This past Saturday was my two year mark on T-injections, 40ml / week (this was just recently lowered, from 60 – my initial dose was 50). I still very much look forward to every injection (not the act itself, but the being-on-T part), and I still regularly think about the ways hormones have improved my life; I don’t tend to take it for granted.
My original plan was for this to be a short-term thing. But I kind of love it. I think my dose will vary over time, but I don’t anticipate stopping really, probably ever. (Of course that’s subject to change!) Not having a menstrual cycle is huge. Being seen as male 100% of the time is… well, there’s some ambivalence there, but it’s definitely an improvement. Now instead of getting confused for female, I am regularly getting confused for being very young. Which can be awkward but mostly is fine.
I’m able to engage socially in ways I really never could have dreamed of. I look people in the eyes way more. My anxiety is almost zero, where previously, I was operating regularly with an underlying sense of fear and dread. Some of these mental health changes can be attributed to finding a medication that actually works well for me, but a lot of it is the disappearance of gender dysphoria.
I’m still legally female, which is on purpose, and I still almost always go into women’s bathrooms and dressing rooms. I’ve never been stopped or questioned.
I don’t love all of it. I still daily pluck hairs out of my face because I don’t like them and I don’t want to shave. I’m pretty concerned about my receding hairline. And if I were really being honest, I liked the way my face looked before being on injections, more-so than now. It just so happens that the way it is now reads as “male,” and that works out way better for me. Oh well…
So here are the face comparisons:
I wanted to highlight this change, on testosterone, because I’ve vacillated so much over time, and it seems worth noting. Initially, this was the thing I feared the most. It’s one of the changes that happens early on, is irreversible, and is most noticeable. I wanted to avoid it all together, partially because I wasn’t ready to come out beyond what I was comfortable with (my community and friends). I didn’t want this change to “out me” before I was ready. Also, I didn’t want to tip the gender balance – I wanted to be, over-all, androgynous and not definitively masculine in any way.
When I was on a low dose of Androgel (for over 2 years), I successfully kept things right where I wanted them. Then I went off T completely for a while, and in that time, I started DJing for a community radio station. I didn’t like listening back to my shows at first, so I just didn’t. They felt cringe-worthy. Eventually I started listening, and improving, and switching things up. I started to find my voice, suuuuuuper gradually.
About a year in, I was ready to plunge into T-injections and all the changes that may come along with that, including my voice dropping. I had already come out with family and at work and had changed my name legally, so those things were no longer road-blocks.
It was a bizarre and largely private thing to go through. I don’t talk all that much in my daily life, to begin with, so it was a lot of testing out the changes, daily, in my car alone. And then also the radio show, weekly. I know there were times when my voice cracked, but I haven’t listened back, specifically, for that. I’m sure I could find those moments, in the archives, if I really wanted to. But I don’t! Haha.
Fast forward, and I am super satisfied with my voice as it is now. I have a hard time relating to how tortured I felt about it in the past. Along with increased confidence and comfort with my body and my place in the world, my voice just feels natural. It also just feels so much easier to find words, to converse in all sorts of situations, and to be more out there. It is awesome in so many ways.
In preparing for my 100th radio show, I did go back to those first few shows and listened to them probably for the first time. And they WERE totally cringe-worthy, haha. My voice was stilted and stiff; I sounded so unsure of myself. I did a cool thing where I isolated some of the sound clips from those early shows, and then I played them live, on my 100th show. Here’s me, talking about lunch over the course of a handful of shows, before T-injections, and then me interjecting over top of that – you can really notice the change in my voice that way! Also my best friend was there in the studio – she’s the third voice on this track:
My hair is the longest its ever been. It’s also only 3/8 of an inch, on the sides. I cut and buzz it myself. I’m not sure whether it was a conscious decision (probably partially conscious), but as my face has become more masculine, I’ve grown my hair out in the back so that it falls over my shoulders slightly. Also, it has gotten a lot more curly since I’ve been on testosterone.
I was initially on a low dose of Androgel for a few years, and there were really only 2 reasons that I stopped, in December of 2015: 1) I wasn’t sure what it was doing for me, at that dose, anymore. And 2) Was it causing my hairline to recede? That was totally freaking me out!
