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.