Binary Options Signals - Simply The Best Binary Options

House Party 6/22/2020 - Part Two

Woodbridge: I hate to say it, but it’s unlikely, Allen. It’s a lot easier to pretend everyone else is wrong, and that you had no other option.
The camera pans to a kitchen. We see Tony the Milkman standing there in his leather jacket accompanied by Jim Baker. The table is adorned with ingredients mixing bowls and other baking supplies.
Tony ”Guys, gals and non-binary pals, I welcome you all to the great bake-off! Mr. Baker and I have decided to put our differences behind us but before we officially align we have decided to have one final friendly competition! Since I beat him in our debut match, I picked a stipulation that I believe will help make the score equal.”
Baker: “Tony, you know I’m not a baker, right? It’s just my name?”
Tony: “I get it, Baker, you’re playing a rib on me so I won’t feel bad for losing. It’s ok! We’re partners now!”
Baker “Tony I’m being se-“
Tony: “As is I was saying, The bake-off! Both of us will be baking something, which will then be shared with the rest of the locker room, unless they’re that piece of shit Joey McCarty, or Joey McCarty’s friends.”
Tony stares directly into the camera: “I know how much the people in the locker room love consuming the labor of others without compensation.”
Baker nods in agreement
Tony: “For my entry, I will be making the favored dessert of bisexuals such as myself… Lemon Bars!”
Baker: “And I’m making… uh… cookies I think”
Tomy: “No need to put yourself down, brother! We all know you’re going to smoke me! Anyways let the games begin!
The to go off in opposite directions and begin preparing their deserts. Tony begins making a crust out of flour cornstarch and other ingredients, carefully slicing butter and mixing, while Jim unsuccessfully attempts to make even balls of store bought cookie dough.
Backstage we see Mark Dutch walking around, peeking around corners and down hallways as if he’s searching for someone.
Dutch: Yo Blackwater! We’re done playing hide and seek! Where are you?
Dutch turns around, staring at each door and peeking into some of them, but to no avail.
Dutch: Where the fuck did he go?
After taking a few more steps he stares to the left of him. The camera turns and he comes across Kyle Scott, looking down onto a large map.
Dutch: Kyle. You got a moment?
Kyle looks up, staring back at the tall Dutchman with a focused look on his face?
Kyle: What do you want? Can’t you see I’m busy?
Dutch frowns for a moment, presumably having a brainfreeze from the shake before he peeks at the map. It’s a detailed map of Ohio that Kyle looks at
Dutch: Have you seen Louis? Louis Blackwater?
Confused, Kyle looks back at Dutch before shrugging.
Dutch: Like.. the B in D&B? Have you seen him?
Kyle: Becca?
Dutch: No. She’s dead. Blackwater.
Kyle: Ooooh! Blackwater. No, I haven’t. Why would I know that?
Dutch: I don’t know.
Kyle: Exactly. Now leave me alone, please.
Dutch: Fine. Thanks anyways.
When Kyle puts his head back down into the map, Dutch continues to walk down the hallway until hearing a loud crash. Immediately, Dutch sprints over to where the sound came from, in the background we see Kyle not even having flinched from it. After a few steps Dutch goes around a corner and immediately is heard yelling.
Dutch: LOUIS!
Louis is found on the ground, holding his head and surrounding him are metal pipes. Dutch gets to Louis and checks him out, staring over him as he tries to get Louis’ attention by shaking him!
Blackwater: I am awake! Stop shaking me!
Dutch: Why the fuck are you on the ground?!
Blackwater: Fuck, man. A fucking mouthbreather attacked me from behind. Hit me right in the fucking liver. REAL LAME, GUYS! I USE IT TO DRINK!
Blackwater holds his hand on his side, presumably where is black, abused liver is supposed to be before he sticks out his hand, trying to get up. Dutch takes it and pulls him up slowly.
Blackwater: Ah.. fuck.. that hurts..
Dutch: You going to be alright?
Blackwater: Yeah.. Fuck me, I had worse. I should check a doc or something. Then go find the cumstain who did this.
Immediately, Dutch’s eyes light up as if he has a bright idea.
Dutch: I got a bright idea! You go visit the doc, I’ll find who did this. I’ll be like Batman doing detective work!
Blackwater: Of course you’d wear leather. You gonna have bat-nipples on your costume too?
Dutch: Fuck off, mate. Let me help you get to the doc.
Wrapping Louis’ arm around his neck, Blackwater begins to walk down the hallway, helping him as they both disappear around the corner.
Blackwater: Really tho, I won’t judge you if you wear leather.
Dutch: ...I’ll think about it.
We then cut back to the ring, where we see Javier not standing solidly in the middle of the ring, but instead rushing down from backstage to it, seemingly not having been ready for once, as he pulls out a card from his pocket, and begins to read.
Javier: At the request of both competitors in this upcoming bout, we will now be staging an impromptu singles match between Dalidus Nova and Buster Braggadocio!
Javier: Clears throat And it is a singles match set for one fall, with a 30 minute time limit! Introducing first-
The Kids are Back hits the speakers, as out from the curtain comes Dalidus Nova, swiftly followed by Miles Alpha.
Javier: From Toronto, Ontario, Canada, standing at 6 feet 3 inches and weighing 225 lbs… DALIDUUUUS! NOOOOOOVA!
Woodbridge: And the crowd here not a fan of Dalidus or Miles.
Paisner: They’re not the only ones…
Dalidus spits out a grotesque, far-too-large mouthful of Hubba Bubba gum at ringside and enters the ring, Miles staying outside but putting himself in Nova’s corner as Freaky Black Greetings hits the speakers.
Javier: And now, from Atlanta, Georgia, standing at 6 feet and three quarters of an inch and weighing 220 lbs… BUUUUUUSTER! BRAGGADOCIOOOOO!
Buster comes out from the curtain, pick in hair and yelling caucasian-themed insults at the crowd with reckless abandon.
Woodbridge: Quite clearly, the audience here doesn’t feel too strongly about Buster either!
Paisner: Seems the crowd and I are finally seeing eye-to-eye!
He slides into the ring, flicking his pick towards Alpha at ringside while he does so. Buster and Dalidus eye eachother up from opposite sides of the ring as the bell signals the start of the bout.
The bell rings, and Buster is quick to charge Nova, who slips underneath the bottom rope and out of the ring.
Crowd: Booooooooooo!
Paisner: Dalidus wasting no time going to his sleazy playbook.
Woodbridge: But Buster’s not having it, look out!
Buster immediately follows Dalidus to the outside, giving chase as Nova stumbles into a run, not expecting Buster’s aggression. The two make a circle outside the ring, until Dalidus slides right back in through the bottom rope. Buster is seconds behind him, but as he gets to his feet he sees that Nova has slipped back outside the ring, grabbing Buster by the ankle and pulling him down and out to the floor!
Crowd: Booooooooooo!
Paisner: Ooh! Buster landing hard outside!
Dalidus starts to lay boots into Buster on the outside, as Miles yells a mix of encouragement towards his partner, and insults towards the opponent. After several seconds of the officials count, Nova grabs Buster and wrestles him back into the ring.
Woodbridge: Finally, both men back into the ring, the only place the final fall can take place.
Not relenting, Nova drags Buster up to his feet in the corner, striking him in the chest with a chop!
Crowd: Ooooooooh!
He winds up for a second one, but not before Buster strikes him with a forearm strike, creating the separation necessary to connect square in the chest with a dropkick!
Crowd: OOOOOoooohh!
Paisner: Buster with the retaliation!
Nova is sent flying backwards, quickly rising to his feet in the opposite corner as Buster continues his attack, flying in with a corner clothesline! Still not giving Dalidus a second to breath, Buster shoots Nova back towards the other corner with an Irish Whip…
Woodbridge: These two men, back and forth across the ring!
...Charging in for another clothesline, Buster is suddenly met by the rising boot of Dalidus!
Crowd: Woooahh!
Paisner: Back and forth quite literally, Mark! Neither man’s gotten a concrete advantage thus far!
Taking a second to breathe, Dalidus re-approaches Buster, bending down to pick him off the mat only to get caught in a lightning-fast small package!
2.. - No!
Woodbridge: Nova damn-near got caught!
Dalidus is swift to fight out, both men twisted away from one-another and back up to their feet, backing towards opposite ropes.
Alpha: C’mon, Dali! Get his ass!
With the verbal from Miles, Dalidus rushes Buster, who ducks underneath a clothesline attempt, grabbing the waist from behind and using Nova’s momentum to run him into the ropes with an O’Connor Rollup!
No! Dalidus reverses the roll-up!
But Buster breaks free, and is quickly up to a knee!
Paisner: Two escapes from both - WOAH!
Still kneeling, Buster is caught in perfect position for the Kneeling Superkick!
Paisner: CHEKHOV’S GUN! Buster falls back to the mat, rolling out of the ring and plopping to the floor outside the ring.
Woodbridge: Buster got caught on bad timing, but makes up for it by getting outside the ring, away from any potential pinfall attempts.
