Questions about microdosing testosterone

A few days ago, I got a message from a reader.  They wrote:

Hi…thanks for taking the time to help others have the advantage of your experience to answer our own questions. I’m non-binary…I had top surgery 3 years ago, but I’m interested in remaining in the middle. I’m interested in a more masculine body structure (less curvy, more masculine fat distribution, stronger jaw line), but wanting to keep my feminine traits like smoothness of skin/not markedly increasing facial hair and not wanting to make the changes to my disposition that it seems can happen with a standard dose of testosterone. I’m interested in being able to build muscle (just definition) for both look and to be strong and healthy. I’ve hit 50, so not so easy with menopause underway. I’m also interested in how this could support my libido.

I’m thinking that microdosing may be a good way for me to do this, but interested in your thoughts. Also, to whom does one go to get this? I’m going to be living in NY/NJ area and it would be great if you could provide any medical professionals in that area. I’m finding that some MDs don’t know much about this and aren’t incredibly willing to discuss. Does one have to have a prescription for this? I’m assuming so. In any case, any info you could provide or point me to would be greatly appreciated.

We messaged back and forth a few times and decided this could be the good basis for a post.  Here’s an attempt to answer their questions, and elaborate on some thoughts they put out there:

Thanks for reaching out!  I started microdosing T so long ago that that word was not yet in use – at least not in this context, haha!  We called it “going on a low-dose of T,” which is clunkier, and it’s cool there’s a more straightforward verb now, even if it brings to mind people taking small amounts of acid for therapeutic purposes, more than anything else at this point.  I’m sure that’ll change over time.

I too, had (have) a list of things I do and do not want from testosterone.  Most of those things have worked out for me, even in the long term, which is mostly based in genetics, but I still feel like I lucked out.  (It can feel like a crap-shoot, especially when you want some, but not all, of the effects that testosterone may cause.)  I haven’t sprouted that beard that I never wanted.  I gained a more masculine body structure.  I still have smooth skin.  It’s helped my libido.  Also my voice is lower, my disposition shifted for the better, it was a real game changer in many ways.  It helped me grow into myself, for sure.

Testosterone is a controlled substance, which definitely means you need a prescription for it.  My journey to actually getting the stuff was bumpy.  Initially I went through a primary care physician who I found to be smarmy.  I put up with him so I could keep getting my prescription until I decided I could do better.  My next physician was hesitant and I really had to advocate for myself super hard.  She conceded for a while but ultimately referred me to an endocrinologist.  The endo wasn’t great either.  I hoarded it as much as I could so that I was not beholden to medical professionals, and so I had the freedom to start and stop when I wanted to, as opposed to when I could get access.  I still do this.  It’s not recommended, but anyone who knows me probably wouldn’t be surprised.

Things have improved vastly in some regions of the US, but of course not everywhere.  Many Planned Parenthoods now offer gender affirming care and hormone replacement therapy on an informed consent model.  Generally it’s a matter of weeks, not months, to get in and get your prescription.  I just did a cursory search, and, by region, here are just some of the places where this is possible:  Southwest Florida, Southeast Pennsylvania, Washington and Northwest Idaho, Northwestern Hawaiian Islands, all throughout Illinois, Western NY, Massachusetts, NYC, Reno Nevada, one tiny town in Arkansas.  Some of these places are not surprising.  Others are.  What makes a specific Planned Parenthood offer HRT or not?!!  One day, eventually, I think they all will.

If anyone has any specific information about providers or options in the NY / NJ area, please leave a comment.  Hope this helps, and good luck!