Testosterone. I talk myself into and out of taking it about once a week. I’m intrigued, but skeptical. Back when I thought the choice was to stay butch or transition to male, I decided not to start it. Then I realized that was a false choice. That regardless of how I identified, I could do whatever I needed to do to feel whole and authentic. Nothing was off the table.
Testosterone. I flinch when I write the word. I forget that I create my own testosterone. Everyone creates natural estrogen, progesterone, and testosterone, but in radically different proportions. I have no idea what my hormone levels are, but I know testosterone is in the mix. Do I want more?
I taunt myself with the question “If you are really transgender, then why are you so hesitant about increasing your testosterone level?” This is a rephrasing of “If you were really transgender you’d be taking hormones.”
I can debunk that. Testosterone, as we know it, has only been available since the late 1930’s. Transgender people existed before synthetic hormones existed. There are people who can’t get access to hormones (money, gatekeepers, availability), and people who have medical contraindications. And people who choose not to take hormones. They are all still trans.
Taking hormones doesn’t make you transgender. Surgery doesn’t make you transgender. Your choice of pronouns doesn’t make you transgender. I don’t identify with the sex I was assigned at birth. That is what makes me trans. That is what I would tell my seventeen year old self. If they would listen.
I tell myself that “taking hormones is extreme” and that my dysphoria isn’t “severe enough” to justify it.
I remind myself that it is only considered extreme to take hormones when you do it to join the other team. Extreme the way top surgery requires a psychological assessment while breast reduction does not.
Taking hormones is not extreme if you are cisgender (i.e. not transgender). According to the CDC (Center for Disease Control), 10.6 million American women are on the pill; most take a combination of estrogen and progestin. Millions of women in menopause are on HRT (estrogen), despite the identified health risks, because it helps with hot flashes, night sweats, vaginal dryness, and osteoporosis. And they believe it makes them look younger.
There is a whole industry of low dose T clinics ready to cater to men who want to increase their virility and energy. Getting access to hormones in the USA is a snap, as long as you are cisgender and have either insurance or money.
You don’t have to have dysphoria to take hormones. You have to believe that the effects of the hormones will make you look and feel more like yourself.
You shouldn’t take testosterone for cosmetic purposes, or to tweak how you look/sound. You shouldn’t take a low dose just so you can say you are on T.
I would take testosterone because I want to lower my voice and square my face and body. To blur the lines. I’ve reached the practical limit of what I can do with diet, gym, top surgery, hair cut, and clothing. I’m not sure it is enough. What I’ve done so far isn’t cosmetic and it isn’t superficial. Whatever I do in the future won’t be either. It might be subtle. Or not.
It isn’t a reversible decision. Changes to your voice and body/head hair are permanent, even if you stop.
No big decision in life is completely reversible. All decisions have consequences, including doing nothing. You can’t travel back in time and put things back the way they were.
What changes do I want to make in my life, and do any of them have anything to do with being on testosterone?
If I could answer this question I could quit therapy.
Notes: Synthetic hormones are a recent discovery. Scientific American ran an article in 1995 on the discovery of testosterone (the history is correct but the article is a little dated), and PBS has a similar article on the history of the pill.
I’m planning to go to the Philadelphia Trans Health Conference for two days (Thursday and Friday). It might help me think this through. I meant to go last year, but I had jet lag and a bad case of the blues. I hope to see some of you there.
A Boy and Her Dog 
I didn’t realize there was a Trans Health Conference, maybe you will see Jello and I next year.
As for testosterone, you are absolutely right. Taking testosterone has nothing to do with being transgender (it helps some reach what they are, but by no means dictates if they are trans). Jello had considered no hormones as well (although in his case I think he was thinking that route in case I freaked out about him transitioning).
Oh and something I had learned, top surgery does not require a psychological assessment in all states (fortunately here in WA state there is no restriction). I am always amazed at the differences.
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The thing about hormones is it is really hard to be read as an adult male without taking testosterone – but it isn’t necessary to take it to inhabit yourself as one (internal expression). Top surgery was a no brainer compared to this.
The therapist’s letter is unfortunately a WPATH recommendation, and most surgeons require it for legal reasons (mine did), but some surgeons are willing to go with informed consent, which is a lot easier. I wrote the letter for my therapist since she is not a gender specialist (fortunately she is a Jamie specialist at this point) so it wasn’t a big or expensive deal.
Lastly, too bad you are in the Northwest and can’t get easily to Philadelphia. There is a conference in Seattle in August that gets a lot of good press, maybe you and Jello could go to that? Here is the link to Gender Odyssey http://www.genderodyssey.org/
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I have this image of you crossing a stream via a pathway of steppingstones. You don’t know whether the water will rise, or stone ahead of you is stable or not, slippery or not, and yet the stream must be crossed. You will reach that other side and whatever is there waiting for you, in your own time, no matter what.
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I like the metaphor, and want a kayak and a life-vest.
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I’ll be at the conference too – I hope to cross paths with you! (I’m bad with facial recognition, so I hope I will know if I see you!)
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Good. Hope I will see you there, I should be able to pick you out from your face/T updates.
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I’ll be in Philly as well!
The terms of this internal debate are so familiar. I’m not sure I ever ended up deciding what the dividing line between “cosmetic” body modification and transition was, though—the more I thought about it, the blurrier it got, and I ended up empathizing more with people who get cosmetic surgeries than I did to start.