Two years later, I was ready to give testosterone another try. The pros I envisioned (lowered voice, redistribution of fat and muscle, heightened libido, bottom growth) outweighed the cons I was pretty sure I’d come up against (feeling hotter, sweatier, potential hair growth and hair loss.) And now that it’s been close to a year and a half, on a “regular” dose of injections, I’m still “in it” with that balance. I don’t love all the changes. But I love some of the changes more than I dislike others.
Hair is a big factor. Probably the biggest factor at this point. I’ll start with the easiest, most fun change:
Happy trail!!! I’ve always wanted a happy trail, and now, finally, I have one. That’s all I got to say about that. It is awesome!!!
Facial Hair: I do not like the increased facial hair at all. I regularly – daily – pluck out chin and moustache hairs with tweezers. I kind of love this activity – it’s satisfying to grab and pull out, one-at-a-time, each hair. However, it’s more and more time-consuming, over time, as I have more to pluck out. In addition, I’m sure I’m missing a bunch, especially finer hairs that can be seen in the sunlight. Is this OK? I guess for now, but it is a fine balance. You know that old belief that may or may not be true? That if you shave, the hairs will come back in thicker and darker? I kinda believe that. I don’t want to take that chance with my face. Also, I’m not ruling out electrolysis, as a long-term solution, if it really feels that overwhelming in the future.
Hairline: My hairline has definitely changed since being on testosterone. I have a much more pronounced “widow’s peak.” This is worrisome. Balding definitely runs in my family. I feel vain about it. As of now, I just arrange the curls on the top of my head so that they fall forward, curly bangs covering up male pattern baldness. But I’m not sure if I get to do this forever. Probably not.
I also got some hair growth going on in other parts of my body, like my lower back and legs – all this feels neutral and natural. I’m neither bothered nor excited about it.
I’m actually leaning toward lowering my dose now, as it gets warmer out. I don’t want to feel overheated and smelly and sweaty. And if a lower dose will slow some of the balding down, I’d probably feel better about it. As long as my menstrual cycle doesn’t come back – that’s the balance I’m aiming for right now… I’m sure I’ll feel differently at other points as well, but this is where I’m at.
Today is a year on T-injections, 50ml / week. I’d been on Androgel prior to this – from March 2013 to November 2015. During that time, I didn’t experience many physical changes at all, which was what I was looking for at the time. And it’s kind of the reason I stopped too – it became unclear what the purpose was, as if it didn’t make much difference whether I was on the gel or not.
So for that whole next year, I was trying to square away other elements of my transition, not sure whether I’d get back on testosterone or not. It just felt like I wanted to get top surgery, change my name, and transition further socially before I would potentially want to pursue a level of hormones that would definitely change things in a noticeable way. In the summer of 2016, it started to feel like the next step. I was still pretty regularly seen as female everywhere, and more than anything, I wanted to be more firmly planted in the middle.
It took about 6 months to get an appointment and get started on injections. I was doing intramuscular injections at first for about 9 months, and not liking it. The need to get psyched up in order to jab in the needle was not fun. When my endocrinologist gave me the option to switch to subcutaneous, I jumped at tat. I am loving this method. I wrote about making the switch here: 9 months on T-injections
I like being on this dose of testosterone a lot more than I thought I would. The only aspects I’m not liking are the facial hair growth and the loss of a sense of smell.
I would say that I am seen as male more than I am seen as female, now. That’s huge. I don’t want that to tip too far in that direction, but so far, so good. I’m still legally female, and I still almost always go into women’s bathrooms and dressing rooms. I’ve never been stopped or questioned.
There are a lot of changes I could write about in depth, but right now I feel like focusing on my voice. When I started Androgel, I was overly anxious about my voice changing, in particular. I think it dropped ever-so-slightly, and I freaked out and lowered my dose even further. And that worked – it didn’t change any further. When I started injections, I was aware that my voice would probably be the most noticeable thing changing, early on. And I was OK with that – something had shifted over the years.
I’m a DJ on a free form community radio station, and I’ve done an hour-long show regularly every week for the past two years. It’s been a total blast. And, it’s been a way to effortlessly track the changes in my voice. When I hear pre-T recordings, my reaction is total cringe. Which is quite the shift, since I used to want to “preserve” that register. Now I really hate it! And I love how it’s changed. I can never go back, and I’m totally fine with that!
