The pain won't end

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I'm a 30-year-old "man" who has felt female for my whole life. Over time, wishing I were female has become very intense pain. Every night and some mornings I cry for an hour alone while squeezing a pillow, all from the pain of being the wrong sex. I'm writing this with trouble seeing the screen because of the tears in my eyes.

I've been taking estrogen for almost 4 years. I still look completely male, to the point of having these suicidal feelings. Many transgender friends of mine have fully transitioned in this time, because their body type was more compatible with becoming female than mine. But I'm still stuck.

I've been on antidepressants for most of my life. I'm seeing both a therapist and a psychiatrist now. Despite their best efforts, it's not helping. I've just sunk lower into despair as time has passed.

My main friends have all moved away. They've also paired off, finding their life partners. Meanwhile, I'm stuck here alone, and I haven't even dated anyone in my entire life due to my severe gender dysphoria. Most people see "lesbian trapped in a man's body" as a joke.

I need help, but there's just nowhere for me to go anymore.

I'm so sorry to hear you're in such pain.

This might be out of left field or not relevant but I read that Aspies often have a lower cortisol response to stress than NTs have. NTs usually have a spike of cortisol production in the morning of each day so they're ready to "face the day" and it acts as a fight-or-flight inhibitor, decreasing metabolism and promoting fat storage. Note that I am not a scientist so there's a good chance I'm explaining this wrong but from all I read this is the basic process.

Fat stores estrogen if I am not mistaken. In any case more body fat contributes to an appearance generally seen as more feminine, regardless of body type. (Endomorph/ectomorph/mesomorph/anycombinations of such). People with ectomorphic body types (male or female) are more prone to high metabolism and lower body fat storage.

Certain types of medicine for depression and anxiety increase weight. I was actually put on a medicine to increase weight when I lost 20 pounds last year due to depression and anxiety, and I gained it all back (and would have continued to gain weight had I not gotten off of it). I wonder if something like this might help you both feel less severely anxious and depressed, and increase weight. I know you didn't specifically mention anything about weight and I know if you're happy with your current weight this might seem like a presumptuous suggestion but it's one way you might achieve more the appearance you're looking for.

That said, I do not mean by this that you are not feminine "enough" the way you are. The female gender has the full range of body types and no one body type can be said to make someone more legitimately a woman than another. {I mean opinions on what constitutes femininity vary very widely... the endomorphic Renaissance ideal v. the ectomorphic fashion-model ideal of recent times.) It only matters how you feel and this is something that might possibly help you physically feel more the way you have the need to feel.