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Good point – cosmetic vs. medical is another false dilemma when dealing with dysphoria. I keep ending up doing things more for personal congruence and to manage my dysphoria rather than outward appearance and outward transition; the net result is that I inch toward masculine anyway and each shift has felt right.
Hope to run into you in Philadelphia.
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“I really hate it when the voices in my head argue among themselves as though I wasn’t even in the room.” If only they could make up their minds about T and tell me. But then B has also not broken down the silence barrier… Damn. I hope you find your answer soon. Take care.
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RIght now I’m in the equalizing stage – I want to defang testosterone so that No Dose, Low Dose, and Full Dose are all real choices with no pathological construct. If I go No Dose, I want to do it with all the information and freely – not because I was too stressed out to do anything else.
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I wish you all the very best on your journey and hope that you’ll find all your answers.
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Thanks. When I actually travel I like to use a guidebook and have tickets and an itinerary. This is completely foreign to me – to travel without a map.
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I’m looking forward to reading more. I think you’re incredbily brave. I wish you the very best.
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Interesting read. I keep looking for answers to the question of whether or not I am trans man or just a lost soft butch, or just a new creature, see I like different things from different ends of that spectrum, I don’t want to have breasts, or to reproduce, I would be happy being masculine in all other ways but I would like to keep my unmistakably feminine name and my lower plumbing.
I think when you already come with a storky boxy build, taking T, for me anyway, if it had been for the purpose of ‘passing’ becomes unnecessary.
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It is a really difficult spot to be in – because you end up doing a DIY – but everyone still wants to pigeonhole you into trans man or butch. I still identify with butch but I also identify probably a little more strongly with being trans (and queer). I get all hung up on not identifying as a straight guy, because it just doesn’t feel like who I am.
Regardless, you can still ID as butch, get top surgery, not have kids, and be merry.
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Oh Jamie, I keep waiting for you to help me make my own decision 🙂 I read what you write as if I’ve written it myself. Same questions. Same debates. Same stalemate.
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I’m trying to figure out how to get out of the stalemate. I am so drug adverse, and skeptical of pharmaceutical interventions, that it is hard for me to think about taking T long term, even though I desire some of the results.
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Great piece, Jamie. My own deliberation was definitely influenced by the ‘trans experience’ as documented by a cis-gender world; I think you captured the essence of this in identifying the ease and readiness at which hormones and surgery are administered to those who want to augment aspects of their assigned gender, but switches from an aesthetic to a medical issue when you’re trans. I hope the Conference gives you some answers!
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Thanks. I wish the medical/psych establishment was more into treating dysphoria and less into making people fit into pre-estalished transgender narratives. If nothing else it will be refreshing to be amongst a diverse cross section of the trans community.
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As always, love your writing. And, ditto all around. Had hoped to go to Philly, but classes begin on Monday. I look forward to your report! Be well.
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Thanks!
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“Taking hormones doesn’t make you transgender. Surgery doesn’t make you transgender. Your choice of pronouns doesn’t make you transgender. I don’t identify with the sex I was assigned at birth. That is what makes me trans.”
YES. Yes yes yes. Amen a million times to this. This is what I have been trying to make certain people understand – that I don’t ‘want to become a man’. I AM a man. What I want to BECOME is more masculine in appearance so that I’m not perpetually misgendered.
The conference sounds intriguing. Please post and let us know what you learned there! 🙂
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Hi Jamie. I will be at the conference this Friday, as well. I thought long and hard (pun intended) today about how I feel in the body I’m in and scoped the pics of phalloplasty and decided I’m going to keep my girl parts for now. I don’t identify as a man but as male. I don’t desire testosterone on any level. It would be great to stand to pee yet if my boy parts don’t look authentic (and it looks SO painful) the surgery would have to wait anyway. I see myself as a boy, I guess. Maybe I don’t fit in anywhere: geder fluid, genderqueer, cis or non-binary. I kind of blend in all areas. I am a rainbow; the sun is shining while it rains. So far, I’m okay with that. What I do desire, though, is top surgery. Boys don’t have the ‘lopes I cart around. Will look for you at the conference…Take care.
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Great, I’ll look for you on Friday!
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It sucks the constant turmoil you have to go through 😦 Cailtlin J made a good point. Say you are lying on your deathbed, and in one scenario you took t, and in the other you didn’t. What would you say to yourself in those two scenarios in your last days?
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I’d probably say that I least I figured out that I should get top surgery. I think I need to wait it out and see if any stronger urgency appears.
I still have a vague sense that I’m considering it because I am supposed to take it, rather than seriously desiring the results.
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Well, even if that’s the case I think you should be proud that you are doing things your way rather than being influenced by outside pressures. Sure the niggling dysphoria and thoughts are there and may continue, but your understanding of yourself surely trumps that. The more self-acceptance you have, the stronger you are against dysphoric whim 🙂
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Hi there again (long time no talk). I feel for ya and what you’re going through while writing this post; I’ve wrestled with the same things too, seems like every 6 months I have a crisis of “who should I be?”…..and then I listen to my inner, inner voice and decide not to go on T. Whatever your choice becomes, know that you are very brave.
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Thanks for letting me know you are wrestling with this too. I wish I had a bunch of other steps to take instead of T, because it would be a diversion but still let me move a little further along. I don’t like the idea of stopping exactly where I am, but that is not a good reason to take T either. Eventually, I’ll sort it out.
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