Physically, I feel 100%, and I’ve felt that good for the past month – like in terms of lifting, stretching, and moving my body. Aesthetically, I’m still not happy, but I’m starting to get used to / feel OK (for now!) with how things look (I’m sure I’ll be looking at revisions down the road, but I’m not going to worry about that right now.) Sensation-wise, I’m a little worried, but I know it’s still early on. My nipples are still numb, and it feels numb/tender within about an inch radius around both nipples. I’m looking into making some gotu kola oil to massage into the tissue; apparently that’s supposed to help with nerve damage. Better late than never, right?
I have my 3 month follow-up appointment with the physician’s assistant on Tuesday, via Skype, and I’m not really looking forward to that…
It’ll be fine…
Otherwise, I’m super happy. I’m so happy to be wearing what I want to wear and also of walking around the house without a shirt on (which I did do, previously, but not as much, and not while my spouse was around.) A couple of weeks ago, I wrote to a friend, “I did not expect to feel much different other than a cerebral satisfaction regarding being able to wear anything from now on. But it’s more of a gut- level confidence: I feel like my posture is different; I walk differently, I carry myself differently. This is what makes it all worth it.” That pretty much sums it up.
Also, I’ve been using 2 pumps of Androgel, daily, for 6 weeks now, without any doctor supervision. I just had some extra bottles laying around, and I felt like starting again (after being off of it for… 6 months?) I contacted my local LGBTQ clinic via email (which is new for me – previously I’d been getting Androgel from a doctor who was reluctant to be a part of my trans-related health) but after more than a week, I haven’t gotten a response. So, I plan to call soon. I’m thinking about trying injections, short term. I think I’ve gotten about as far as the gel will bring me, and I STILL want to look and sound slightly more masculine. Like, enough so, so that people are confused, or at least they’re hesitant to actually say “ladies.” So sick of the “ladies.” It happened again today. Blah.
Three years ago today, I took a huge leap, not at all sure this was what I wanted to be doing, but fully positive I needed to try just to find out. Even though I’m not currently on T, this date is still a really big deal for me.
When I started, I felt, almost immediately. that this was the right decision, and that I could have benefited from testosterone way sooner, if I hadn’t been so unsure I could just take a low-dose to see what it felt like. Those first few weeks, I wrote a lot in my journal, things to the effect of: “feel hungrier, more energized, had to get up at 5AM because I was doing overtime [Saturday morning]. Buzzed through the 8-hour area, as if I didn’t lose any sleep and am in fact on speed. Floated through the rest of the day in a cozy, mellow cocoon.”
About 4 months later, I stopped writing just privately, and decided to start this blog!
First post: low-dose testosterone for the rest of my life
At the time, I thought about testosterone and it’s effects all the time. I was hyper-aware of any physical changes (mostly not wanting anything to change) and also my internal states. It’s impossible to inhabit that way of being, long-term, of course, and other life events happened, causing roller-coaster-like mental states. And I started to wonder what testosterone was doing for me anymore.
I had been treating testosterone like a psychotropic drug, in my mind. And, in a way, it kind of is (a naturally occurring one). I wasn’t on any medications, and I kind of saw it as the solution to my mental health issues. Until it wasn’t. (But it did feel like it was for quite a while.)
When I did go back on medications (a little over a year ago), the purpose of taking testosterone started to feel like it was getting diluted. And the reason to stay on it became, “I need to keep as much as I can the same, right now, so that I can stabilize” rather than, “Testosterone is stabilizing me.”
Right around the end of December, I finally switched to a medication that seemed to be working (maybe for the first time ever, for me). And right around that same time, I decided to stop taking testosterone. Was the timing coincidental? No. It felt like I found a substitute, actually. And I’m still feeling really really good.
I’m still undecided about how much more masculine I would like to look and sound, and if I would want to use testosterone to get me there. It’d be awesome if I could pick and choose… (probably most trans-people wish this). I would pick a moderately lower voice, a little more muscle mass, and a higher sex-drive. I would toss the facial hair and balding, the acne, the feeling too hot, and the other body hair.