Dalidus, with an annoyed look on his face, walks towards the ropes, crossing them and landing outside the ring beside Buster. As Miles stands beside him, Dalidus again tries to get Buster into the ring. This time, however, Buster slips from Nova’s grip, slamming his opponent's head into the edge of the ring!
Crowd: OOOOOH!
Paisner: Buster was playing possum!
With Nova dazed, Buster turns to Alpha, kicking him in the gut before grabbing the back of the Canadian’s head and swinging him into the ring post!
Woodbridge: Miles hit hard, and the crowd loves it!
With Alpha laid out outside the ring, Buster swings Nova’s legs up and onto the canvas, sliding in after him.
Paisner: These two have fought at a lightning-fast pace thus far, and it looks like Buster is aiming for an equally-fast conclusion to this bout!
Buster sits Nova up in the center of the ring, shooting a quick kick into his back to keep him in place. Breaking into a sprint, Buster hits the rope facing his opponent, running back at Dalidus with intentions to hit a running knee strike…
Woodbridge: Bravado Bust - Nonono!
However, Dalidus lays back and the knee flies right overhead, as he reaches upwards and catches Buster between the legs, pulling him back down to the mat with another roll-up!
3.. - NO!
But Buster kicks away, breaking the pinfall! Returning to his feet, Buster is unable to avoid a forearm strike from Dalidus, stunning him long enough for Nova to drive a knee into the gut and snap down with a quick DDT!
Paisner: DDT from Dalidus, and these two just will not slow down!
Woodbridge: Ya may not like them, - God knows I don’t - but they’ve got some mighty gas tanks on ‘em!
Dalidus, now behind Buster, brings his opponent to his feet with a waistlock, before throwing Buster’s arm over his neck and throwing him backwards with an Inverted Exploder Suplex! Buster flies far through the ring, but his boots collide with the skull of the official, sending him falling to the mat like a sack of potatoes!
Paisner: Cord Cutter, but the ref’s down!
Woodbridge: Buster ate all of that!
Dalidus begins to go for a pinfall, but spots the official down on the mat. Looking up towards a less-than-admiring crowd, he gives a shout to his partner.
Dalidus: Miles! Gimme a chair!
Paisner: Oh, sonuva…
Miles, still reeling from the collision with the steel post, grabs a steel chair and slides it into the ring as Buster begins reaching for the ropes in an attempt to get back to a standing base. Meanwhile, Dalidus grabs the chair from the mat and sizes up Buster from behind.
Woodbridge: Buster’s gonna get his brain rattled!
As he turns around, Dalidus charges with the chair raised high, swinging it downwards just as Buster sees, quickly rolling underneath the blow leaving the chair to connect with nothing but air!
Quickly up to his feet, Buster reaches into his tights to retrieve his signature black marker! Throwing the cap into the crowd, he immediately strikes Dalidus in the left eye with a jab from the marker!
Nova falls to the mat, clutching at his face! Buster returns to the official, trying to get him back into the match, when he is struck from behind by a sudden forearm blow, courtesy of Miles Alpha!
Woodbridge: The third man! Miles, getting himself involved once more!
Buster falls to his knees as Miles pulls him away from the ref, before swiftly bringing him up in a Fireman’s Carry and driving his boot into Buster’s skull with a Benadryller!
Paisner: Alpha with the Defeater to Buster!
*Woodbridge: He’s out cold, without a doubt!
Looking behind him to spot the official slowly coming to, Miles rolls Buster onto his back and pulls the blinded Dalidus on top of him, before slipping out of the ring and hiding from the officials view as he begins to slowly make the count!
Paisner: Absolute bullshit!
Javier: The winner of this bout via pinfall, at a time of 7:02: DALIDUS! NOVA!
The Kids are Back hits the speakers, as Miles comes back into the ring to assist Dalidus out of it, a shit-eating grin plastered on his face.
Woodbridge: In what was looking like quite the match, Dalidus steals one from Buster with the help from Miles Alpha!
Paisner: It’s bullshit, Mark. Complete bullshit.
The two walk through the curtain as the camera cuts away.
Mark Dutch is walking around the backstage area. He comes across Tony the Milkman, seeming to take a breather from the chaos of the kitchen, wiping off a milk mustache.
Dutch: Milkman! Tell me everything you know about the attack of Louis Blackwater!
The Milkman looks confused.
Tony: I don’t have any information for you, unfortunately. I do have a wonderful lemon cake! Would you like a piece?
Dutch takes a good look at the lemon cake Tony is offering, but he shakes his head.
Dutch: No, I cannot be distracted. I have responsibility!
Tony: Your loss!
As Mark Dutch continues to walk around, he peeks into a room and sees Big Money Maverick on the phone talking to someone. Dutch begins to speak to himself.
Dutch: Mav….maybe it was him….
Big Money Maverick: So yeah, if you're interested in doing business, let's talk about financials…
As Mav talks on the phone, and Dutch watches from outside the room, Dutch is suddenly approached by a backstage crew worker holding a bag of cheetos.
Crew Worker: Looking for the guy who attacked Blackwater? I don't think it was Mav.
Dutch: Why do you say that?
Crew Worker: He's been in this room making phone calls for hours, I should know…
The crew member swings the door open, cracking it behind him so the camera and Dutch can still see inside. We see the crew worker hand the bag of Cheetos to Mav, and Mav sets the bag on a table next to him, alongside many other drinks and snacks that Mav presumably forced the worker to get for him.
Dutch: Hmm...maybe not...but…...I don't know….
Dutch walks away from the room, and immediately is face to face with Stephen Romero, who’s holding an athletic jump rope in his hands and sweat covers his tank top.
Romero. Heard you were looking for who snuck up on Blackwater.
Dutch: Yeah. By the way, thanks for going after Balandran for my hotdog.
Romero looks back at Dutch, scratching the side of his head with a confused look.
Romero: Oh yeah. Uhm. No problem, I guess. Look, we two have been in the business for a while.
Dutch: True.
Romero: Yeah, and I noticed a trend which might work.
Dutch’s eyes are wide open as he looks back at Romero.
Romero: Usually, if you go to the ring and call out who did it.. they often show up and take responsibility. That or someone else shows up who wants to fight. It’s a 50/50 chance.
Dutch: Now that you say it, yeah.. you’re right. Thanks, Stephen.
Mark Dutch pats Romero’s shoulder before he looks at his now sweat covered hand. Immediately, Dutch wipes his hand off on Romero before he quickly walks away. Romero looks down at the sweaty handprint before letting out a sigh.
The camera returns to the kitchen, where we see Milkman back in after his break, and his crust has been pulled out and he’s pouring in a filling into it. Baker is on Twitter instead of watching whatever he has put in the oven. Bakers oven start producing smoke, whole Tony’s produces an absolutely gorgeous looking loaf of pastry
Baker: “Shit!”
Baker runs over the oven and opens it, quickly pulling the cookies out without wearing any form of hand protection
We open our next scene, as we see Stephen Romero backstage once again, clad in his wrestling gear and changed into a cleaner, and very small black tank top. So small the tank top is dangerously close to slipping inward a bit and potentially revealing his nipples. With this phone on hand, as he starts an instagram live stream from his phone, quickly getting up to around 14 unique viewers. As he begins to speak.
Romero: Hello world! I’d just thought i’d give a bit of insight into how I go about preparing for whatever I need to do when i’m at a show! The first thing to bring, always, always have this-
Romero opens one of his bags layed in his locker, inside revealing many bottles of water.
Romero: Stay hydrated, constantly! And you can stay hydrated with….uh….actually I don’t have any sponsors for this yet……..use tap water if it’s safe where you live, get some re-usable bottles if you can! I think when it comes to price points it’s not something you’d regret if you splurged on, but not something you need to splurge on either. I might even recommend not splurging, because with some extra money, you can become a patron for 1 cent a month! We are already at fifty-three patrons, and you can get in on the new hotness, and access to exclusive content! Now, to show y’all some more-
Romero grabs a significantly sized lunch box, as it seems to contain generous servings that make up a large rice bowl. First ingredient is obviously a lot of rice, with sliced pork, green onion, cilantro, mushroom, carrot, and avocado all being found in significant portions.