Aaaand, here’s my face:
I surpassed my best guess at a timeline. When I started in January, I gave the whole venture 6-8 months. I thought I’d start getting uncomfortable with the level of masculinization by that time, and I’d stop. Not for good, just for a while, to level back out, and then most likely start again within another year or two. Something like that. BUT! I really like what’s going on. I like everything except for the facial hair growth, and that’s been pretty minimal thus far. Minimal enough to manage, without having to shave. I like my voice, the muscle growth, legs getting hairier, and clit growth. I haven’t noticed my hairline receding any further than it already has (I was on a low dose of gel for 3 years and saw my hairline change). And I really really really like the cessation of menses. I never had severe symptoms with that, but having it as one less thing, showing up to deal with, cyclically, is a really big plus.
Today was also my 3rd appointment with an endo, and I have a new one now (the one I started with moved to Oregon). I liked her immediately. She wrote down notes. She was curious if my psychiatrist sees other trans-patients, and if I like her, so that she can have someone to refer others to. Same with my therapist. She wanted to know about my experience with my top surgeon. I gave her my full report. She just seemed to really want to get a grasp on who’s who within trans-health, and to glean a lot of that information from actual patients, which felt really validating.
I asked her questions about needle gauges, and she asked me if I was interested in sub-cutaneous injecting. I said, “yes!” even though I hadn’t thought about bringing this up in particular, in advance. It’s just something I’ve heard other trans-people on testosterone talk about as an easier and less painful route. But I assumed it was something totally different, like a different style needle, possibly a different type of oil, etc. I learned it’s not – you just use a significantly smaller needle, and inject it into fat instead of muscle.
This next paragraph is going to be kinda graphic, heads up if you have a needle phobia! So, imagine using a fairly long and thick needle and just jabbing that straight down into your quad muscle, perpendicularly. And then having to push the oil out of the syringe, which does take some force because the oil is thick. This has been painful, to varying degrees, and often there is blood. Sometimes my muscle is sore that night and into the next day. Now, instead!!! I’m gonna get to use a thinner needle, and just slide that in at an angle, but fairly parallel with the skin. It’ll only have to go in a half inch or so, not one-and-a-half inches. It’ll still be hard to push the oil out and in, but just the fact that it’s a layer of fat and not a thick meaty muscle sounds pretty good to me! I can’t wait to switch over! I’ll have to watch some videos or something. The endo did suggest I could come in and a nurse practitioner could show me, but I think I got it.
The one thing about the appointment that felt a little off was she gave me a quick exam, with all my clothes on. This was in itself was fine, although I was caught a little off guard.. She checked my lymph nodes, breathing, throat, etc. Then she said to lay down, and even though I was wearing a t-shirt and hoodie zipped up all the way, she kind of put her hands under there and said she wanted to take a look at my chest. Maybe she could have asked. I probably would have said sure. But she was like, touching my nipples and commenting on skin retraction. And it felt weird. It’s not like it was lingering in a bad way. I pretty much immediately got over it. It was just very unexpected.
And, like always, here’s my face:
This actually happened a few months ago – she was fired from a nearby college on May 24th. It’s only now hitting larger news outlets because there are now three state-level civil rights complaints, trying to get her re-instated. I read about it in the newspaper while at work, yesterday.
She was treating transgender students who came to her with a previous diagnosis. She was definitely qualified to do so, having gone through many hours of training in trans-health care, attending a conference sponsored by WPATH (World Professional Association for Transgender Health), etc. She was doing this at the college’s expense, which just makes it seem like it was condoned by the college, right?!!
WPATH’s stance is, “With appropriate training, …hormone therapy can be managed by a variety of providers, including nurse practitioners, physician assistants, and primary care physicians.” Apparently, this was outside the scope of what the Student Health Center did, but this was never communicated to her. The termination came from out of the blue.
Hormones are prescribed for other reasons at the health center, with no problem. Birth control, ovarian disease, and low testosterone are all treated regularly.
Interestingly, the information on the Student Health Center’s website changed two months after her firing: While it had said, “comprehensive primary care,” and “continuity of care,” it now says, “basic primary care” and has no mention of continuous care. At least they’re being accurate about the downgrade???
This just angers me to no end because this doctor took it upon herself to step it up and become well versed in an area that, for whatever reason, makes so many medical professionals so squeamish and stand-offish. And if this was something she did of her own volition, and it was well within the standards of care, then back it up! What was the university afraid of? There are standards in this field, despite the fact that the medical professions are grotesquely behind the curve with this, in general. A bunch of transgender students were left in the lurch.
The college’s associate vice president of student wellness was quoted as saying, “We are fortunate to be situated in [city], where there is a strong medical community rich with resources.” As if to say that students can just go elsewhere. I’ve tried “elsewhere” around here, as an adult, and it was a super-frustrating process. If I think back to who I was at age 18 or 19, disrupted care at the on-campus center in this regard would have definitely sent me into a tailspin and/or mental health crisis. I would have felt like I didn’t have the means or psychic energy to find out another path. I would have felt deeply cut, in a personal way, by my institution’s sudden change in policy.
It just seemed like this college was at the forefront – it could have laid the groundwork for other area places of higher education to follow. And then it just took a huge leap back into the wrong direction. One step forward, two steps back sometimes I guess, right?
I had a bunch of problems with getting continuous care. I was first getting hormones from a sketchy-ass doctor. I finally felt so disgusted with his practice that I sought out another path. I went to one specifically because she was listed as being LGBT friendly and knowledgeable. That ended up being wrong basically – she told me she didn’t know how she had gotten on that resource list. I had to have a pretty heated conversation with her – her stance first was that I could come to her for primary care, but I should continue to get my hormone prescriptions through that other doctor. I told her I wasn’t going to do that. She told me this was beyond her scope and if she had a male patient with low-testosterone, she would not even monitor him for that reason.
We finally landed on a compromise. She would continue to prescribe what I was already at, and she would monitor that. If I wanted to make any changes though, I would have to do that through other means.
When I did want to make other changes, I first got on a long waiting list for an LGBT-specific clinic. I kept hearing negative stories about the quality of care there, so I decided to also try another approach: an endocrinologist. I had to get on a long waiting list for that, as well. I’ve been going there since January, and so far, I’m happy because I don’t have to deal with the PCP anymore. Getting an endo was not like adding yet another medical professional and another series of appointments. It was more like, instead. Unless I get like, a rash or something, then I’d go back to my PCP.
All of this was hard enough, and I am an adult who has worked really hard at advocating for myself. Thinking back to who I was as a student I would have withered under this kind of stress. Students need to be able to access trans-specific care on their campuses. Period.
A note about the lack of specifics in this post: I left out the doctor’s name and the name of the college, city, etc. because that’s been the way I’ve always operated with this blog, in order to keep some anonymity. I’m not sure anymore whether it’s all necessary, but I’m not about to try to figure that out here-and-now. If you’d like specifics and the names of the sources I got a lot of this information from, just leave a comment, and I’ll get back to you!
I have a mild case of trichotillomania. It’s come and gone during different times in my life, and it’s always been specific to the hair on my face, not on my scalp.
Trichotillomania, to paraphrase wikipedia, is an impulse control disorder, also known as “hair pulling.” It’s generally triggered by anxiety and stress, and is usually treated with CBT (cognitive behavioral therapy.)
In the past, I have honed in on eyebrow and eyelash plucking, using my thumbnail and pointer finger-nail as tweezers. It hasn’t been bad over-all, like I still have eyebrows and eyelashes, it’s just that my left eyebrow is a little bit sparse. It’s barely noticeable.
I also would get chin hairs, from time to time, starting in adolescence, and I would pluck those too, with my fingers or tweezers. This was, apparently, “pro-social” behavior, because I was socialized as a female, and therefore, it’s necessary to eradicate any hint of a mustache or “chin whiskers.” ??? I mean, there’s a whole industry just devoted to that – bleaching the “mustache,” laser-hair removal, waxing, etc. Blah!
Still though, I keep pulling those hairs out not as a gendered statement, but rather because I liked the sensation of getting at them from the follicle, that very specific and very minutely visceral feeling of a “pull” away from something rooted underneath some of the layers of the skin. It’s much more satisfying to get them with my fingernails, but I also use tweezers, so I can get ’em all! The reason I’d say it’s within the realm of “trichotillomania” is because I will do this out in public and I can’t seem to get myself to stop. It’s not just in front of my bathroom mirror. It’s during break at work, with people sitting in the same vicinity. It’s during a meeting, because I am bored. It’s during a movie with a stranger sitting two seats away. Etc. Honestly, it doesn’t feel like a big deal. It’s a rough life to be constantly conforming to societal standards, at least in my opinion…
Facial hair, for me, is a hard limit. I do not want a beard. If I have a shadowy mustache, that’s fine by me, but that mustache never stays for very long before I start plucking out each hair individually. It’ll always happen eventually.
Now that I’m on a regular-ish dose of testosterone, I am getting more facial hair. And I just will not give in and shave. First off, I don’t feel like it! I prefer my methods, even if it ends up taking 10 minutes per day – more or less – to “groom” my face. Secondly, I do think that I believe that old wives’ tale, on some level, about the more you shave, the thicker and darker the hairs will fill in. I do not want to do anything that could potentially promote more facial hair growth.
I do realize this is a little bit counter-intuitive (is that the phrase I’m looking for?) Like, most people who are taking testosterone are embracing the full effect, whatever that means for them. But as someone who is non-binary, it’s a little trickier. Like, I like this effect, but this other thing screams “masculine” a little too loudly, and I’m not really feelin’ it. Something to that effect.
If my facial hair growth ever did start to feel unruly / out of my control, and / or the “grooming” ritual were creeping up toward closer to a half hour per day, something like that, I would not rule out laser hair removal At this time, it just seems a little too extreme, expensive, and unnecessary. But, hey, with this kind of journey, sometimes you never know what is coming up next!
Today is 6 months on 50ml injections / week. I didn’t know I would end up liking it as much as I am. At this rate, I may be on it for a while, whereas previously I was thinking roughly 6-8 months.
I have not noticed anything major since the 3 month mark, except for probably just my voice, and also some psychological changes, which can be chalked up to any number of different things, first and foremost my “mood disorder” and the tweaking of my psychotropic meds. (All for the better, thankfully!)
I also just celebrated 4 years with wordpress (got a notification from the company haha)! That’s pretty cool – I’ve been writing roughly once a week this entire time. I have over 200 posts “published.”
Also, locally, we just celebrated pride in our mid-sized city. We’re always a month behind everywhere else with that. Why? I have no idea! But I definitely do love the fact that it’s in mid-July as opposed to June. It makes it all the more easier for me to be involved, with work and everything else going on with the end of the school year. I’ll be making a post about that, as I do every year, for sure!
Speaking of work, I will be going back to work tomorrow, finally. I’m neither nervous, worried, or anxious. I’ll just see what’s what when I get there. I have been out for 2 months. Since my hospitalization in mid-May. That is a long time to be out. It has been relaxing, exciting, productive, and eye-opening. I hope I can keep that feeling with me as I go back to the drudgery of a 40hr / week routine.
Hey, my T shot is also tomorrow, so I can have that to look forward to, at the same time. And, the fact that I’ll be working again does not negate all the awesome things I’ve been up to. Gonna try being more social and friendly and network-y. Wish me luck!
Also, here’s my face:
Content note: blood, needles, things that might make you squeamish, self-injury.
Three days ago, I did my 24th shot of T. I started to psych myself out – for some reason, it suddenly seemed super-difficult. The needle looked extra long, and it has been looking that way for a while now. I decided maybe I should stick it in a “meatier” part of my quad muscle. I did, and must have hit a vein – it HURT a LOT and it bled quite a bit. I just felt like, “Damn, I’ve been working myself up about the pain more and more lately. I just wanna do it like a routine, without any glitches!”
It then occurred to me to look up the gauge online and see what was the range. I looked at my zip-lock baggie from the pharmacy, full of my syringes. I suddenly realized that my newer ones were a different shade of green than my older ones. I was looking at 23 gauge versus 21 gauge. In addition, the 21s were 1.5 inches, and the 23s were 1 inch – my fear that I was gonna hit my femur was semi-legit! I need to go back and get more 1 inch needles, pronto!
Needles are scary, right? It makes sense that people would fear needles. They hurt. Also, what about negative associations to getting shots at a doctor’s office, as a small child, vaccines and booster shots, stuff like that.
And then there’s the taking of the blood. Like, say, you have a medical condition that causes you to need regular blood draws to make sure everything is on track. If you are transgender, this is a common best practice.
When I was 17-21, I had to get regular blood work done every 3-6 months, because of a psychotropic drug I was on. I can’t remember the reason why. ( To check liver functioning, and/0r cholesterol? I forget.) It was a hassle, at the very least. But I did start getting very comfortable with it: I was present, it barely hurt – I just looked away so I didn’t have to see the vials filling up with blood.
Because of this, probably, I was intrigued by the idea of donating blood. I did it a handful of times between these ages (17-21), both at my high school and at my college. It was one of the most bizarre things, in my opinion: Here we are, a bunch of us, all laying down on cots. Any one of us might pass out at any time, and that would cause a chain reaction for others to pass out too. There are these nurses hovering over all of us, making sure we can stand up OK as if we are rising from the dead, with these baggies of blood tied to us. They are on hand with cookie packets and juice boxes. We can have as many as we want…
The one reason I stopped doing it was because I had a hard time maintaining the minimum weight requirement during college (110 lb). I didn’t have an eating disorder, per se, I just didn’t have an appetite or desire for much of anything at all. I also struggled with anemia.
And self-injury too. In that case, pain was my friend. I guess I can best describe it as, I would work myself up into such a frenzy that cutting my skin felt like the only thing that would bring me down. I was hyper-ritualistic about it. It was a fairly common occurrence for years, but never “severe.” And I don’t do it anymore.
Testosterone has changed my relationship to pain, for sure. I’ve written about that here:
Differences In How I Experience Pain
Here’s a quick excerpt (I wrote this somewhere around 3 years ago):
Before I started taking testosterone, I had a peculiar, but not really uncommon, relationship to pain. In many cases, I derived pleasure from pain. I would create sensations of pain, within my control, in an effort to calm myself. Also, when I’d hurt myself accidentally like for example, hit my arm on a doorway, I would feel alarm, followed by an adrenaline rush, followed by a pleasant soothing wave.
Now? If I hurt myself, it hurts! If I accidentally ran into a doorway, it would not be pleasant in any way, shape, or form. I remember the first few times I got hurt in little ways, in the first couple of months of being on testosterone; I was so surprised by how much pain was coursing through my body. I just felt like, aaaaaah! I’ve been swearing under my breath and feeling unnerved by how much stuff hurts.
So what am I trying to get at? I guess I just want to acknowledge that sticking yourself with a needle, in an ongoing way, is a really intense thing to do. And it’s totally understandable that some trans-people would just have a hard limit and say, “I’m not doing that.” For myriad reasons. So at least there are other options:
– Gels, patches, and creams (unfortunately, quite costly)
– Sub-cutaneous injections (not as deep)
– Stuff like Nebido that’s injected every 3 months or so
Does anyone have experiences with switching methods?
Doing self-injections feels like a badge of honor, but I’m not quite sure that it feels like an “honorable” thing to do…
Oh, hey, dang, I’ve been absent for a while. I was in the hospital, again because I was manic (the time before that was January, 2015). This time it was a week: from May 15th-22nd. I’m currently out of work until June 19th. I’m sure once I’m feeling up to it, I’ll be writing a lot in the upcoming weeks. For now though, I’m thinking I’ll have a handful of short, somewhat abstract updates to this blog. The first one being:
I am a transgender person and I was hospitalized for mania and my blood was tested, and I was administered my testosterone shot, but my T-levels in my bloodstream were not monitored at any point in time during my stay.
I feel legitimately angry, like, about as angry as I am capable of getting, about this. Because I experienced some really really bizarre symptoms while there, that I would chalk up to hormonal issues, but there’s nothing for me to measure that against.
I was shouting A LOT. Like, I am not a shouter. I was SUPER vocal, the entire time I was there..
My menstrual cycle came back in a super condensed, concentrated form, for about 3 days…
Sex drive?? Zero
I called people out in their shit, in real time (generally something might occur to me later, what I should have said)…
I was actually able to keep my anxiety in check this time…
Smells and tastes were all over the place…
Blah! When will it sink in, that transgender people face different challenges, and these need monitoring too!