So you’ve decided to take testosterone. Starting T is an exhilarating and highly disorienting experience. Along with much anticipated changes like a lower voice and a squarer jaw, you’re bound for a radically altered social landscape and shifting internal world. You’re coping with the demands of a second adolescence and a gender transition–and you’ve probably got a full plate of regular life stuff, too.
My first year on T was one of the most beautiful, transformative, stressful and challenging passages of my life. Nearly five years later, I feel at home in my body and my social role; gender isn’t on my list of concerns. If transition is right for you, and T is part of that transition, some time on testosterone is likely to give you a similar sense of ease, belonging, and the precious freedom to worry about other things. Testosterone therapy works. The trick is getting through the intensity of transition with your resources and relationships intact. Here are a few suggestions for surviving your first year on T.
Each person is different, so please feel free to take or leave anything here as it is helpful to you. I’ve aimed this post at people taking T with the intention of bringing levels into the male range.
1. Expect chaos. You are diving head first into a storm of transformation–physical, social, emotional and otherwise. So expect stormy conditions for awhile. Your sleep, appetite and libido are all likely to change dramatically (including possibly increasing by an order of magnitude). You may also notice that your moods are all over the map and that people are treating you differently. Know that you are going through an intense period of change. Remind yourself that this does not last forever. Make any accommodations that you can to make this a bit easier on yourself. Eat snacks, take naps, take time to care for yourself. This is not good time to take on any huge new projects. Let transition be your project for awhile.
2. Express yourself. This is an emotional time. Hormones are throwing your moods out of whack. You’re undergoing an important process that you may have brooded over for years. And you’re coming up against the longing, shame, stigma, and hope that characterize the trans experience.
I found that, along with some moodiness associated with my body being in flux, starting T brought up a lot of emotions around being trans. For the first time, I was able to feel my anger at my family and my society for failing to see and accept me. Moving through these feelings is an essential part of the transition process.
Make sure you have plenty of opportunities to vent, share, and connect with other people. See a counselor, talk with friends and family, attend a trans support group, play your favorite sport, keep a journal, create music or artwork, yell as loud as you can from the top of a mountain. Whatever strategies work for you, be sure to create space for your feelings and find ways to express them.
3. Patience is a virtue you probably don’t have. After all the agonizing about transition, after all the hoops and hassles, comes another tremendous challenge–more waiting! You have to wait for your voice to drop, wait for hairs to grow, wait for your body to change shape, wait for others to see you as male. Perhaps you are more patient than I, but this was one of the single hardest parts of transition for me. I was tired of waiting and I had an intense fear that testosterone would somehow not work on me and my body would never change.
But it did work, and it does work. A year from now, you are going to look very different. As much as you’re able, enjoy the ride. Be patient if you can be. At least, be patient with you impatience.
4. Masturbate. Everybody talks about how libido increases with T, and for me, it was totally true. If masturbation is something you enjoy, now is an excellent time to enjoy it. I jerked off a lot during my first year on T. It’s a great way to adjust to any libido changes, and also provides a nice chance to relieve stress and get to know your changing body.
5. Be self-absorbed. Might sound like weird advice. But people in transition are guaranteed to be a bit more self-absorbed than usual. It’s an intensely introspective, self-focused process. After years or decades of living in the closet, our selves need some extra attention. Like the first time around, this adolescence is a process of self-expression and discovery. It’s important to pay attention and try on different ways of moving and being. So don’t fight it–just go with the flow and be self-absorbed for awhile. Trust that by going into this process completely, you will soon enough arrive on the other side.6. Remember to listen. It makes sense to be focused on yourself right now. But don’t neglect the important people in your life, either. Show up for your partner, friends and family by giving them your time and your full attention. Be ready to put the transition stuff down for awhile and hear about what’s going on for other people.