Romero: Being as large as I am and working in such a physically draining industry, the portions that I need to function would incapactiate a normal human being. Whether I am exaggerating or not is up to your own interpretation. And now, some may wonder how I get mentally prepared for a match? It heavily depends, for ippv matches where there’s more on the line, I tend to psych myself up with intense music, let out energy through running in place, my ippv matches are more about being intense. With lower stakes matches or House Party matches, I tend to moreso leave my training at the gym, I just try to show up in as good and happy of a mood as I can. Easier said than done of course, but with things such as forming alliances recently, I always have some others to lift me up. I think specialist and Rizwan are in the break room, lets go visit them actually!
Romero then walks out of the locker room and into the hallways, and as he just enters the hallways, he bumps into someone right in front of his whole stream!
gayboygayboygayboygayboygayboygayboygayboygayboy: omg king u okay??!!??!!
MarioFantatic37: Nooooooooo don’t get hurt from an unexpected collision your so sexy haha
After a moment of surprise, we see the person Romero collided with as he exited the locker room, GiGi, who now sees that Romero bumped into her, and gains a fury in her eyes.
GiGi: Hey! You! The audacatity to have said the things you have and now this?! Do you want to know the consequences! Well i’ll show you them!
GiGi then whips out her phone herself, a look of anger on her face throughout the process of doing this, as she starts up an instagram live stream of her own…….and instantly changes to a fake wide smile as she starts the stream up, hundreds upon hundreds of viewers quickly pouring in. She glances up at Romero with now a smug smile at the sheer numerical differences in their streams, as she begins to talk to her fans.
GiGi: Hello GiGi Gang! Welcome to an impromptu stream, brought on by more severe aggression against me! And guess who’s the person behind it!
GiGi dramatically swings her phone to reveal Romero in the shot, who’s holding up his phone for his stream as well, as GiGi’s chat goes-
Upon realizing who they’re seeing, as GiGi continues to speak.
GiGi: Once again I have been put in serious danger by Romero, by him as the much larger person trying to bulldoze over me and hurt me in the process!
Romero: I...literally just accidentally bumped into you.
GiGi: You’re lying! I can’t trust a word you say after your threats towards my livelihood, and now my physical well-being! You know what, this calls for retaliation, Kaitlyn, you’re strong, get him!
As GiGi commands this though, we don’t see anything happen, GiGi, confused as to why Kaitlyn is not doing something for her, turns around, and sees that Kaitlyn has mostly fainted due to the sheer scale of her infatuation with GiGi. Connected to GiGi only by holding on to her foot, where many in chat upon seeing this foot holding simply comment “God I wish that was me”.
Romero: Well, considering the state of Kaitlyn, i’m not sure she’s up for much of a fight in this moment. So unless you are, I think we’ll need another method to settle this, through what has been my goal, a stream battle! Where I handle mine with honesty and openness!
GiGi: Is that all? Easy! You’re on! Kait! Come with!
GiGi then begins to walk away, but is very noticeably slowed by the mostly dead weight of the head over heels Kaitlyn clinging onto her. Due to this GiGi is not able to make nearly as smooth an exit from the scene as she was hoping, but tries to make the best of it by highlighting the struggle she’s going through due to this, pointing the camera down in the process, showing her pastel colored shoes, as we see several “POGGERS” and excited proclamations of “FEET!” in her chat at this.
Romero meanwhile heads his own way, as we see support from the members of his chat-
gayboygayboygayboygayboygayboygayboygayboygayboy: Romeo, u r fuckin sick ur gonna do it
Thats_So_Shibe: Bro no homo but I would like to have anal intercourse with you
Romero makes his way quickly over to a break room, where we see Rizwan and Specialist chatting over a cup of tea for Rizwan, and several cups of coffee for each member of Specialist, as Romero mutters to himself for a moment-
Romero: Fuck what do people like...spinning, they like spinning right? HEY RONDEL!
Rondel then stands up, he and Romero making intense eye contact.
Rondel then jumps on top of the table, Rizwan able to save his tea, but all of Specialist’s coffee gets spilled. Rondel then not only spins, he balances on one leg to do the spin, mixing in several hops into the spin to add even more onto it, before finishing the spin, and stepping off the table. He then offers to replace everyone’s spilled coffee, as he goes to get more, but not before he and Romero both communicate to each other with a thumbs up. As the chat that has now grown to 25 unique views POPS OFF
We then cut back to GiGi, where we see on her stream her attempts to geti Kaitlyn functioning again. We see GiGi more gently poking her, shaking Kaitlyn, throwing a glass of water on her face, all to no avail! Before she finally switches up the strategy, and slaps Kaitlyn across the face, this action finally making her functionable again, as a wide smile forms on her face, as she springs to her feet. This once again drawing many “damn I wish that was me’s” from the chat. As GiGi then speaks to Kait-
GiGi: So, you’ve been allied with Romero before right? Knowing him from that, and knowing him now from his evil actions, what do you think he could be doing right this moment?
Kaitlyn: Uhm, he could be showing off his wardrobe right now? Yours is just, so much more expansive and prettier than his, I think you can easily take away the few viewers he has by showing off your-
GiGi: Not bad...but I think I got an idea better.
We then cut back to Romero again, where he’s showing off more of his wardrobe, where he is currently clad in a maroon red beret, glasses straight from a sexy secretary halloween costume, a white/maroon striped shirt tucked into tight fit jeans, and a leather jacket over it all. Romero hits several poses in this outfit, but as he’s focusing on himself in the mirror and showing off the outfit and his figure in it to the audience in his chat, we see GiGi and Kaitlyn sneak up in the background. Keeping a low profile, but enough to be noticeable in the lower frames of Romero’s stream, and obviously visible on GiGi’s stream as we switch to her view of her slowly crawling her way towards Romero’s set up. Where we see his set up is organized into different pieces, the tops/bottoms/jackets/hats/accessories all put into different sections. We see GiGi and Kaitlyn coordinate to take one thing of each from all of those while Romero is focused entirely on his posing. Then they go to make their escape and with wonderful timing, because as they start, Romero for the first time fully turns around to show off the outfit from behind! GiGi and Kaitlyn barely dodging out the way with all the stolen clothes. As we then hear Romero say-
Romero: Alright, I hope that was enough for all of you! Now, onto the next outfit…
Romero then goes through each his sections, making most of his next outfit….but cannot find the hat for it!
Romero: Yo what the fuck… know what, i’ll skip that one, next outfit!
Romero then goes through his next outfit…..but finds that he is now missing the jacket that goes with it!
Romero: HUH?! Again?!! Well uhhh….third time’s the charm I guess!
Romero then looks through his next outfit…..but cannot find the top to it!
Romero: WHAT THE FUCK?! Hold up, somethings going on here….
Romero then goes to grab his phone, and check insta live chat, where they are spamming “GIGI STOLE YOUR CLOTHES” in the chat, as an anger then manifests in Romero’s face.
Romero: She took my clothes?!........I’ve gotta do something about this man..
We then cut to GiGi and Kaitlyn still streaming, where we now see GiGi attempting a try on an article of clothing she stole from Romero, a denim jacket…..emphasis on *try, as we see that the jacket looks less like a normal jacket, looks less like an oversized jacket, but more like a straight up blanket on GiGi, nearly completely covering her all on it’s own.*
GiGi: What do you say Kait? I think these are so big on me they could really work as a unique shoot, maybe make it available for patrons donating $750 and up, or you could take them for yourself if you want, they’d still be quite large on you but not to the point where you could make your bed with it.
Kaitlyn: Oh, um, no, no thank you, I think i’d like to see more you wearing some of his stuff..
GiGi: Ooohhhh, well I know I already have one patron on board, say, how exactly would you enjoy seeing me wear it?
Kaitlyn: Well...uh….maybe with, nothing….uhhh
GiGi: Nothing what?
Kaitlyn: Uh…..umm…......nevermind…
GiGi: Alright, just if you ever do want some of this stuff let me know, you gotta take advantage of your top patron exclusive reward of receiving one individual piece of clothing from me!
As GiGi says this, we then hear the door into where they are get kicked down, as through the rubble, emerges Stephen Romero, Kaitlyn looks defensive and ready to scrap, as GiGi initially panics.
Romero: Hey! All that is my damn clothes!
In her panic, GiGi grabs the oversized denim jacket, and tosses it at Romero’s face as a distraction! Before GiGi bails out the room before anything can escalate! Kaitlyn still looks primed to defend, but GiGi forcefully grabs her anyway, pulling her away from the scene all the same.As Romero the takes his denim jaket he got thrown back in, he smiles that it still fits, and puts in on, striking a pose to his crowd in his chat.
