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.
I keep reading about other trans guys' experiences and feeling like... Oh man... I need to get back on testosterone.
More and more I'm realizing that, while I wasn't ready to go further on HRT when I started it, I do ultimately need to transition more. I need the puberty I never got.
I'm realizing more and more that I have a lot of internalized... androphobia, I suppose, would be the word. My mother understandably taught me to be more wary of men than women, and my emotionally distant father has been the only man in my life since forever. (It's been nice to get to know him for real over the last year or so.) I've internalized the particularly transandrophobic fear that, if I went "too far" with HRT, I would become something I've been taught to fear. If I go "too far," I'll have betrayed something.
Learning that I was trans has also brought me into online spaces with more transfemmes than transmascs, and learning about feminism through these spaces also brought up a lot of anti-man rhetoric that I'm trying to unlearn in a feminist way—rhetoric that came from understandable places, largely either from radfem ideas separated from transphobia or from externalized dysphoria in discussions by trans women in largely feminine spaces. All very understandable, most of it not even hateful so much as vaguely resentful toward the idea of "being a man", but ultimately a harmful environment for me to explore my gender in.
When I got top surgery, I was filled with anxiety because I had little to no positive examples of what my body should or could look like after the fact. Not with my body type, anyway, and largely not without the effects of testosterone beforehand. I knew I wanted to be rid of my breasts, so I went through with it with... probably less information about what to expect at the end than I should have. (Though it was thoroughly necessary, and I don't regret it.)
I think my hesitancy to transition also comes from having managed to internalize transmisogyny—the idea that I could never properly express my womanhood as a genderfluid person if I went "too far" with testosterone. I don't believe this about anyone else, but I suppose the harmful bias is in there. Even as I've wished before that I'd been through an AMAB puberty, as I've wanted to be feminine in ways that celebrate the effects of testosterone, I've still thought... "What if, by the end of it, I feel like those trans women who say they were 'ruined' by it?"
Which I think leads me into the next realization I've had, which is that I've also internalized the (false) idea that trans people who were AFAB are privileged. That, if I made myself appear AMAB to onlookers, maybe I would lose that "privilege." I'm realizing here that I'm scared of losing the "privilege" that being uncomfortable in my own skin has supposedly lent me. But I know that I would never put that on others; of course I'd never say that a trans woman shouldn't risk the "privilege" she'd lose by rejecting the manhood society places on her. But that's how internalizing things works, I suppose. It can make you very hypocritical.
All this, and then sometimes I'll watch a short film about a transmasculine experience, or I'll read an article about a trans man's life, or I'll actually seek out the thoughts and words of guys like me, and... It's triggering, honestly. It makes me yearn. It makes me want but it doesn't eliminate these feelings of fear and self-disgust.
I stopped taking HRT because my arms started looking like my grandfather's arms. The grandfather who brazenly, proudly supports Trump, who went out more often during the peak of COVID, who knows that my sister and I are both trans and sent an envelope with $20 checks "for the girls" for Christmas that included me and excluded her. (I gave her my check out of spite for him.) I stopped taking testosterone because my body started to remind me of the man who had encouraged my sister to join the military, which traumatized her, and who disaproved of my mother's second marriage because she fell in love with a black man.
It is... very hard to accept yourself as a trans man who needs testosterone to be comfortable in your own body when the people your body starts to resemble are hateful and horrible, and when some of the people at the forefront of the movement for your rights project that onto you too, even unintentionally.
But with every story I hear about a trans guy sharing my struggles and doing what they need to, what they want to, and being supported by those they choose to surround themselves with... I feel more emboldened. Sure of myself and what I need.
Keep sharing stories of love and success, and of struggles and fights, and pride.
Stanford Health Care delivers the highest levels of care and compassion. SHC treats cancer, heart disease, brain disorders, primary care iss
Stanford currently recruiting patients on masculinizing hormone therapy for a study on the treatment of hormonal acne. (As of 10/22/24)
Requirements and exclusions below the cut.
Inclusion Criteria:
* transgender male or gender diverse patient on MHT
* on a stable dose of MHT for at least 3 months prior to the study
* anticipate being on the same dose of MHT for the duration of the study
* have steroid-related acne vulgaris as determined by the investigator with onset or worsening after initiation of MHT
* have at least 20 papules or pustules on the face
* consistent skin care regimen (topical and systemic medications) for at least 4 weeks prior to enrollment and continue it for the duration of the study (however, note exclusion below that topical steroids on face not allowed for 4 weeks prior to enrollment and during study)\*;
* age 16 years old or older
* potential participants who are or planning to be sexually active with partners that produce sperm will need to use a medically reliable form of birth control (including but not limited to condoms, intrauterine device, oral contraceptives) before enrollment and during the study unless they have documented surgical hysterectomy, tubal ligation and/or oophorectomy
* Note inhaled steroids are allowed as long as regimen is stable one month prior to enrollment and during the study
Exclusion Criteria:
* changes in topical or systemic anti-acne medications or procedures within four weeks of study enrollment
* use of topical steroids on the face within 4 weeks prior to enrollment and during study
* pregnant or breast-feeding patients
* unable to provide informed consent, follow the protocol, attend study visits, or any other circumstance or condition which the investigator deems may obscure interpretation of results or affect safety of the potential participant.
If you are someone who has been on Testosterone HRT for a year or more, how often do you pass as a man in public?
always
most of the time
some of the time
rarely
never
I'm not sure
Voting ended onAug 20, 2023
If you vote on this despite the question not applying to you, you're transphobic. If you want to see results copy the link into your notes or save it as a draft or something so you can look at it later when the data has been collected. Don't fuck with my results the way you fucked with @genderkoolaid 's
i’m a femme lesbian (afab), but i’m heavily considering going on a low dose of T and having jaw surgery so that i can lessen my gender dysphoria caused by my voice and face. i was wondering if there are any other femmes on T out there?
oh absolutely — if you’re a femme on T drop a reply so anon can connect with you ! x
my aunt, who i live with, isn’t really on board, but they’re not against it either. they think that people generally shouldn’t go on HRT til their brain is fully developed (p sure they’re thinking older than 26, which like i understand, but also no?? ppl die waiting??) but they think specifically to me that i aestheticize identities. i think what they mean by this is that i look at an identity, like being indigenous, for example, and that i only see good things, that if i am _x_ then all my issues will go away. which isnt whats happening, w my indigenous identity or being trans. from being Indigenous, ive mostly just gotten pain. i know that reconnecting is not all sunshine and rainbows and it comes with its own challenges and confusion. i know that going on T will bring lots of joy, and also lots of new challenges. *and* i know im trans. i know this isn’t gonna be something i’ll regret. im trying to bring balance between my spirit and my body, yknow?
im so excited to start hrt. nervous there’ll be a fuck up with my doctors or the ‘script, but i dont think there will be. my face and my body and my voice will start to feel less like they belong to someone else, to society, to capitalism. and, im hoping, im thinking, that as im on T and my body feels less like a flesh prison (by way of hrt and by way of the steps I take on my own, which im already doing some of), it will be easier to make my life as much mine as i can.
i know that there will be challenges, both in how my body and mind change, and in how i interact with the world. but ive been waiting for this since i was eight years old and i first began to understand that my body wasn’t mine yet, in many ways. ive been waiting for this for so long, and im so fucking grateful it has come. im so grateful, and im so lucky. i know that this whole process would have definitely been more difficult for a Black person or really anyone with darker skin than me. and it really really shouldn’t have to be that way, and i really hope to change these bullshit systemic issues however i can.
