Hi i have no idea how tumblr works but i saw some of your posts and wanted to ask a question, im a trans guy myself for 5 years now and i genuinely dont know anything about testosterone and so on. i see a lot of positive things about it but i get told about so many awful side effects and even life shortening incidents. of course i try to stay positive but its difficult to decide on what to believe. id love to start taking testosterone but ive never gotten to truly study it. i want to ask you, a trans male yourself if the side effects truly are definite and life threatening?
Hi!! I’m so glad you came to ask questions. There’s so many things about T that are hard to research, and a lot of misinfo and fear mongering around. This may be long, but hopefully can answer some of your questions.
(TL;DR: T is no more life threatening to a healthy individual as most other medications. You may see a long list of potential side effects but you could find this same list with many others, and there are things you can do to mitigate these risks, especially if you work closely with your care team.
I’m not sure what you mean by definite, but if you mean permanent, only some changes are. Most of the changes on T are reversible, and you are generally able to stop at any time with guidance from a health professional). :)
Read more just because this post is very long.
Is T life threatening?
ALL medications have the potential to be dangerous or fatal. I don’t consider T to be any more life threatening to a healthy individual than Ibuprofen or Acetaminophen, and most side effects are not dangerous. In some rare cases it can be ill advised to take T or you should take caution when doing so, however.
Things that may PREVENT YOU from taking T due to health risks:
- Pregnancy or breastfeeding, as it can cause defects in the child.
- Currently having or having a personal history of hormone-sensitive cancer such as breast cancer.
- Having problems with blood clots, such as when a blood clot forms in a deep vein (deep vein thrombosis), or there's a blockage in one of the pulmonary arteries of the lungs, (pulmonary embolism).
- Having uncontrolled coronary artery disease.
- Uncontrolled cardiovascular conditions.
- Severe liver or kidney disease.
- Some psychiatric conditions, such as poorly controlled psychosis or other conditions that may impact your ability to consent to the procedure.
Things that should make you stop and talk to a healthcare provider before starting T*:
- Severe acne (T will make this worse or prolong the condition in almost every case)
- a family history of heart disease or breast cancer (for the latter you may consider top surgery before testosterone)
- high levels of cholesterol
- a high red blood cell count
- had a blood clot in your arms, legs, or lungs
*You should be discussing any of the risks/side effects with your provider prior to starting T anyway!
Some notable potential risks include:
- a severe allergic reaction (anaphylaxis) to some methods of T: rare, but most common with the cottonseed oil some injectable methods are suspended in.
- Heart-related risks: unhealthy cholesterol levels, high blood pressure, increased fat around the heart/other organs, excess red blood cells, heart disease
NOTE that all the above can be prevented/the risk can be mitigated by maintaining a healthy weight, be active (exercise!), attend ALL MEDICAL CHECKUPS, and quit smoking/vaping.
- Liver damage
- Cancer (link to cancer is speculative, it is unknown of excess T converted back to estrogen increases the risk of developing certain cancers, but it is a possibility)
- Diabetes
- Headaches
- Emotional changes
- Hair loss (due to male pattern baldness. If a lot of the men in your family are bald, you may end up bald, too).
- Worsening of/Changing of ADHD symptoms
This may seem like a lot, and that may be scary. But remember that most medications have a very long list of possible side effects & risks; There are things you can do to mitigate them.
The following GREATLY REDUCES your risk of complications and/or GREATLY INCREASES the chance that any complications will be caught early:
- Take your medication ONLY AS PRESCRIBED.
- Tell your clinician immediately if you experience any problems with your treatment.
- Follow through with ALL of your follow-ups including physical exams and blood tests, especially early on in your treatment.
- Talk with your clinician if you have or develop any of the conditions that make it risky to take testosterone. Your doctor will be able to advise you with next steps.
- If you decide to stop at any point, discuss this with your clinician first to decide the safest way to do so.
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Below is a list of what changes you can expect on masculinizing HRT, but keep in mind that these are vastly genetic and your mileage may vary. You will experience most of these, if not all, but to what extent & how long it takes depends on genetics, your T dosage, and your method of administration.