Romero: Well…..I lost several hundreds of dollars and cool pieces of clothing because of that……...but at least this denim jacket is still sick though!
Romero then strikes more poses for the fans, as we gradually fade out on the scene.
We come back to the ring, where we see Javier standing in the middle of the ring, ready to announce.
Javier: The following is a tag team match, set for one fall, with a 30 minute time limit! Introducing first-
The Fall III by Doping Hornets comes through the speakers, as we see Mercenaire and Marshall Wheeler both come out from behind the curtain. Both disregarding the audience, as they stride to the ring with confidence.
Javier: From Houston, Texas, and A Dark, Dark Place respectively, weighing in at a combined 480 pounds, Marshall Wheeler, Mercenaire, Coup d’Etat!
Woodbridge: Being announced from Houston and A Dark Place as separate things? Ain’t those the same thing?
Paisner: Mark!
Woodbridge: Sorry, had to take the opportunity when I had it. Digressing from that, we’ve got one hell of a tag match coming up! As we got two men who are talented and angry, one hell of a deadly combination if i’ve ever seen it. Feeling overlooked, they have a chance to channel that anger into their biggest tag challenge yet in SPECIALIST. They’ve proven they can take care of those they should absolutely beat, now lets see how they fare against those where it’s more of a 50/50.
Wheeler and Mercenaire continue to stoically march their way down to the ring, paying to mind to the jeers tossed their way, as they both reach the ring apron, and step through the ropes in sync with one another, before the two take a spot at the end of the ring, looking out to the entranceway, awaiting their opponents.
The Anomoly by Scar Symmetry blasts heavy riffs throughout the venue, as we see Presagio Del Fin and Nelson Butterfly out on the entranceway. Clinging onto one another, a look of determination on their face.
Javier: And introducing next, from Parts Unknown, weighing in at a combined 437 pounds, Presagio Del Fin, Nelson Butterfly, S.P.E.C.I.A.L.I.S.T.!
Paisner: Now, two very strange men coming down to the ring, the traditional pair of SPECIALIST representing it tonight, and despite their unorthodox in-ring methods, there’s very few others who have as much chemistry and knowledge of each other inside and out as SPECIALIST do. And that unorthodox style? Might be exploitable, but if you don’t know that exploit, you get torn apart by it. And inexperienced wrestlers like Mercenaire and Wheeler may be prime for not knowing, this could be a huge win for SPECIALIST here tonight!
Butterfly and Presagio make their way down to the ring with their arms linked together, interacting with the fans, handing out hand slaps as they walk down the entranceway. They begin to practice their respective underhooks and pins to make sure they’re warmed up, before finishing their way to the ring, as they step into it. We see both Coup d’Etat and SPECIALIST talk amongst one another, as we see Mercenaire and Presagio step onto the aprons. While Wheeler and Nelson stay in the ring, Undersach signaling to see if they’re all ready, and getting nods from everyone, rings the bell!
As the match starts, Wheeler and Nelson slowly approach each other, they lock up, as Wheeler then goes to slip behind Nelson right after! Grabbing Nelson’s head, pulling it back, and driving a european uppercut into the back of Nelson’s head! Nelson holding at the back of his head, before Wheeler shoots a forearm shot into the back of Nelson’s head! Sending Nelson stumbling forward, as Wheeler then runs the ropes, and comes back to attempt an enzu lariat to the back of Nelson’s head, but Nelson drops down! Fitting in between Wheeler’s legs, as Wheeler stops himself after a moment, and turns around to Nelson who had gotten back to his feet, who grabs Wheeler in a double underhook! Wheeler tries to struggle out, but Nelson lifts his knee up into Wheeler’s face! Doing it multiple times until he has Wheeler sufficiently harmed, where upon which, Nelson tosses Wheeler back across the ring with a butterfly suplex! Wheeler landing hard on his back, gritting his teeth in pain!
Paisner: Wheeler trying to quickly strike Nelson down, but Nelson dropping down, then quickly into offense through his patented double underhook!
Wheeler then begins to push himself up, sitting up, then getting onto his hands and knees to try and make his way to his feet, but Nelson swoops in quickly, nails an elbow to the top of Wheeler’s head, and hooks Wheeler’s arms to bring Wheeler up on his own terms. Nelson takes Wheeler over to his tag corner, shooting a look at Presagio to cue him to tag himself in. Presagio sets himself up near Nelson, as Nelson tosses Wheeler up into the air with the set up for a double underhook powerbomb, but instead of following through with it himself, Presagio instead comes in as the one to catch and add his own force to slam Wheeler down to the mat with the assisted tiger bomb! Presagio sitting down with it!
Paisner: Nelson combining well his double underhook and tag team mastery! And of course Presagio keeps the sit-out for a pin!
1! No! Kickout from Wheeler!
Wheeler kicks out with a bit of force, rolling onto his stomach as he does, as Presagio gets up, sizes up Wheeler as Wheeler begins to push himself to his feet, and runs towards the ropes! Jumping onto and bouncing up off of them as he reaches them, and launching himself back at the now to his feet Wheeler with a springboard hurricanrana! Keeping it for the rana pin!
2! No! Kickout right at 2 from Wheeler!
The force from Wheeler’s kickout pushes Presagio off of Wheeler, Presagio flung outwards as the two have their backs to one another. Both of them attempt to rise to their feet, but Presagio as the healthier man is a good deal faster, and with that, hooks Wheeler from behind him, gets back-to-back to him, and goes down into a backslide pin on Wheeler!
2! No! Kickout from Wheeler again!
As we get another kickout from Wheeler, both men go to scramble to their feet, and as Wheeler rises, Presagio responds with a knee to the gut to double him over, and keep him in place! Following up by going to the ropes, and jumping off for another springboard! This time going for a springboard crossbody, as he connects with Wheeler! But suddenly, Wheeler rolls through the momentum of the crossbody! Coming out of it with Presagio in his grasp, holding Presagio in front of him! Wheeler then lifts Presagio, and goes to toss Presagio over his head, but Presagio shifts his momentum in mid-air and lands on his feet!
Paisner: Presagio nearly reversed, but he finds his own way of escape! Directly countering the counter!
And as Presagio lands on his feet, he grabs Wheeler from behind and goes to roll him back into an o’connor roll!.....but Wheeler once again moves his own momentum through! Going into his own o’connor roll!....but he still does not stop! Continuing to follow through by going to lift Presagio up in a rolling german suplex! Lifting Presagio up halfway, but Presagio desperately struggles! Kicking his feet and swinging his arms, until he lands enough wild strikes to force Wheeler to let him go! Wheeler backs off a bit, as Presagio takes a moment to catch his breath and recover, before beginning to run towards the ropes!.......but not before Wheeler recovers himself, and comes forward to spin around, and connect with a spinning back elbow to the back of Presagio’s head! The impact and suddenness of the strike knocking Presagio flat to the mat!
Presagio is completely laid out, as Wheeler bends his knees for a moment in order to catch himself, before grabbing the limp body of Presagio, and dragging it over to his tag corner, where upon which he lifts Presagio’s body and tosses it into said corner, and tags in Mercenaire. Wheeler then lifts his leg up high, and presses it up against Presagio’s neck to both keep him in place and choke him out!
As he does this, Mercenaire enters the ring, and backs up to about the center of the ring, before rushing towards the corner, and just as Wheeler releases his foot choke and moves out the way, Mercenaire connects with a big boot in the corner to the head of Presagio! Knocking him back down limp to the mat!
Presagio is completely out on the mat, as Merc stands over him, leans down to grab him, then tosses him right back in the corner where he begins to lay in body punches to the stomach of Presagio! Doubling Presagio over in the corner, as Merc then lays in pointed elbows to the back of Presagio’s neck! Raining down elbow after elbow on Presagio, forcing him lower and lower down in the corner, until he’s dropped to a seated position. Upon which Merc just puts his boot on Presagio’s face, and rubs it in!
Woodbridge: Mercenaire just absolutely relentless right now! No mercy nor respect given!
Undersach begins to count off Mercenaire, and gets all the way to the 4 count before Merc removes his boot and finally relents!
submitted by youto2 to wrestlingisreddit [link] [comments]

