk / benefit of HRT and other interventions like surgeries, and they absolutely do not apply the same to cis women - in fact, the empirical evidence we have about body dysmorphia in cis women is exactly the opposite of the findings for trans women (i.e. for cis women interventions like surgery generally don’t generally improve outcomes or reduce distress or symptoms, and meanwhile they increase risk significantly; there isn’t even a protocol for HRT in non-menopausal cis women because there is absolutely zero reason for it, HRT is only needed when your body doesn’t produce enough of its own hormones - and we have no evidence your body isn’t producing enough estrogen let alone that it’s producing so much testosterone that you need an anti-androgen).

It’s a pseudo-science myth perpetuated by influencers and grifters that “more estrogen = more feminine”. The informed consent paperwork I signed to take HRT as a trans woman specifically says that taking more estrogen increases risks and does not increase feminization. And worse, unlike a trans woman whose body does not produce female levels of estrogen, your body likely already produces estrogen in more than sufficient amounts for your body’s functioning; it’s very unlikely you need more estrogen, and taking extra estrogen like this can increase your risk of breast cancer as well as disrupt your monthly menstrual & hormonal cycles.

Your body will also seek to maintain homeostasis and will likely reduce the amount of estrogen it produces in response to taking exogenous estrogen (the same as taking any other hormone your body naturally produces - e.g. if you took melatonin every night, eventually your body will just produce less melatonin and rely on the exogenous melatonin, you essentially form a “tolerance” over time that brings you back to where you started), so again you’re wasting money and risking your health for no added benefit.

If you were denied a hormonal blood test, it could be because the doctor didn’t think there was sufficient reasons. Do you have significant facial hair, male-pattern baldness, dark hairs growing on your chest and belly, etc.? What is the evidence you actually have that you need an anti-androgen?

For context, when I had some cysts between my ribs as a teenager, the doctors took one look at me and immediately ordered hormone blood labs to check my estrogen because I looked feminine (soft skin, light body hair, not much facial hair for my age, larger breasts than boys my age, etc.). Doctors generally will run labs if they believe there is a credible reason to do so - all this tells me is the doctor you saw didn’t think there was justification for it.

While doctors are not always right, they’re also not always wrong; sometimes an issue like this could be a mental health concern and not a physiological issue, to be worked on in therapy.

It would be nice if you had a doctor who could explain to you why you don’t need your hormones checked, but if they didn’t think you needed it, one possibility is that you just don’t have the typical signs and symptoms of someone with an endocrine disorder (or intersex condition).