This will probably be my last update in this series “___ years on testosterone without noticeable masculinizing changes,” since I’m not currently on testosterone. It doesn’t make sense! Most definitely I’ll start it right back up if I decide to go back on. And I imagine, where I am right now, that my reasons will be different. Less of, “what would testosterone feel like?,” and more of “how much do I want my body to change?”
From my experience, I kind of feel like, if you’re on the fence about hormones, and you’re not sure about how you feel, gender-wise, it’s worth a try (if you can get access). It might take you to a new place on your journey. It might jump-start something inside you. It did for me. Or, on the other hand, it could help you rule something out. I know someone who was unsure about starting estrogen, but they kept obsessing over it. Once they went through the steps, and had the estrogen on hand, they suddenly strongly felt they did not want to continue to pursue that path (after taking only one day’s worth of the hormone.) So, either way, you may learn something about yourself…
When I started moving forward with the process of getting top surgery, I did so with the assumption that I would be paying in full out of pocket. My therapist had looked into coverage a while back, for me, and told me it was not covered. Still, though, times are changing, and I had a sliver of hope that my insurance plan might have been updated. In my state, government funded health care now fully covers transgender related treatment and surgeries. Maybe mine would, by now, too?
Yesterday, I was on the phone with a customer service person for over an hour. At first it seemed promising. I gave her the category number – F64.1 (gender identity disorder in adolescents and adults) and the code for the surgery type – 19304. She said, “Double mastectomy?” and I said, “Yes.” She then proceeded to try to find out whether the surgeon was in network or out of network. She told me that if she’s in network, I would be paying a total of $70. If she was out of network, I would be paying a $750 deductible, and 80% would be covered beyond that. I started to get my hopes up – either of those would be awesome! – but also remain skeptical. The customer service rep made calls to my surgeons office, to the surgical center, and to some other places. She determined in the end that it would be out of network.
At that point, I said, “OK, I just want to make sure you’re doing this through the category of gender identity disorder? It is a gender-related surgery.” She responded, with a blankness in her voice, “That’s an exclusion under your policy.” I replied, as my heart sank a little, “OK so nothing will be covered. So it doesn’t matter whether she’s in network or out of network?” “Correct.”
I was mad that she overlooked the category I gave her, as a first piece of information, and moved forward as if there would be coverage, only to let me down. And that once I made it clear, she didn’t have anything more to say to me that might be helpful.
I asked her about the appeals process. She said I would pay for and get the surgery, the office would submit the claim, the claim would be denied, and then I could work toward getting some reimbursement.
I brought her attention to a 7 page document that is called Medical Policy, Subject: Gender Reassignment Surgery. It lists criteria that need to be met in order for a surgery to be deemed “medically appropriate.” I asked her what this was, and what would happen if I gathered enough information to move ahead with this. I told her it was difficult to understand exactly what I was reading. She said she was reading along with me, and that yes, these policies are confusing. She then put me on hold again, and when she came back, she completely derailed that conversation – she steered me back toward the exclusions. She added that not only was the procedure excluded on the basis of gender identity disorder, it was doubly excluded because it falls under “cosmetic surgery.” The conversation was basically over at that point. I stayed on the line to complete a survey about the call, and I gave her good ratings because she was way more helpful (making multiple phone calls on my behalf) than I was expecting.
I keep going back to this medical policy document. I don’t know for sure, but I have this feeling that it’s the loophole for filing a grievance. That if I can prove it’s medically necessary, I have a shot at getting at least partial coverage.
However, the criteria are so extremely binary in nature. Some examples
Right around this time of day one year ago, I was just getting out of the hospital. I remember the out-take process was long / we had to wait on meeting with certain people first. I was so antsy to go, that once we finished something at the front console, I went to open the door to leave. I didn’t think about the fact that you had to be buzzed out! Oh yeah, no coming and going as we please – I forgot…
I got coffee at a snack bar on the way out, and we went home. I was super up and psyched to be out of there. It wasn’t till later that I got depressed. For a full year, more or less.
Within the past month, I’ve made some major changes that are impacting my mental health. I currently feel better than my baseline. We’ll see if this lasts.