Also be prepared to listen to their feedback for you. At some point, someone is going to tell you that you’ve been a jerk recently, you’re angrier than you used to be, or you’re waving your male privilege around. From one guy to another, they are probably right. Don’t make time for folks who put you down or reject your transition–but be ready to hear challenging feedback from the people who love you. This is just part of being a dude in our society; you’re not going to do it gracefully on your very first try. Listen with patience and openness, and be curious about how your behavior can change.
7. Celebrate small changes. Most of us are focused on the big, exciting changes, like muscles, a beard and being seen as male everywhere you go. But the little changes are just as delicious, and in some ways, it’s the small stuff that really makes your transition. Notice the new hairs sprouting up on your belly, each time your voice cracks, the way people move a little differently around you, the veins just a bit more visible on your arms, even the pimples. It’s all these tiny signals that sooner or later come together and present a new side of you to the world. Enjoy them.
Readers–what advice would give to someone just starting T? If you’ve started T recently, how are things going so far?
To T or not to T? It’s a tough question. Testosterone is a powerful hormone that can radically alter your body and your internal landscape. For many trans guys and some nonbinary people, testosterone is a ticket to a new world in which body, mind, spirit, and social perception finally align. But how can you know in advance whether that new world is really right for you? And what if the ticket is one-way?
I have been on testosterone for 4 years, and I’ll probably continue for the rest of my life. I spent several years desperately agonizing about whether to take T, and today I can say it was one of the best decisions I have ever made. Here is the advice I wish someone had given me back when I was wrestling with this question.
1. Do your research. In my experience, trans people turn into veritable internet librarians when it comes to our transitions. If you’re reading this post, chances are you’ve read dozens of articles on the physical effects of testosterone, plus sought out hundreds of blogs, videos and photo timelines documenting others’ experiences on T. But if you haven’t done all that yet, do it.
2. Talk to a doctor. A lot of people–including me–make talking to a doctor the last step of this quest. In retrospect, talking to my doctor early on would have greatly simplified the whole process. Ask whether it would be safe for you to take T based on your other medical conditions, what the process would be to get a prescription, and whether you’ll need any referrals. This gives you a timeline and clear series of steps if/when you decide to move forward with testosterone. If your country uses a structured clinic system, find out what is required to qualify for treatment and how long it takes to access hormones. This info will clear up a lot of the stressful questions that make this process such a challenge, such as, Will I be able to get a prescription? What tests will I need? How long will it take? How much will it cost? Do I need a new doctor? With that out of the way, you can focus on figuring out what you want and need.
3. What will you regret? Suppose you start testosterone tomorrow. Imagine yourself in 10 years. What might that person regret? Now, suppose you never take testosterone. Again, 10 years down the line, what might you regret? Nobody knows the future, but I found this a very helpful exercise. I realized that my greatest fear was never taking this opportunity, looking back and wishing I’d started T as a young guy. On the other hand, I couldn’t muster any real fear about, say, being perceived as a boring straight guy or not trying harder to live as a butch. (I tried as hard as I could.) Look into your heart; there may be helpful answers waiting there for you.
4. Do you want the whole package? Testosterone is a gamble. Each person responds differently based on dosage, genetics, length of treatment, and possibly magic. Think carefully about the effects of T, and ask yourself whether you are open to the whole range of possibilities or really only want some of the outcomes. The changes can happen to varying degrees and in different combinations. You might go in imagining yourself with a deep voice, toned muscles, and smooth skin, and wind up a chubby tenor covered in hair from head to toe–or vise versa. A lower dose will cause subtler and slower shifts, maybe no visible changes at all. But basically there are no guarantees, except that you’ll generally move towards more male-typical traits. Are you looking for the whole experience, external and internal? Or are there just a few specific changes that you want? If, for example, you want a more masculine physique and voice, and are wary of any other changes, you might want to experiment with diet, exercise and voice coaching before you try hormone therapy.