Hormone Therapy for Transfeminine Non-Binary Individuals and Femboys 101

In the last few years there has been increasing interest in transfeminine hormone therapy for non-binary individuals. The goal of this form of hormone therapy is often to induce some but not all aspects of demasculinization and/or feminization. Sometimes the aim is to achieve a more androgynous or completely androgynous appearance. Other times it's to achieve a partially or fully feminine body with the sole exception of breast development.
In some cases, the person may not even identify as "transgender" but rather as, e.g., a femboy. These are cisgender males who don't want genital reassignment surgery nor generally want decreased sexual function but nonetheless want to have more feminine bodies. See femboy, feminineboys, and femboytransition for relevant subreddits. Whatever the goal, these non-conventional transfeminine non-binary and even cisgender individuals are increasingly deciding to act on their feelings and pursue hormonal changes.
I am a transgender woman, but I totally sympathize with these individuals, whether transgender or cisgender. Since this approach is very new and there is very little available that's written on this topic (including close to nothing in the published literature), I thought that I would do a write up on the topic. In this thread, I'll go over the various possibilities for non-conventional feminizing hormone therapy for non-binary individuals and femboys.
It should be noted that the content in this thread is experimental and preliminary. There have been no studies of non-conventional hormone therapy for non-binary individuals as of present, and there are no standards or guidelines to inform this kind of hormone therapy. Instead, all of the information in this thread is extrapolated from theory and from research in other patient populations, such as cisgender men with prostate cancer and/or gynecomastia and transgender women. The content of this thread should be considered an exploratory "white paper" of sorts rather than as therapeutic recommendations or anything of the sort.

Conventional feminizing hormone therapy

In conventional hormone therapy for transgender women, otherwise known as male-to-female hormone replacement therapy (MtF HRT), the goal is to produce complete demasculinization and feminization. This is achieved by suppressing testosterone levels into the normal female range and increasing estrogen levels into the normal female range. It's generally done by administration of estrogens, which induce feminization and suppress testosterone levels (thereby providing demasculinization and permitting full feminization), and optionally by administration of antiandrogens or progestogens, which block or suppress any remaining testosterone that persists even with estrogen therapy.
Medications used in MtF HRT include estrogens like estradiol and estradiol esters such as estradiol valerate; antiandrogens like bicalutamide, spironolactone, and GnRH agonists/antagonists; and progestogens like cyproterone acetate and progesterone. 5α-Reductase inhibitors like finasteride and dutasteride have been used as targeted antiandrogens that inhibit only specific androgenic effects, namely in skin and hair follicles.
For a thorough introduction to feminizing hormone therapy for transgender women that covers the effects, medications, routes, and dosages, see Hormone Therapy for Transgender Women 101. In addition, see the Medications#Medications) section of the Transgender hormone therapy (male-to-female)) article on Wikipedia.
If a non-binary transfeminine person or a femboy doesn't mind complete demasculinization and feminization, including breast development, then conventional feminizing hormone therapy can be employed. If this is not the case however and prevention or minimization of feminization or breast development are desired, things become more complex...

Achieving androgen deprivation

If the goal of non-binary hormone therapy is simply to achieve an androgynous appearance with minimal or no feminization, this can be achieved via deprivation of testosterone without concomitant administration of an estrogen. There are a number of ways to achieve androgen deprivation or testosterone suppression in people assigned male at birth. These include high-dose progestogen therapy, medical and surgical castration with GnRH agonists/antagonists or orchiectomy, high-dose androgen receptor antagonist therapy, and a few other miscellaneous possibilities. In this section, I'll discuss androgen deprivation largely from the standpoint of efficacy. There are issues with androgen deprivation alone in terms of tolerability and safety due to the co-consequence of estrogen deficiency however, which I'll discuss in the subsequent section.
Testosterone suppression with high-dose progestogens
Androgen deprivation can be achieved with high doses of progestogens, which suppress testosterone levels by up to 70 to 80%. This is a substantial decrease in testosterone levels, but isn't quite into the female range. Androgen receptor antagonists can additionally be included to block the remaining 20 to 30% of testosterone that isn't suppressed if desired. For these purposes, low-dose cyproterone acetate (e.g., 5.0–12.5 mg/day; link) plus bicalutamide (e.g., 12.5–50 mg/day) or spironolactone (e.g., 200–400 mg/day) is likely to be an effective regimen. As an alternative to cyproterone acetate, high doses of other progestogens, such as just about any other progestin, or alternatively rectal progesterone (link), can be used instead.
Testosterone suppression with medical or surgical castration
Another option for androgen deprivation is the use of a GnRH agonist or antagonist. These medications suppress testosterone levels by about 95%, or into the normal female range or male castrate range (<50 ng/dL). However, GnRH agonists and antagonists are very expensive, although there may be some viable options for obtaining them more cheaply (e.g., purchasing from certain online pharmacies/vendors).
Alternatively, a gonadectomy, or surgical removal of the gonads, can be performed. However, this is expensive (a few thousand dollars USD), requires minor surgery, can be difficult to obtain. Most surgeons require letters from gender therapists and real-life experience; informed-consent surgeons do exist however. It's also irreversible, notably resulting in permanent loss of testes and sterility. With that said however, gonadectomy is far less expensive and much more convenient than GnRH agonists and antagonists in the long run.
Testosterone blockade with androgen receptor antagonists
High-dose bicalutamide monotherapy (e.g., 150–300 mg/day) is an option for androgen deprivation therapy (link). However, bicalutamide monotherapy increases testosterone and hence estradiol levels. The testosterone will be blocked by bicalutamide and will not have effects, but estradiol is increased to a concentration range that allows for marked or full feminization, including breast development. In addition, bicalutamide alone, even at very high doses, might not be enough to completely block male-range testosterone (link). With these considerations, if the goal is full demasculinization with no feminization or breast development, bicalutamide monotherapy is not something that, at least alone, can achieve this.
High-dose bicalutamide is expensive and potentially cost-prohibitive. High-dose spironolactone monotherapy is not a good option for this route as it is a relatively weak antiandrogen and likely falls far short of being able to handle male-range levels of testosterone (at least 200 mg/day appears to be required to fully block female testosterone levels; source; sixth paragraph specifically). Concomitant partial suppression of testosterone and estrogen levels via additional use of a progestogen (e.g., cyproterone acetate) may be a more feasible option than an androgen receptor antagonist alone.
Some potentially major advantages of high-dose bicalutamide monotherapy are that in contrast to marked or full suppression of testosterone levels, bicalutamide monotherapy largely preserves sexual desire and erectile function and likely does not result in infertility.
Other options: lower doses, 5α-reductase inhibitors, and nandrolone decanoate
Another option is only partial demasculinization, which can be achieved essentially by using lower dosages of the medications discussed above (e.g., cyproterone acetate, bicalutamide). If desired, 5α-reductase inhibitors can be added in this context to more substantially decrease scalp hair loss and body hair growth. Note that if testosterone is more fully suppressed or blocked however, there is likely to be little or no benefit with 5α-reductase inhibitors.
Yet another possibility could be to incorporate low-dose nandrolone decanoate, an androgen receptor agonist and anabolic–androgenic steroid (AAS) with much less masculinizing/androgenic effect in skin and hair follicles (link). This drug will help to suppress and hence replace testosterone levels. Nandrolone decanoate might also have the benefit of helping to maintain sexual desire and function. However, nandrolone decanoate was recently discontinued in the United States. Oxandrolone is another, similar AAS, but has been associated with liver toxicity.