I changed medications: I had been on Geodon, Wellbutrin, and Klonopin (for sleeping). I didn’t think the drugs were doing anything; I still felt shitty, and in December, it was getting worse again. I was having vague suicidal thoughts and was having trouble making it through my daily routine. I talked about this in therapy, and my therapist asked if I would talk to my new psychiatrist about it. I said, “Yeah, but what can she do? What else is there to try?” It seemed hopeless – I’ve been on so many drugs, and overall nothing had ever worked out long-term. My therapist just said that she might have some ideas. So at my next appointment, I did talk to her, and she suggested switching off of the Geodon onto something else. She listed a few, told me about what they work best for and what side effects accompany them, and left it up to me to pick one, basically. I said Seroquel, but I couldn’t really tell you why. I didn’t have much faith. I did the tapering off /ramping up thing, and surprisingly, right when I hit a certain dose of the Seroquel, my day got way way better. And then the next day. And the next. And now it’s been 23 straight days where I have felt free of crippling anxiety and vague suicidal thoughts. I feel present in my body, and I am looking forward to simple things that make my day more interesting / better. Like listening to a radio show, or going to get a bagel, or just, anything that previously would not have brought me any extra joy. I’m kind of floored by this. I’ve never had this experience with a drug before. We’ll see if it lasts…
I went off testosterone: I had been increasing my dose for a while, but it was a fine line between looking for more masculinizing changes and worrying about my hairline receding. (It had started to.) I found myself obsessing about my hairline and feeling negatively about testosterone. I felt stuck and stressed. Eventually, I decided, why don’t I just go off it for now and stop all the worrying. I have my whole life to figure out if I want to look more masculine or not – it doesn’t have to happen right now. So I stopped, and I felt better. I worried I might hate feeling colder or having less energy or having more aches and pains or experiencing a drop in mood. But none of those things happened. I haven’t been looking for anything to be different, and as a result (partly) nothing feels different. (I’ve been reading this book about expectations and beliefs and how much our judgement gets clouded – maybe testosterone hadn’t been doing much for me if I hadn’t been looking at what I thought it was doing. This is convoluted, and of course there’s more to it – it’s a powerful hormone! – but so far, so good.)
I stopped going to therapy: I have been going to therapy consistently for 4 years. Much of that time was weekly, sometimes we scaled back to every 2 or 3 weeks. The past few times recently, I didn’t know what we were doing / didn’t know what to talk about / we were going in circles. All of a sudden, it occurred to me that maybe I didn’t need to go. And instead of that thought freaking me out, it settled in and felt right. So on Tuesday, I talked to my therapist about it, and she said it sounded like a great idea. We wrapped some things up for now, with little fanfare, and she made sure the door was open if I ever want to go back. I imagine I probably will, but for now, I had just been spinning my wheels, and it feels good to put an end to that. Maybe I can focus more on other areas of my life…
Considering how unstable I’ve been for a long time, these are some pretty huge changes. And I am finally starting to look forward to what’s ahead!
This 3 month period has been the most turbulent in terms of applying Androgel. I had increased my dose over the summer from 1 to 2 pumps, and then in October I increased to 3 pumps. From November 19 – Deceember 5, I was off T completely, something I had not done since I started. And then starting December 5, I went back on at 4 pumps.
The reason for the increases is that I’m looking for some masculinizing changes to happen. They haven’t yet, even though I have quadrupled my dose. Maybe I just need to be more patient. I got a blood test done yesterday and have a doctor’s appointment on Monday – I will be super curious to see what my testosterone levels are at. I feel like I should be well within the male range. If I continue to not see changes, I may have to decide to switch to injections, but I hope I don’t have to. I’m not looking for a drastic change, and I’m surprised this dose, which I believe is within the standard range for someone transitioning, isn’t doing anything. Maybe it’s just still too early.
The reason I stopped T for about 2 weeks was because I’m told that in order to get top surgery, the surgeon should be telling you to be off T before and also after, to help prevent blood clotting. The surgeon I’m looking into requires being off T for a total of a month. I’d never tried being off T before, and I wasn’t about to try it for a first time right as I’m gearing up for a major life event. So I thought I’d do a practice run. It didn’t go too well. Maybe some of it was in my head, but I did not feel all that great. (Although, I have to say I don’t feel great right now either; of course countless factors contribute to how you feel.) I definitely felt like my body hurt more, I didn’t feel like eating as much (something I have trouble with anyway), and I felt colder, for sure. My mood plummeted, but it was still within a range I could tolerate… I might do another practice run at some point to feel more confident about it; I do not like the idea of being off T in order to have surgery, but I know it’s important.