5. Seek guidance from a higher power. With a decision this big, it’s a good idea to turn to whatever sources of wisdom you find meaningful. Does your culture have traditions for gaining insight, beginning a journey or making a hard decision? Do you find meaning in prayer or meditation? Some places you might turn include scripture, religious leaders, faith healers, wise friends or family members, mentors and mental health professionals. This could take many forms depending on your beliefs and culture. A few ideas to get you thinking: get your Tarot cards read, set aside a day to meditate on the question, ask God for help, ask for the answer to come in a dream, create visual art exploring your feelings, go hiking or camping alone. The point is, you probably need to get outside of your mind to find a real answer. Find a way to access higher wisdom or deeper insight that works for you. Whatever resources you have, call on them now.
6. Whatever you do, do it for you. You’re probably facing opinions and pressure everywhere you look. Transitioning is taboo, so you’re probably feeling some pressure not to modify your body, to make it work in your assigned gender (possibly for the sake of feminism, the children, or something), and/or not to do something “artificial” or “unnatural.” On the flip-side, there’s also a strong norm that if you’re going to transition, you better transition to be a normative man or woman, including hormones and surgery. So you’re probably also feeling some pressure to follow a certain path through transition, including a dose of testosterone that will put you in the typical male range. It’s almost impossible to think clearly in this hurricane of social sanction. But, as much as you’re able, try to sort out your own needs and preferences, and make your choices from a place of self-love. Whether you decide to take testosterone or not, do it for you.
7. Go for it. At some point, you have to take a leap of faith and go with your best guess. You may find that you’ve taken plenty of time to think, done thorough research, and reflected deeply on the question, and you’re still not sure what you want. Make an educated guess and move forward, knowing you can change course if needed. If you’ve spent a year or five reflecting and you just can’t stop thinking about testosterone, you’re probably going to have to try it yourself to be satisfied. Let your fears slow you down and make you careful. But don’t let your fears paralyze or stifle you. It’s okay to venture into the unknown. In fact, it’s wonderful.
What questions do you have about testosterone therapy? For those who have been on T, how did you make your decision? What do you know now that you wish you had known then?
I recently switched up my testosterone prescription. I am now using Androgel, after nearly 4 years of injections. I am really pleased with the change and thought I’d compare and contrast the two experiences.
I initially started with injections for two reasons. First, the cost–it’s generally much cheaper. (If you’re paying for testosterone cypionate out of pocket, you might want to look into Strohecker’s Pharmacy. Affordable and awesome.) Second, my doctor informed me that people usually see faster changes with injections, and fast changes were my no. 1 priority at the time.
I’m a rather anxious person, and over the last few years I developed a very negative relationship with my shots. In the beginning, I was highly motivated to get T into my system, so I didn’t really care. Once hormones changed from a matter of urgency to plain old health maintenance, I found it harder and harder to do the shots. I also found the shots got a lot more painful as I shed fat and gained muscle. Alma dutifully did every single one of my injections, despite my frequent complaining about them. (Thank you!!!) I kept thinking things would improve with time, but in fact, they got worse and worse. A couple months ago, I finally decided I’d had enough.
With some effort, I found an affordable way to get the gel. My insurance covers it at a great price if I get it through a special home delivery pharmacy, and it works out to be only slightly more expensive than the injections ($160/year vs $120/year). I’ll be aging off my dad’s insurance plan in a year; hopefully I will be able to continue to get the gel at a reasonable price after that. We’ll see.
Some things I love about switching to Androgel:
- No needles!
- No pain!
- I can do everything myself (never worked up the nerve to do my own injections)
- Levels feel more even (used to get breakouts & feel low-energy at the end of my shot cycle)
A few things I don’t like about Androgel:
- Volume of gel I have to apply. I am on a lower dose (3 pumps/day, similar to 75mg/week in injection terms) and it’s still so. much. gel.
- Worrying about accidentally exposing someone else to T (namely Alma)
- Skin is a bit dry and itchy where I apply the gel
The few downsides are minor inconveniences. I’ve switched my showers from morning to night, so that takes care of the accidental exposure issue. Lotion is helping with the skin irritation. I will get my levels checked in a few months to make sure the gel is doing its job. All in all I’m really pleased with the switch.
Readers who take hormones–what method do you use?