Avoiding estrogen deficiency

While androgen deprivation therapy is effective for achieving the desired changes – specifically demasculinization without feminization – it is not recommended by itself. This is because estradiol is produced from testosterone and hence androgen deprivation results in estrogen deficiency as well. Estrogens are essential for maintaining bone density in both men and women, and without them, a person will quickly lose bone mass, eventually develop osteoporosis, and be at a high risk for bone fractures. Skeletal/postural disfigurement will also eventually occur (image, image). In addition, the person is likely to experience other menopause-like symptoms, such as hot flashes, mood and sleep issues, sexual dysfunction (e.g., low sexual desire, erectile dysfunction), and accelerated aging of the skin (link). An increased risk of weight gain, type 2 diabetes, cardiovascular disease, and dementia is associated with androgen/estrogen deficiency as well. As such, extended deprivation of both androgens and estrogens with no estrogenic supplementation is not advisable in the slightest.
With that said, a couple of clarifications should be made. Due to preservation of estradiol levels, high-dose bicalutamide monotherapy has minimal to no risk of bone density loss or most other menopausal symptoms. In addition, the low-dose cyproterone acetate plus low-dose bicalutamide option may have less of a risk of menopausal symptoms and possibly osteoporosis as well. This is because high-dose progestogens (of which "low-dose" cyproterone acetate certainly qualifies) can help treat certain menopausal symptoms such as hot flashes and possibly bone density loss, and also because some estradiol will be preserved (since testosterone will only be suppressed by 70 to 80% rather than more fully). With that said however, in the latter case, it's probably best not to take any risks.
Selective estrogen receptor modulators (SERMs)
Instead of only androgen and estrogen deprivation, the inclusion of so-called partial estrogens, or selective estrogen receptor modulators (SERMs), can be employed. These medications are partial agonists of the estrogen receptor, and have mixed estrogenic and antiestrogenic effects depending on the tissue. For example, the SERM raloxifene has estrogenic effects in bone, fat tissue, and the liver, but antiestrogenic effects in the breasts. In general, SERMs reduce bone density loss and osteoporosis risk while not causing breast development (and actually blocking it). A full list of SERMs can be found here. However, practically speaking, only raloxifene (Evista), tamoxifen (Nolvadex), and toremifene (Fareston) are available, inexpensive, and commonly used. For an overview of the estrogenic and antiestrogenic effects of the different SERMs in different tissues, see here. In general, SERMs have a fairly similar pattern of effects. Although we have some idea of the differential tissue effects of SERMs, in many cases we do not know how they behave in specific tissues. For example, only a single clinical study has shown that a SERM, specifically raloxifene, has estrogenic effects in fat tissue (link). In addition, it's less clear how SERMs behave in, for example, skin, or in most of the brain.
SERMs also have various side effects. For instance, SERMs commonly produce hot flashes as an adverse effect. However, the fairly recently introduced combination of bazedoxifene/conjugated estrogens (Duavee) has been found to reduce the incidence of hot flashes in postmenopausal women (source). It is still on-patent and hence is expensive however. In any case, SERMs are also likely to produce other menopause-like symptoms. Additionally, SERMs have estrogenic effects in the liver and therefore increase production of coagulation factors and decrease production of insulin-like growth factor-1, among other potentially undesirable changes. Due to the increase in coagulation with SERMs, they have a notable risk of blood clots and cardiovascular complications like stroke. Some SERMs, like tamoxifen, also have unique off-target actions and risks, like rare liver toxicity. Raloxifene is probably among the safer SERMs.
SERMs are effective for maintaining bone density. However, they are, unfortunately, only partially effective for this purpose; significantly more so than no treatment at all, but less so than estrogens. Indeed, SERMs have actually been found to significantly antagonize the effects of estradiol on bone (source). In addition to SERMs, other measures to maintain bone mineral density, such as bisphosphonates like alendronic acid, calcium supplementation, and/or vitamin D supplementation, could be included for further benefit to bone health (source, source). Bisphosphonates have adverse effects and risks however. Weight-bearing exercise is also beneficial for bone density (source). Interestingly, probably due to its off-target antimineralocorticoid activity, spironolactone may be an option to prevent bone density loss; it was found at 100 mg/day in one randomized controlled trial to fully prevent GnRH agonist-induced bone density loss in women (source). However, this was a single small study that has yet to be replicated, and hence supporting evidence is weak.
Low-dose estrogen supplementation
An alternative to partial estrogens is low-dose estrogen therapy. The problem with this route however is that, in the absence of testosterone, estrogens are highly effective at inducing feminization even at low levels. For example, late pubertal girls and cisgender women with complete androgen insensitivity syndrome (CAIS) have estradiol levels of only 30 to 50 pg/mL (high male range or just above it) yet have complete feminization, including full breast development. See here and here for information and photographs of CAIS women to get an idea. A dosage of oral estradiol of roughly 2 mg/day or estradiol levels of about 30 to 50 pg/mL are what are needed for complete prevention of bone density loss, yet such levels of estradiol are able to induce full feminization (source, source). With that caveat however, estradiol has a much better tolerability and safety profile than SERMs. But taking estradiol in conjunction with marked androgen deprivation, even at only low doses, would essentially be a full transition. It may be feasible to take it at very low doses, achieving estradiol levels of only maybe 20 pg/mL, however. But this would not adequately protect against bone density loss and other menopause-like symptoms, and would likely still produce at least partial feminization. (Even GnRH agonists/antagonists and orchiectomy alone have a rate of mild gynecomastia of as high as 15%; source.)
Onset and reversibility of bone density loss
Somewhat reassuringly, bone density has been found to substantially or fully recover within a few years following discontinuation of progestogen-only birth control (and consequent marked but partial suppression of estradiol levels) in young premenopausal women (source). Hence, a limited-duration treatment period, for instance to try out non-binary/femboy hormone therapy, might be reasonably safe in terms of bone health. However, long-term therapy should definitely ensure adequate measures against bone density loss.

