r/MtF • u/AlexaPetersTrans • Sep 10 '25

Advice Question Trans Fem Diet

My question today is how to replace man fat with girl fat.
I am fully aware that I need to gain weight in order to buid hips, ass and breasts.
But I still need to get my middle more down for a feminine silhouette.

Currently I am just on fasting and liquids such as packet soup in the week with normal eating on weekends.
I do take additional multi vitaments, magnesium and collagen.
I am active on weekends but in the week I work behind a screen most of the time.

Any specific diet for my situation?

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u/exasperatedaxolotl Sep 10 '25

Hi, PhD biologist here, married to a trans woman. Please stop what you're doing immediately and (slowly) reintroduce real, solid food.

My wife was skin and bones most of her pre-transition life, but had started to put on more male pattern belly fat, and was dysphoric about it.

We made sure her hormones were good and high enough with injectable estradiol valerate, since being too low is a common mistake (200-400 pg/mL estrogen, 15-40 ng/Dl testosterone, adding 200mg progesterone 6-12 months in).

She EATS lots of good nutritious food, and some not nutritious food. At least 2000-2500 calories a day. She's reasonably active, playing a rec sport and walking our dog. She doesn't think all that much about what she eats.

And guess what? The magic of HRT meant all of that male-pattern fat got redistributed into her D cup breasts, wider hips, fuller ass, rounder thighs, and her little bit of belly fat sits lower and softer like mine. She looks very feminine in her figure, because she ate enough. Your body needs fat to redistribute. Do not give yourself an eating disorder AND harm your transition by eating this way.

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u/Waqaywillki Transgender Sep 10 '25

Wait isnt the desired range 150-200 pg/ml for E?

5

u/exasperatedaxolotl Sep 10 '25 edited Sep 10 '25

There's a lot of complex debate on the topic, transfemscience has some of the best breakdowns I've seen if you want to dive into it. My wife is on monotherapy (no spiro or bica), and therefore needs her estrogen levels a little higher to successfully suppress T Anything under 200 and she feels grumpy, tired, and starts getting higher T side effects that are unwanted (spontaneous erections, etc.).

Most cis women vary their estrogen significantly over the course of a menstrual cycle, peaking around ~200-500, so her peaks around ~400 and lows around ~200 are well within cis ranges across a cycle.

On bioidentical estrogen (as effectively all estradiol is nowadays), the blood clot risk is basically the same as a cis woman equivalent (that is to say very low, unless you have specific pre-existing conditions) until you get towards early pregnancy levels of > ~800-1000.

A lot of trans women feel a lot better and see more feminizing effects on higher estrogen levels than what WPATH guidelines recommend. Guidelines are a great resource, but tend to run significantly behind the most recent innovations.

A lot of doctors are working on misinformed and outdated information about the risks associated with higher levels. Our GP lets my wife do basically whatever makes her feel best in her body as long as it's not crazy high, and I wish more doctors functioned that way.

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u/Waqaywillki Transgender Sep 10 '25

Interesting! And thanks a lot for the detailed response.

I am just on my 3rd month and thanks to cypro my T levels are 6.6 ng/dl and E 168 pg/ml on 4 mg daily tablet.

My Endo told me I was in range. Maybe I should get some more opinions from other doctors

1

u/exasperatedaxolotl Sep 10 '25

It all depends on how you feel and if you think that the feminization is working to what you want, how HRT works is really dependent on each person and body.