THINGS T WILL NOT CHANGE:
- If starting HRT after your growth plates have fused (after you have stopped growing; after puberty) you WILL NOT grow taller.
- Your breast size/density will not change on T, though they may become saggier and easier to bind.
- T WILL NOT prevent pregnancy. I’ve heard conflicting information over whether or not T actually affects fertility, but it seems the general consensus is that it does not. You will have to stop T if you are trying to get pregnant, however.
- T will also not protect against STIs or STDs.
PERMANENT CHANGES:
- Enlargement of the clitoris (bottom growth). This creates a “phallus” of sorts which is usually between 1-2 inches. You will grow foreskin. You will need to wash it.
Bottom growth IS PAINFUL/UNCOMFORTABLE to some when it is growing In. It becomes very sensitive, so touching it can hurt, but this discomfort decreases within 6-8 months. If you’re lucky, like me, you will experience some mild itchiness but no other discomfort.
You can reduce the rate at which bottom growth grows using DHT. This will also slow down other effects, however, such as facial and body hair growth. Discuss with your provider before doing this if it’s something you are interested in.
- Voice drop. The voice dropping is unavoidable on T, and it is an effect that cannot be reversed. Some change happened within the first month for me, with much of it occurring between 2-4 months on T. I’m still experiencing some changes in my voice 11 months in, but it is minimal.
- Thickening of some facial bone structure.
- Hair loss, for the most part.
- Increased body & facial hair growth.
REVERSIBLE CHANGES:
- Increased libido. (When people tell you this is rough, LISTEN. Truly, it was so difficult to get through the roughly 2 week period ~a month in where it was so bad. I could not think about anything else, could not focus—people were right about teenage boys being ravenous).
- Increased appetite, weight gain, and fluid retention.
- Increases muscle mass.
- Fat redistribution. (Decreased fat in breasts, butt, & thighs, increased fat in the abdomen)
- increased sweat and changes in BO
- prominence of veins and coarser/rougher/tougher skin
- Acne (may cause scarring if severe, however)
- Menstruation stopping
- Vaginal atrophy/dryness/itching that may occasionally cause pain w/ vaginal penetration during sex
- changes in mood & emotional stability
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METHODS OF ADMINISTRATION:
Injections:
As the name says. cheapest option & great for keeping your hormone levels relatively stable. Offers very quick changes.
12-weekly shots - an option different from weekly shots, they give a higher dose in one go every 12 weeks. Done by a doctor or other professional licensed to give vaccinations. I wouldn’t recommend this for people just starting HRT as it offers little flexibility with changing your dose, but you absolutely can if you want to.
sub Q - smaller needle that goes into fat reserves in stomach, thighs, or butt. Injected by yourself every week, though your nurse will likely be willing to do it for you if you wish. A partner or other trusted adult may also be able to do it for you. You will get injection training from a professional, don’t worry.
Intramuscular: bigger needle that goes into muscle in your arm. Recommended by the FDA over sub-Q, reaches your bloodstream faster. I believe offers the chance for higher doses at once. Injected once every 1-2 weeks. Usually self-administered/administered at home, but like sub-Q you can get a nurse to do it for you also. You will get training for this as well.
Patches:
don’t know much about these, but they do exist. I’d encourage you to do your own research on them, but to my understanding they are transdermal patches that go on your thighs or stomach and release the hormone over the course of a few days. Replaced 2-3 times a week, I think?
Gel:
What the name says. A gel form of T that you spread over your arm and allow to soak in over the course of a couple hours. This is done DAILY. Generally expensive & not often covered by insurance, but great if you have a fear of needles. You CANNOT allow anyone or any pets to touch this area after application or they will absorb some of the T themselves. This can be toxic to pets as well I believe.
Implants:
a small pellet that goes is implanted into your arm and slowly releases T over the course of a few months. Has to be replaced roughly every 3 months. Like the 12-weekly injections, I wouldn’t recommend this for people just starting HRT as it offers little flexibility with changing your dose, but you absolutely can if you want to.