Here are some past posts in this series. In earlier posts, I talked a lot more about the effects of testosterone. I guess it’s starting to get a bit redundant!
And, as always, some pictures of my face:
And I guess I should start by saying that though I’m not experiencing any noticeable changes specifically from T, I have definitely noticed changes in my overall well-being from the moment I decided that I was ready to start taking T. It was kinda like this relief that, well, things might start to make more sense soon. So, I’m genderqueer, I have started calling my gender “confusion”, the act of feeling comfortable when people do not see me as male or female but instead are confused by my gender presentations. In my dream world children always ask me if I’m a boy or a girl and adults give me weird looks and avoid using pronouns for me. For the past two years I’ve gone by Kale and have used they/them pronouns when I feel like I can express that desire to others (I have a really hard time with coming out as GQ). In those two years I have increasingly struggled with who I am.
My partner and I uncovered a video I had gotten while in a support group about 10 years ago – a collection of trans-related TV programs from the late 90s / early 2000s. We’ve been spacing it out, watching some of it each weekend.
Part 3 was a program on A&E from 1998 called, “The Transgender Revolution.”
As soon as we started watching it, my partner said she remembered seeing it in a class at College – that’s pretty cool. And her reaction was positive, like it had been worthwhile. And it was – it showcased a few trans-people in respectful and dignified ways. It was also the most political, by far. There was a clip of Leslie Feinberg, and there was footage of Riki Wilchins talking about hate crimes and founding Gender PAC. She talked about going to senators to get policies changed, and going to the APA to get “Gender Identity Disorder” changed. Brandon Teena was talked about, as well as two more recent cases of the murders of trans-women.
The first portrait focused on Tonye, from Tampa, FL. He lives on a farm, works as a sheriff, has a wife and 8 year old daughter. He talks about all the discrimination he has been up against at his job. He also says his community has been hostile – his farm animals have been killed; other times they have been turned loose. He started an online group called TOPS – Trans Officers Protect and Serve, in order to get support for people like him. He had to undergo an internal confidential criminal investigation at his job, which he says is just a pretext for prejudice. It was left on an uncertain note – we don’t know the outcome of his struggles at work.
Next the program focused on Nancy Nangeroni, an engineer from MA. She talked a lot about overcompensating and living as a very macho guy, taking a lot of risks. The turning point for her was when she endured horrible injuries from a motorcycle accident – she realized she could not keep living the way she had been. One great quote from her: “I’m not a pre-op or a post-op because that’s not what defines me as a person.” She founded the IFGE – International Foundation of Gender Education.
The third portrait was really moving because it was done anonymously. “Terry” never showed his face, and neither did his wife and his mother. He owns a construction company and lives completely stealth. He equated being trans to having cancer – it’s something that you live with, and getting treatment is a matter of life and death. His story focused on him getting metoidioplasty. It was made clear that he needed this procedure to be legally recognized as male – he was living in fear of being outed because his documents all had an “F” on them.
The program wrapped up by discussing the extremes of gender in the society we live in. Toys, etc. “In time, the movement may leave America forever changed.” A nice note to end on.
My partner and I uncovered a video I had gotten while in a support group about 10 years ago – a collection of trans-related TV programs from the late 90s / early 2000s. We’ve been spacing it out, watching some of it each weekend.
The first weekend, we watched The Discovery Channel’s “Changing Sexes.” It was appalling.
Last weekend, we watched an Oprah show from 2004 about transgender children. Surprisingly, it was so well done that it felt relevant and spot on, for children today, more than 10 years later. Oprah made some blunders in terminology and wording (“transgenders,” “When you grow up, what? You want to officially have an operation?” “Children who suffer from gender confusion”), but other than that, the tone was surprisingly respectful.
The show focused on 3 families:
Kaden, an 11 year old FTM trans-person, and his mom.
Dylan, a 5 year old child who strongly feels he is a girl, and his parents.
Hal, a 9 year old FTM trans-person, and his parents.