Prevention or minimization of breast development

Suppression or blockade of estrogens
If the goal is to produce full demasculinization and some or full feminization with the sole exception of breast development, there are a number of ways to possibly achieve this. Androgen deprivation without estrogen supplementation will achieve demasculinization without any feminization or breast development (except for bicalutamide monotherapy of course). However, it's not recommended for reasons described above and wouldn't provide feminization. SERMs are an option; in addition to their capacity to treat osteoporosis, they are used to treat gynecomastia in men, and are capable of fully blocking gynecomastia induced by estrogens when used at sufficient doses (source). However, SERMs may allow for only partial feminization rather than full. Aromatase inhibitors, in contrast to SERMs, have no apparent place in this form of hormone therapy, as they are, surprisingly, poorly effective for prevention of gynecomastia (source, source).
A problem with SERMs: increased testosterone levels
A problem with the use of SERMs to prevent breast development is that when they are used in a person assigned male at birth in whom the gonads are intact and testosterone levels are not suppressed, they will induce a substantial increase in gonadal testosterone production and hence circulating testosterone levels. In men with hypogonadism (low testosterone levels), the SERMs clomifene (20–50 mg/day) and enclomifene (12.5–25 mg/day) increase testosterone levels from about 200–300 ng/dL to about 450–600 ng/dL (a change of about 2.0- to 2.5-fold, with an absolute increase of 250–400 ng/dL in this patient population) (source, source). Because they are so effective at increasing testosterone levels, SERMs are used to treat male hypogonadism as an alternative to exogenous testosterone administration. Worse still, SERMs appear to cause even greater increases in testosterone levels in non-hypogonadal men. One study found that 50 mg/day clomifene increased testosterone levels by about 850 ng/dL in healthy younger men and by about 500 ng/dL in elderly men (source).
If testosterone levels are suppressed, increases in testosterone levels with SERMs will, depending on the degree of testosterone suppression, be less applicable (e.g., with high-dose progestogen therapy) or not applicable at all (e.g., with medical/surgical castration). However, if a SERM is combined with, say, bicalutamide alone, the situation may become even worse. This is because bicalutamide itself produces considerable increases in testosterone levels similarly to SERMs. In elderly men with prostate cancer, bicalutamide monotherapy induces a 1.5- to 2.0-fold rise in testosterone levels, increasing them from about 300–400 ng/dL to about 500–600 ng/dL (an absolute change of about 150–250 ng/dL in this patient group) (source). In healthy younger men, bicalutamide has been reported to increase testosterone levels to the "upper end of the normal male range" (presumably into the range of around 900–1,200 ng/dL) (source).
As bicalutamide is a competitive antagonist of the androgen receptor, its efficacy is fundamentally both dose-dependent and dependent on testosterone levels. Consequently, in combination with a SERM, it is possible that testosterone levels will become too high for bicalutamide to block. Moreover, endogenous androgens and estrogens are together responsible for maintaining normal homeostatic negative feedback on the hypothalamic–pituitary–gonadal axis (HPG axis) in people assigned male at birth. It seems logical that with little to suppress the axis, gonadal production and hence circulating levels of testosterone and estradiol may simply continue to rise until they overwhelm bicalutamide and/or the SERM it's combined with and restore negative feedback on the HPG axis. For these reasons, it's possible that the combination of bicalutamide and a SERM alone might not be a practical option for non-conventional feminizing hormone therapy.
With all of that said however, the combination of bicalutamide and tamoxifen has been assessed in various studies in men with prostate cancer (source), and increases in testosterone levels have, rather surprisingly, not been a problem in these studies. In terms of the findings, bicalutamide and tamoxifen together do, as expected, increase total testosterone levels. However, the rise in total testosterone levels is not much different from that which occurs with bicalutamide alone. Moreover, free testosterone levels are either increased to a certain degree or are not actually raised at all (source, source, source). This is thought to be due to the fact that SERMs have potent estrogenic effects in the liver and result in increased production of sex hormone-binding globulin (SHBG), consequently reducing the fraction of free and hence bioactive testosterone in the circulation. This serves to offset the biological influence of the increase in total testosterone levels. In accordance, and reassuringly, unfavorable changes in markers of androgen receptor signaling, like higher prostate-specific antigen (PSA) levels, have not been observed relative to bicalutamide alone in the studies.
It's not clear why studies of bicalutamide plus tamoxifen have observed increases in total testosterone levels that are not that different from those of bicalutamide alone. Whatever the reason, these studies suggest that the combination of bicalutamide and tamoxifen (or certain other SERMs) might actually be feasible still for non-conventional feminizing hormone therapy. With that said however, elderly men are a different patient population than non-binary transfeminine people and femboys. Older men have diminished increases in testosterone levels with bicalutamide and SERMs compared to healthy young men. In relation to this, the combination might not be as favorable for younger people assigned male at birth.
Tamoxifen very well may be exchangeable with raloxifene for use in combination with bicalutamide. However, it should be noted that in contrast to tamoxifen, raloxifene has never been studied in combination with bicalutamide. Or, at least, not in gonadally intact men; one study of bicalutamide with raloxifene in castrated men with prostate cancer does exist, but that doesn't provide much in the way of useful information (source30260-9/fulltext)). Nor has raloxifene actually been properly studied for prevention of gynecomastia. A single retrospective chart review reported that it was effective for pubertal gynecomastia in boys (source). But that's all the data we have. Conversely, there are many high-quality studies of tamoxifen for prevention of gynecomastia, including in combination with bicalutamide.
In any case, used by themselves in men, raloxifene has been found to result in lower increases in testosterone levels than tamoxifen or toremifene (source). As such, bicalutamide and raloxifene together may indeed be similar in terms of testosterone levels relative to the combination of bicalutamide and tamoxifen. This might just be due to raloxifene having lower efficacy as a SERM than tamoxifen or toremifene at the relevant clinical doses however (source).
Topical androgens
Another possibility for prevention of breast development is topical application of a non-aromatizable androgen (i.e., an androgen that can't be converted into an estrogen), such as dihydrotestosterone (DHT; Andractim), to the breasts. Androgens substantially oppose the actions of estrogens in the breasts, and have been shown to be effective in the treatment of gynecomastia similarly to SERMs (example).
Unfortunately, pharmaceutical topical DHT is only available today in France (link). Some compounding pharmacies in certain countries might provide topical DHT preparations. However, DHT is reportedly not available from any compounding pharmacies in the United States (source). In contrast to DHT, testosterone readily converts into estradiol via aromatization and can actually induce some gynecomastia due to excessive estrogenic exposure. As such, unlike non-aromatizable androgens like DHT, use of testosterone for this purpose isn't appropriate. There are few or no other options for topical androgens besides testosterone and DHT, so the practicality of this route is limited.
In contrast to SERMs, topical androgens may not be fully effective for preventing breast development. In addition, topical application of androgens to the breasts is very likely to cause local body hair growth and other local androgenic effects (e.g., masculine skin changes, oily skin, acne), which for many transfeminine individuals is probably unacceptable. Lastly, there is a risk of systemic distribution of the topically applied androgen (example) and hence androgenic or masculinizing effects elsewhere in the body. This risk would be lessened in combination with an androgen receptor antagonist like bicalutamide however, although androgen receptor antagonists also risk blocking the local effects of the topical androgen.
Breast removal surgery and breast irradiation
Two non-medication-based alternatives for prevention of breast development are prophylactic surgical breast removal and prophylactic breast irradiation.
If there is no excess skin, mastectomy, or breast removal surgery, can remove the breasts without leaving obvious scars, as was the case in this young transgender man. Mastectomy is a highly effective means of preventing breast development. Of course, it requires surgery however.
Exposure of the breasts to radiation inhibits subsequent breast development (photos). Irradiation of the breasts is an inexpensive, easy, and effective technique that is commonly used as prophylaxis against gynecomastia in men with prostate cancer treated with estrogens or high-dose bicalutamide monotherapy (source00080-6/fulltext)). It is less effective than SERMs however and generally only reduces the severity of gynecomastia rather than fully prevents it (source00080-6/fulltext)).
More concerningly, there is a theoretical increased risk of breast cancer with exposure of the breasts to radiation (source30220-7/fulltext)). Research has observed a 100-fold higher incidence of breast cancer in young women whose breasts were exposed to radiation during childhood as a consequence of radiotherapy for cancer when compared to other young women (source). On the other hand, limited available evidence so far suggests minimal if any increase in breast cancer incidence in elderly men treated with breast irradiation to prevent gynecomastia (source30220-7/fulltext), source00080-6/fulltext)). We have no data on what breast cancer risk might be like in young breast-irradiated transfeminine people. In addition to theoretical cancer risk, low incidences of heart and lung issues have also been associated with breast irradiation in elderly men with prostate cancer (source, source). Due to these health risks, breast irradiation for prevention of breast development may be an inadvisable option.
An obvious drawback of breast development prevention with both surgical breast removal and prophylactic breast irradiation is that they are irreversible. If the person ever changes their mind about not wanting breasts or eventually decides to fully transition (a not uncommon occurrence), there is no going back on the choice to permanently negate breast development.
Degree, onset, and reversibility of breast development
For reasons that are not entirely clear, it's notable that transgender women tend to have suboptimal/poor breast development (source, photo examples). The reason for this is not entirely clear, but there are various theoretical possibilities (link). Likewise, in generally elderly men with prostate cancer, high-dose bicalutamide monotherapy and high-dose estrogen therapy both cause high rates of gynecomastia but produce only mild-to-moderate gynecomastia in 90% of cases (source, source). (Whether their advanced age is a factor here or not is uncertain though.) Hence, any person who was assigned male at birth should, generally speaking or on average, not necessarily expect a marked degree of breast development. There are always exceptions however, with a subset of transgender women experiencing considerable breast development. Hence, the degree of breast development is a matter of chance, and caution should be advised.
There are a few things to note about breast development. One is that it occurs slowly and is not something that happens overnight. Another is that it's not going to progress further if medications are withdrawn. And finally, it seems to be at least partially reversible if medications are discontinued within a certain amount of time (e.g., one year) (source, source). For these reasons, it should be entirely feasible for a given person to self-monitor their breast development, and, if it becomes too much for their liking, to alter their medication regimen as desired in order to prevent further or reverse existing breast growth. Hence, breast growth is not necessarily something that should be feared excessively.