Pills:
Until recently I was under the impression that pill forms of testosterone were banned in many places because of their toxicity to the liver. I remember hearing however that there are one or two brands that exist and are sold, but you may be hard pressed to find them. Talk to your care provider if interested and do a lot of research, but I would honestly recommend every other method to this one myself.
SOURCES:
Masculinizing hormone therapy - Mayo Clinic
Each person responds to testosterone differently. Here is a list of things which will and will not change on when taking testosterone to ma
Structured Content
Not used as a source, but I do recommend reading the gender dysphoria bible for further information: https://genderdysphoria.fyi/en
A dive into the multitude of ways that gender dysphoria manifests and what it means to be transgender.
(If you have any questions put them in the comments and I will answer them).
It will be interesting to see how my breasts take shape. Here are some facts about HRT (Hormone Replacement Therapy).
(1) There are 4 types of estrogen you need to have for proper growth to occur. The most prominent ones are Conjugated Estrogens and Estradiol Valerate, which is a synthetic estrogen hormone (it's in the birth control pill which has also progestin).
(2) the dosage is key!!! for Conjugated Estrogens I was on 15mg and Estradiol Valerate 6mg. Anything less than that and you will see nothing. From May 2024 until end of November 2024 I was on lower dosage and I saw absolutely no physical results.
(3) all the estrogen is rendered pointless unless you lower the testosterone levels. As of December, I was on the maximum dosage of testosterone blockers. There are many different types of testosterone blockers. The one I'm on is Spironolactone 200mg. All the dosages are in Milligrams daily. Only when I was on the maximum allowed dosages is when I started to feel my breasts growing.
(4) the dosages are all determined based on your health and blood tests. These hormones have severe side affects on your kidneys and liver, just to name a few, including cancer! you will have to monitor your blood works every 3 months in the first year then every 6 months afterwards. It is extremely dangerous to go on high dosage without proper blood works to determine your health status and how much your body can take or you risk cancers and pre-mature organ(s) failure.
(5) For the first year and a half, you will experience (scalp) hair loss due to the fluctuating hormone levels in your body. This will stabilize after approximately 1.5 years from taking HRT. If you were prone to male baldness prior to taking HRT, then you will initially experience baldness and in about 1.5 years some of your fallen hair might grow back, although not all of it. This varies from person to another but the rule of thumb is that if you had male baldness prior to HRT then it will be the hardest on your hair.
(6) Average breast growth is A-cup for most and the majority of growth will be noticed in the first 6 months to a year. After-which, the growth might continue at an extremely slow rate.
(7) If you do the surgery downstairs then you will not need to take testosterone blockers, only estrogen required.
(8) if you don't qualify for the government program, expect to pay anywhere from $150 to $650 every 3 months for the HRT. This will totally depends on your health situation and what type of HRT you are taking and at what dosages. Mine are pills taken orally.
(9)There are many forms of HRT. I'm taking pills. There is a patch you stick on your skin and it releases HRT through your skin. Also, there is a cream type and lastly there is injection.
I just saw a post about crying on testosterone and thought I'd share my experience so far.
I don't think it's exactly harder to cry, just different. I have bawled my eyes out just a few months ago, pretty similar to how I did before hrt. Sometimes I feel like crying, but my previous standard light crying with wet sobbs has been replaced with dry sobbing and yowling.
I personally don't feel like I lost a way to express emotions, it's just very different and sometimes confusing to figure out how it works now.
thicc brows. no pic bc im too lazy and depressed but yea theyre nice
bit of face acne. not much
got my first tiny mustache. shaved it immediately. been waiting to do that.
lots of back acne. some of it hurts and it's made binding w a binder impossible so ive been using kt tape
voice cracks started. probably went down like a tone or so. idk i havent checked since last time
gained weight...im now 112lbs. got belly fat. and i hate myself.
Mental/Emotional stuff:
around 1 month sober
back to eating disorder
heavy black/white thinking. balance? don't know her
heavy splitting on some friends
back to being suicidal. feel like everyone hates me/would be better without me. i love everyone so much but im so insignificant. ive failed everyone. ive failed me. my parents. my entire family. all my friends. my pets. everyone...