Kaden’s story focused on how horrific it was to start puberty, his social transition, and how hard it’s been for his mom, although she is supportive. His mom talked about him being able to take further steps, (hormones and surgery), when he’s 18. I found this video and article on Huffington Post – a Where Are They Now from 2013, where Kaden is 20. He ended up getting to start testosterone at age 14 and get top surgery at 16. He seems happy.
Dylan’s story focused on the tension between the parents and between Dylan and his dad. His mom is fine with his son’s preferences and who he might turn out to be. She will buy him dolls and engage in discussions about how he feels he is a girl. His dad does not approve, and there is already a big rift in his relationship with his son. The parents fight about it. The dad stated, “I discipline him.” Things seemed skewed in a way in which the dad was demonized. Dylan was not on the show, but he was shown backstage, happily coloring.
Next, a gender therapist talked about the best practices in how to handle a child going through this. To just be there for the child and love them no matter what. And it might be a phase; it might not – and that’s OK. She claimed that about 1/3 of children grow out of it, 1/3 grow up to be gay, and 1/3 grow up to be trans. I wonder if these statistics hold up?
Hal’s story focused on how open and accepting his parents were, after he verbalized suicidal ideation at 6 years old. His parents claimed that Hal can make his own choices about his path, when he is ready. They talked about difficult moments, and Hal was kind of put on the spot. At 9 years old, I think he was too young to be on the show, talking about his story. He was crying through it. That was hard to watch.
Lastly, a MTF trans-adult came on the air to talk about her life path and how much easier it could have been if she had been able to transition at a younger age. Instead, her doctors were suggesting a lobotomy, and her family was seriously considering it. Luckily they didn’t go through with it, and she grew up as male, had a family (is now divorced but it seems amicable) and is living more authentically now.
This show touched ever so briefly on heavy issues, but shied away each time. Hate crimes were brought up. Homelessness. Suicide rates. Racism. Class issues amongst the families could have been explored. Oprah tends to focus on the positives, which is definitely doing a disservice. But in terms of talking about what kids need, she directed the conversations in the right directions.
The show closed with Dylan’s dad proclaiming that he is now going to go buy his son some dolls when he leaves. When Oprah asked why, he said, “Life is more important.”
Stay tuned for part 3: A&E The Transgender Revolution from 1998.
My partner and I were recently sorting through / condensing our VHS collection. We came across one that was labeled “transgender videos,” and it sparked a memory. I was in a support group in 2005-2006, and one of the facilitators put together this tape and made copies for everyone. It has 4 parts. Parts 1 and 2 are from 2002 – a program on the Discovery Channel called Changing Sexes. My partner and I watched this over the weekend.
We knew it was going to be really bad, but we could not envision how utterly atrocious it turned out to be. This was only 13 years ago, and it’s amazing how far we’ve come; it’s like a public opinion time capsule…
First off, the term “transsexual” was used, and they got it wrong. They referred to FTM trans people as “transsexual women” and MTF trans people as “transsexual men.”
Part 1 was about MTF trans people, and they focused on the stories of 3 people. One was just coming out, one had been out for about a year, living her “real life test,” and one was getting ready to have surgery. A LOT of time was devoted to her (Angela’s) journey toward surgery; they even followed her to Montreal and were in the operating room with her and her wife. Angela was 59 and had just recently come out and starting taking hormones. This last step would “complete her.” (Her words.) They pointed out how lucky she was, in that she could pass and in that her wife stayed with her. She lived in Fresno, CA, and hosted a monthly support group in which people came from upward of 100 miles away to attend.
There were a lot of sensationalistic soundbites. A couple:
“What pushes men to risk everything they have to become women?”
“Believing you were born in the wrong body may be a delusion that won’t be corrected with surgery.”
“Watching a parent change from male to female is bound to leave a strong mark on a child’s psyche.”
A therapist was quoted as saying, basically, that people may be convinced they are a transsexual, but once they start the theraputic process, they may come up with alternatives to having to go through a sex change.
Kenneth Zucker, from the Toronto Centre for Addiction and Mental Health, was on the program, basically saying that transsexual tendencies come from one’s upbringing, and that kids have developmental plasticity, even if there is a biological predisposition. I recently read this blog post, partially about Zucker – apparently he is still around, but his clinic is under review, and is not accepting new patients.