Summary of main potential treatment options

For full demasculinization and partial to full feminization with the exception of minimal or no breast development, here is a review of the major potential treatment options for feminizing hormone therapy for non-binary people and femboys discussed above:
And variations thereof based on the above discussion as well (e.g., 5α-reductase inhibitors, prophylactic mastectomy, additional bone density interventions, etc.).
As some of the commenters have touched on, low- to moderate-dose estradiol monotherapy, resulting in only some or partial suppression of testosterone levels, may also be a useful approach. At least partial breast development is likely to occur with such a route however.

Obtaining care and medications

It may be difficult to find a physician who offers transgender hormone therapy and is familiar with non-conventional hormonal therapy approaches for non-binary transgender people. It can likewise be difficult to find such a physician who is actually willing to treat such people. And this is probably extremely difficult for cisgender femboys, who may best be served by simply claiming to be non-binary or transgender but just wanting an atypical transition. With these considerations, do-it-yourself (DIY) hormone therapy may oftentimes be the most or only real practical option in this particular situation. For materials on DIY hormone therapy, see the Wiki at TransDIY, which includes a list of no-prescription-needed online pharmacies.
submitted by Alyw234237 to MtFHRT [link] [comments]

Darolutamide, a new second-generation nonsteroidal antiandrogen, was just approved for medical use

Darolutamide (brand name Nubeqa), a new second-generation nonsteroidal antiandrogen, was just approved for medical use by the FDA in the United States. It was specifically approved for the treatment of prostate cancer in men, similarly to bicalutamide. This is the first global approval of darolutamide as a medication.
You can read more about darolutamide at the following links:
Darolutamide is a second-generation nonsteroidal antiandrogen and hence is a highly efficacious and selective antagonist of the androgen receptor, the main biological target of androgens like testosterone and dihydrotestosterone in the body. Darolutamide and other second-generation nonsteroidal antiandrogens like enzalutamide and apalutamide are notable in that they have much higher affinity for the androgen receptor and greater antiandrogenic efficacy than first-generation nonsteroidal antiandrogens like bicalutamide, flutamide, and nilutamide. The affinities of these antiandrogens for the androgen receptor are about 5- to 10-fold higher than that of bicalutamide. Although clinical potency is more complex than just affinity, the second-generation nonsteroidal antiandrogens indeed seem to be considerably more capable as antiandrogens than bicalutamide and the other first-generation nonsteroidal antiandrogens. Shortly following the introduction of enzalutamide in 2012, it was amusingly referred to as the "emperor of all antiandrogens" in the title of one review publication (link).
Enzalutamide and apalutamide have certain unfavorable properties however due to non-selectivity for the androgen receptor. Specifically, they are strong inducers of cytochrome P450 enzymes such as CYP3A4, which notably metabolize estradiol and other medications used in transfeminine hormone therapy. In addition, enzalutamide and apalutamide are weak negative allosteric modulators of the GABAA receptor, and hence have a risk of seizures and other off-target central-nervous-system adverse effects such as anxiety and insomnia. These properties are undesirable and limit the appeal of these two new antiandrogens in transgender women.
Darolutamide has none of the problems of enzalutamide and apalutamide. It does not induce nor inhibit any major cytochrome P450 enzymes at clinically relevant concentrations, and hence has a much better profile when it comes to drug interactions. In addition, darolutamide appears to negligibly cross the blood–brain barrier. As a result, it has no risk of off-target central-nervous-system side effects, including seizures.
Darolutamide does unfortunately have some issues of its own however. One issue is that whereas bicalutamide, enzalutamide, and apalutamide all have long half-lives (e.g., 3 to 10 days), darolutamide has a relatively short half-life of only about 16 to 20 hours. As a result, it needs to be taken twice per day at roughly 12-hour intervals, similarly to spironolactone. Another issue is that, similarly to first-generation nonsteroidal antiandrogens like flutamide, nilutamide, and bicalutamide, darolutamide has been associated with abnormal liver function tests (specifically elevated AST levels and increased bilirubin levels). This is unfortunate, as it indicates that darolutamide may pose a small risk of liver toxicity similarly to bicalutamide. In contrast, enzalutamide and apalutamide are not associated with abnormal liver function tests. In any case, with its lack of seizures and major drug interactions, the profile of darolutamide is arguably nonetheless still greatly advantageous to that of enzalutamide and apalutamide.
One unique and very special property of darolutamide is that the medication, as mentioned above, appears to negligibly cross the blood–brain barrier. This is based on the fact that androgen-receptor antagonists consistently increase testosterone levels by up to about 2-fold due to blockade of the androgen receptor in the pituitary gland, whereas darolutamide does not affect testosterone levels. The lack of blockade of the androgen receptor in the brain with darolutamide is notable for the following reasons:
At the same time however, the lack of blood–brain barrier permeation with darolutamide can obviously also be a drawback. If darolutamide does not cross into the brain, then it will not block androgen signaling in the brain and will not prevent the masculinizing effects of androgens on cognition, emotionality, sexuality, and so forth. With that said however, estrogens and progestogens suppress testosterone levels, and can hence substantially diminish the brain effects of androgens in the body regardless of whether darolutamide is the antiandrogen or enters the brain. In this context, the lack of brain penetration of darolutamide may not be as significant of an issue for transgender women.
One final and very important general caveat of the second-generation nonsteroidal antiandrogens is that they all still have patent protection, and hence are very expensive (e.g., $6,000 for one month of treatment). And insurance almost certainly will not approve coverage of them for use in transgender hormone therapy. Moreover, these medications will be remaining on-patent for many more years. Enzalutamide was introduced in 2012, while apalutamide was approved in 2018 and darolutamide was of course just licensed now in 2019. Patent protection on medications generally lasts around 10 to 15 years. Only once patent protection expires will inexpensive generic versions be marketed and will we see darolutamide and the other second-generation nonsteroidal antiandrogens become affordable.
That day will eventually come though, and when it does, I think that darolutamide and the other second-generation nonsteroidal antiandrogens, along with orally active GnRH antagonists like elagolix and relugolix (link, link), will be fantastic additions to the available medication options for transfeminine hormone therapy.
submitted by Alyw234237 to MtFHRT [link] [comments]

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