A year after I graduated from college, I came out to my friends as nonbinary - someone whose gender is neither male nor female. Soon after coming out, I realized that people would always call me “miss” or “ma’am”, even when I dressed in masculine clothing, and this was something with which I was increasingly uncomfortable.
My facial features were indisputably feminine, regardless of whether I was wearing a dress or a suit.
To try to appear more physically androgynous, I decided to look into testosterone treatment. Transgender men take testosterone (or simply “T”, as many trans people call it) for its masculinizing effects. It permanently lowers one’s voice, enlarges one’s clitoris, and increases one’s body hair. It also shifts the distribution of body fat and makes it easier to gain muscle mass, giving one a more masculine-appearing body, as long as one keeps taking T.
Within a few months of coming out, I knew I wanted to try testosterone treatment; within six months, I was at my doctor’s appointment.
My initial doctor’s visit was in late December 2012. In a lot of places you have to go see an endocrinologist to discuss hormonal transition, but my doctor’s office specializes in LGBTQ people, so I just had to go see my doctor after an initial visit with a therapist. I knew I wanted to get on testosterone and fortunately my doctor was supportive.
After discussing the effects and risks, most of which I was already aware of, my doctor recommended injections. From my research, I knew that injections were the usual choice, but they caused changes much more quickly and drastically than some other methods, like testosterone gel. I wasn’t aiming to become A Manly Man and was still a little nervous about embarking on “second puberty,” so I wanted to start on hormones as slowly as possible. I brought up the option of starting with a topical gel instead.
Originally designed for cisgender men with low testosterone, it’s an alcohol-based gel that you rub on your arm once a day and you absorb it through your skin. My doctor listened to my concerns and agreed that in my case, the gel would actually be the best choice. I left the appointment with a prescription that I filled a few days later.
I was on this type of gel for seven months, before I switched to injections.
I first applied the gel on New Year’s Eve. It smelled strongly of alcohol and felt gummy against my skin, taking nearly an hour to really absorb. And for the first week or so, that was it. Just a boring nightly ritual, and some new pimples which may or may not have been due to the testosterone.
A couple of weeks in, I started seeing some of the initial effects. And frankly, some of them sucked. After all, I was starting my body on a sort of second puberty, except this time it was like being a teenage boy instead of a teenage girl. I not only got acne but I started to smell different. I was diligent about showers so I never got really gross, but I went from, “Yeah I should probably take a shower daily but if I don’t, I’ll be fine” to “Oh God, I can never miss a shower again.” Testosterone makes your body stink differently - and more. I also started to grow noticeable body hair in new places, like my upper arms and my stomach.
Much more appreciated was the drop in my voice. It was subtle at first, a scratchy throat that led to my pitch dropping slightly. Prior to getting on testosterone I had an embarrassingly high-pitched voice. In high school my dad hung up on me one time when I called and said, “Hey, it’s me,” because, as he said afterward, “You sounded like a small child, so I didn’t think it was you.”
TMI Time: The first three months I was on T, there was ENTIRELY too much going on in my pants. While testosterone allegedly causes vaginal dryness, it’s never happened to me. And early on, I still had a monthly period. Lighter and shorter, but still a noticeable 3-4 days of menstruating.
But then T started doing something else fun: spontaneous erections. Testosterone makes your clitoris grow significantly, and my newly-enlarged clitoris decided that sometimes it just needed to swell up like a tiny erect penis. It wasn’t noticeable but it felt really weird, especially when I was wearing a pad.
More so than any physical changes, testosterone had a huge impact on my mood. I stopped crying as easily and generally didn’t feel as overwhelmingly sad and anxious as I had so often before. Testosterone did make me more prone to anger, but it was an increase in irritability, not a sudden, uncontrollable temper.
In fairness, I’m not sure how much of that was placebo effect and trying to act more masculine, and how much was the testosterone itself. Regardless, T affects different people's moods differently.
Overall, however, I felt more emotionally stable and robust. I used to be extremely emotionally fragile, and while to this day I’m more on the delicate side of things, testosterone has played a role in thickening my emotional skin.
After three months, I was fairly happy with the results and wanted more, so I doubled my dose. The changes continued to progress, and I got my first prickles of facial hair. My emotions were a bit tumultuous the couple of weeks after I adjusted my dose (thanks second puberty!) but then calmed down again.
I knew that changes in facial shape and fat distribution took several months, so I didn’t see much there at first. As winter turned into spring, however, my fat began to migrate from my thighs to my stomach, and the shape of my face started to subtly change to look more masculine.
As the months passed, I noticed I was becoming more comfortable in my body and myself. I felt right in a way I never had before. I don’t know how else to describe it. I had gone into this process with a lot of self-doubt and worries, and while my life wasn’t magically fixed, I realized that I had absolutely made the right choice for me.
In July, I decided to switch to injections. By then, I knew I wanted to stay on T indefinitely. I was happier and enjoying the changes to my body (for the most part). I also knew that if my health insurance changed, the gel, which is significantly more expensive, might not be covered, so I wanted to switch over before it was an absolute necessity.
The only problem was that I hated needles.
It turns out that wanting testosterone treatment is a damn good motivator. The nurse did the first shot for me, teaching me all the proper steps. The injection itself was scary but not actually that bad. I chose to get injections every other week, rather than weekly, so I wouldn’t have to deal with them as often. I also opted to start at a moderate dose, about half of what most transgender men take.
For the first three months of shots, I went into the doctor’s office. After the first, the nurse basically just watched. I did all the steps to prepare, then sat around for anywhere between one and ten minutes as I mustered up the courage to do the injection myself. I was adamant that I learn how to do it, and by the end of the three months, it was easy.
Since then, I’ve done them at home. Other than the one time I hit a nerve and my leg felt like it was on fire for several minutes afterward, they’ve gone smoothly.
My voice had slid down a couple of times when I was on the testosterone gel, but the big change happened when I started injections. I spent the entire month of August with what felt like a low-grade sore throat. By the end of it, my voice had dropped an octave. Around this time, I also started being “read” as male just as often as female; by the end of the year, strangers addressed me as “sir” about 80% of the time. My body hair continued to increase, and my face and body shape kept slowly shifting as well.
You can see how the shape of my face changed after 18 months on testosterone. And how much happier I look!
Now, I have to shave my face at least every other day, and I have hair in a plethora of places I never did before, including the backs of my hands. I’ve gained a little bit of weight, largely around my stomach, but there’s more muscle under it than I ever had pre-testosterone. I feel better than ever, and even though I’m no longer conventionally attractive in a feminine way, I feel much better about my body. It feels like mine.
This summer I took the last step in my physical transition process and had gender-confirming surgeries, removing my breasts and internal reproductive organs. I’m secure in my gender identity, happily living in neutral between male and female. I feel like myself, and countless things that used to bother me, from my height to my hair to my strong emotions, I’ve come to accept, even embrace.
Taking testosterone was a huge step, but for me, it’s the best life-changing decision that I’ve ever made. My body and mind are finally harmonized, and I love myself for who I am, not for who society tells me I should be.