Part 2 started out with, “The story of four transsexual women, and their quest to live as men.”
Someone named Thomas Wise, MD, from Johns Hopkins, was quoted liberally in both sections. More than once, he made an analogy to people struggling with anorexia. Basically, would you allow them to continue to make changes to their bodies because they see themselves as too fat? No? Why should we allow people who see themselves as the other gender make changes to their bodies?
One of the stories was about someone named Dirk. He was getting testosterone through a urologist, and he was binding with a combination of ace bandages and sports bras (no mention of how dangerous this is.)
More sensational sound bites:
“What defines a man? Can women ever become one?”
“Are they real men? Imposters? Or something else?”
“She has started hormone injections, rendering him virtually unrecognizable.”
Again, the segment focused heavily on surgeries (both top and bottom), again with footage from the OR.
Twice, a study was brought up, from the Netherlands, in which scientists thought they may have pinpointed a part in the brain, the BSTC structure. In autopsied MTF people, the size was closer to that of a biological woman, and in FTM people, the opposite. Other scientists debunked the findings, saying that it was the cross-hormones that changed the brain structure. It was unclear what finding or not finding this evidence might imply for trans-people.
This program was worthwhile in showing human stories, and that’s what I remember taking away when I first watched it in 2006. Although it was invasive and sensationalistic, these were real people going through real adversity, and it felt important to me at the time. I told a friend who was also in the group that I had unearthed this video, and he said he has purposefully never watched it. I don’t blame him. I mean, it’s not something I would consider “supportive” of trans people. (That’s a huge understatement). So for it to be given out at a support group – I mean, that’s all that was available at the time – it’s what was out there.
It’s reassuring to see that public opinion is changing, but there are still plenty of people who hold on to archaic notions about “transsexuals.”
Stay tuned for part 2 – talking about an Oprah show about transgender children, and an A&E investigative reports: Transgender Revolution.
It’s strange to stick to this same title, “without noticeable masculinizing changes,” because lately, I have started to aim for masculinizing changes. But it still fits because nothing of note has changed yet. About 6 weeks ago, I doubled my dose. I’d like to see my face change shape, and I’d like my voice to drop. Ultimately, I’d like for strangers to gender me as “male,” as the default, instead of “female.” At least more than half of the time. As of now it’s maybe 10% of the time. We’ll see. So far all I’ve noticed is more acne… Oh, also some beginnings of a “happy trail,” which I’ve always hoped to have!
So I’ve jumped from 1 pump of 1.62% to 2 pumps. I might even go up to 3 pumps just to see. Alternately, I might stop all together, just to see. I have my whole life to be on testosterone or not be on testosterone, and now that I’m finally starting to feel more mentally stable again, I’m just kind of really curious.
Here are some other posts from this series, to fill in more information:
As of now, I feel more sure about other transitional steps than I ever have before. I just can’t seem to get there yet. I feel sure about legally changing my name and about top surgery. And I can imagine some first steps. I just can’t wrap my head around implementing them. A part of me feels like this attitude is a hold-over from feeling so unstable for so long. Not a good time to pursue permanent changes. Just wait for more forward momentum to kick in naturally. A part of me wonders if I should just push myself to get the ball rolling, and positive feelings about it will follow. Right now, I just feel scared. And I guess I’ll sit with that. I don’t think it will last forever. I reached a tipping point with testosterone. (That one, in my mind, felt comparatively easy, I guess!) There’s no reason I won’t reach that point with other changes. I don’t want to force it.
The newest change is that my mom told extended family about my new name (super grateful to her), and people (almost everyone) were using it at a recent family gathering. This felt really validating and also alarming(?) I guess would be the word? I have to say that I’m still alarmed by my new name. It still feels like, “is that me?” I definitely still feel like I have to change it, and if I were to go by a new name, that would be it. There is no better name. But I guess ultimately I feel like, why couldn’t the name I’m used to just have worked out. (I’m super slow to warm up to change – if it’s not obvious.) This tells me that it’s not quite time to pursue legally changing my name. There will be a time – it’s just not yet.
To conclude, here are some face shots: