The Rest of the Testosterone Circus in My Head

The Bearded Lady is 3rd from the left.

The Bearded Lady is 4th from the left.

Last week I posted part of my internal dialogue on low dose testosterone. This week I continue the argument. I also learned two new terms: “androgenic alopecia” which is the medical term for male-pattern baldness, and “hypertrichoisis” which is short for abnormal hair growth on the body.

You say you are in the middle, but you are actually just at the far end of female. To get to the real middle you need to take testosterone.

I know where I am. I don’t need to take testosterone to feel like I’m in the middle. I get read either way until I speak. Strangers resist seeing the middle. It confuses them. They want to pigeonhole me back into something they understand: butch lesbian. A Jamie on a low dose of testosterone could look just as confusing as a Jamie on no dose, except for maybe a lower voice.

There is no “real middle” in-between the two social constructs of female and male; there is only a place that I call the middle. I’m not sure why I don’t call it genderqueer. I’m not sure why I don’t call it non-binary.

The part of the middle I am comfortable in is the masculine middle, not the feminine middle. I am not fluid. I don’t have days where I feel female or want to be read as female. I’m in the middle, but it is the boy/man middle. I’m not sure how much deeper into the middle I can go. I’m not sure that testosterone will take me into the middle instead of directly to male.

You only want to take testosterone to fit in. You want to be able to say that you are on testosterone so that people will take you seriously.

I’m embarrassed that there is some truth in this statement. I’ve never felt like I fit in anywhere and mostly I’m OK with that. I didn’t fit in as a girl. I didn’t fit in as a butch lesbian. I’m used to being an outsider. I’m used to being a couple of standard deviations away from the average.

I have a flicker of shame that I am not on testosterone. That anything short of a binary transition on testosterone is lame. That even if I believe I am “trans enough”, I don’t believe I am visibly masculine enough. I know I don’t have to prove anything to anyone, but I wish I looked more masculine.

Low dose testosterone might make me look slightly more masculine, but is not going to help me fit in anymore than finding the perfect pair of sneakers will help me fit in. The question I should be asking is will testosterone make me feel more comfortable in my own skin? The only way to answer that is to experiment with it.

You don’t know what you want to look like or sound like, except that you are never happy where you are. You are thinking about taking testosterone because you don’t know what else to do.

It is my condition to be vaguely dissatisfied with how I look, and to be critical of my gender expression. I distort what I see in the mirror, or at least I hope what I see is not what everyone else sees.

If I take testosterone, and I still feel awkward and uncomfortable, then I will have exhausted all the transition avenues open to me. If I put off taking testosterone then I can still hope that testosterone will put me at ease.  I’m afraid that neither hormones nor drugs can quiet my restlessness.

My mother never let me forget that there was something wrong with me because I was not like the other girls. She berated me. She nitpicked. She criticized. She told me I was a freak. She was a nasty piece of work right up until she died.

It is easy to say that she was wrong; it is hard to exorcise her voice from my head. It is hard to suspend self-judgment. It is hard to use a kind tone of voice with myself, to not see myself through her eyes. I’m afraid that tuning her out is a never-ending project. I will have to do it over and over again, for the rest of my life. Kind of like going on testosterone.

Notes: I haven’t found anything interesting in the scientific literature on low dose testosterone for genderqueer or non-binary people. I did find three useful documents on hormone therapy: the 2014 Protocols for Cross-Gender Hormone Therapy from the Callen-Lorde Community Health Center in New York, this technical paper from the Endocrine Society on starting hormone therapy with transgender patients (which is the basis for WPATH’s Standards of Care), and this article from the American Society for Reproductive Medicine on testosterone therapy and menopause.

24 thoughts on “The Rest of the Testosterone Circus in My Head

  1. Mrs Fever

    I have debated since your last post whether I should comment…

    But I have conversations with my gynecologist and endocrinologist that start with, “In your extreme clinical situation…” (them, speaking to me), and I have been sick – literally – of hormonal issues for more years than I care to count.

    In my experience, hormone therapy is a bitch. I have both of the hairy messes you name in your first paragraph. I also have frighteningly high triglycerides and the libido of… something ridiculously libidinous. All thanks to excessive quantities of testosterone in my system. But hey! The higher the testosterone, the stronger the orgasms! (Even if they *are* more time consuming to achieve. Because what would an imbalance be if t was actually, y’know, BALANCED?)

    My situation is admittedly different than yours. Just because I carry my weight like a man (in the middle) and experience mild psychosis when I take hormones doesn’t mean it will happen to you. But it does happen. Maybe T won’t affect your blood sugar or your sex drive. But those are very real side effects. And I know you will research and discuss and decide and then research more and discuss again before you *do* when it comes to this part of your journey. I know that. And I know that you will do whatever is right for YOU.

    Again, I was really unsure about whether to comment. And please know that I’m not trying to persuade you in one direction or another; nor am I in any way against you (or anyone else) taking hormones if it is what you want to do.

    I just wanted to put it out there – sorry for the TMI – that hormones *can* be a solution…

    But they come with their own set of problems.

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    1. Jamie Ray Post author

      I really appreciate your commenting based on your experience; lots of women are prescribed hormones (estrogen, progestin, or testosterone) during peri and full menopause. I took Depo-Provera before I had my hysterectomy (to stop me from bleeding) and I hated how I felt on it – I did not like how I felt (a combination of numb and irritated). On the other hand, I didn’t have any control of the dosage.
      Transition stories (and trans testosterone stories) tend to be very, very, positive – with a few very negative detransition stories thrown into the mix. My guess is that the truth is more in the middle, and that people who experimented and opted out mostly do not write or talk about it very much – most people do not like to write about their failings or their mistakes or their disappointments.
      Testosterone is a very powerful drug, and there are aspects of it that are appealing and scary, but it is the only available drug/hormone that masculinizes – so it is either to T or not to T.

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  2. Lesboi

    “If I take testosterone, and I still feel awkward and uncomfortable, then I will have exhausted all the transition avenues open to me. If I put off taking testosterone then I can still hope that testosterone will put me at ease. I’m afraid that neither hormones nor drugs can quiet my restlessness.”

    This is quite a dilemma and a mental challenge. I can see how this circular thought pattern can keep you from making a decision. Two questions for you. One, what is the worst case scenario if you try it and it doesn’t quiet your restlessness? Two, what if it doesn’t quiet the restlessness but you like other things it does for you? Ok, a third question..and maybe this is the most important question…what is your goal with taking T? What do you want it to give you or do for you exactly and what if it doesn’t?

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    1. Jamie Ray Post author

      The worst case scenario is that I feel alien on testosterone instead of more like myself. I have some concerns about receding hair line, hair where I don’t want it, and my voice not changing – but they are minor concerns – particularly if I feel like testosterone fits.

      In terms of what I want from testosterone – I think I want a partial shift, not a complete shift, towards masculine (I want more congruence between how I feel and what I see when I look in the mirror). I’m pretty sure I do not want to transition all the way to male, but I do want to move away from female.

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  3. rimonim

    You know, in a certain way, none of these arguments seems too terribly relevant to the question of whether you should take low-dose T. So you don’t have perfectly pure motivations, part of you wants T to legitimize you and part of you knows that’s impossible and part of you wants to reject that desire to be legitimized, etc. If you do take T, you will have plenty of unpacking to do…and if you don’t take T, you’ll be unpacking the same baggage. You already are.

    I think the real question is, will T improve your life?

    You don’t need to have all your shit worked out to deserve medication.

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    1. Jamie Ray Post author

      The only way to find out is to go on it. In general, I’m not a person who starts and stops stuff or who is always on to the next thing (Pilates, Cross Fit, Hot Yoga etc.) I tend to do things slowly and thoroughly and stick with them (job, partner, friends). I finish a book if I start it, even if I don’t like it.
      It is difficult for me to say “I can start T and then if I don’t like it I can tinker with the dosing it or stop if it doesn’t feel right – and then reevaluate and start again if I want” – it sounds good but it isn’t my style. And you are right, my issues are still going to be there T or no T.
      I wish T was in Spinach (like Popeye) and I could just pop open a can/make a salad and have it not be a big deal. I’m still trying to de-pathologize it for myself.

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      1. Lianna

        Thank you for sharing this; your thought process mirrors mine very closely, and I probably don’t have to tell you how useful and comforting it is to see how someone else is dealing with similar issues. Also, I totally thought about Popeye the other day in relation to taking T and building muscles!

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  4. genderneutral

    Jamie Ray – reading your last two blogs I am struck by the contrast. I had so many years of just shoving the knowing and want down, that when the door flew wide open for me, I headed straight for it. Yes I took a month or two, but in that time mostly considered how is this going to impact me socially and professionally. I never questioned what I knew I needed to do for me and I have had no regret. I appreciate your capacity to think through this so thoroughly. I tend to feel, then act then think. Others think then feel then act and so on with the myriad formations of choice making. I do hope, for your sanity, you don’t overthink it, thus prohibiting yourself from action. Any action. The great thing about being human is we get to change our minds when and if we need to and rarely do we know what needs to shift until we enter the game.

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    1. Jamie Ray Post author

      I’ve always had a very negative attitude towards medication (for me, not for everyone else) – I did not want to take drugs for depression or anxiety – and I avoid taking antibiotics and painkillers unless absolutely necessary. The concept of going on testosterone because I think it would help me has been hard for me to wrap my brain around – I like a lot of the potential results of testosterone, but I don’t like the idea of being on it, and I don’t like that it is not easy to control/program how your body reacts to it. I had a comparatively easy time figuring out that I really wanted top surgery – I’m much more wary of starting testosterone.

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  5. Pixie

    For a lot of reasons I much preferred having the gel form of testosterone than the injections. But one of the reasons was because of how much less “serious” it felt. I have similar feelings about medications. I even refuse to take pain meds for my horrible migraine headaches unless I actually have a need to be semi-functional.

    Beyond getting the initial prescription, the gel has been very not-intense. I order it online (via Strohekers!), it comes in a brown box like everything else I order online, it gets used like hand lotion (more or less…), and there is very little about it that strikes me as “prescription medication.”

    It’s a trick of course, because it is a medication and there’s still blood tests and doctor appointments involved with using it, but the tricking my brain into seeing it as not helps me not get too stressed over it.

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    1. Jamie Ray Post author

      I think if I do choose to try at it will be either gel or cream. The daily dosing sounds like it has fewer ups and downs than biweekly shots and more control over the amount. And for me control is always a good thing.
      Thanks for the advice (I still use your T shirt shopping suggestion).

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  6. gok9go

    I have found that my strong thoughts about T come seasonally. Each season (spring) that the question arises, I think about T and talk about it with myself and with my therapist. Each time I come to the same conclusion–I don’t want to change the way I think, and I definitely don’t want to deal with the additional hair (nor with potential receding hairlines). I have no desire to change my voice (it’s low naturally, and I love it). I would kill for the metabolism that comes with T (and the ability to build muscle easier–of course, getting myself back to the gym would help…). I don’t want the increased health risks. My partner is super supportive of recognizing when I am thinking about T (it does come up more mildly throughout the year), and I feel very fortunate for that. Every time I come to the same decision not to go on T. However, it doesn’t mean that the thoughts don’t come up.

    I know the paragraph above is a bit of rambling that is probably not helpful in terms of what you are thinking. But, perhaps it helps to know that the debate is alive and well in another person and their dog. 🙂

    (On a side note, I wore a tie for the first time at a professional conference this past weekend. The knot I tied apparently looked fabulous, and it was the first tie knot I ever tied! I went with the “if not now, when?” approach to answer my own question of whether I should do it. Best part: I got compliments!)

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    1. Jamie Ray Post author

      Great to hear from you and to get your thoughts on T. This is my first round of wrestling with it with Donna’s fatalistic acceptance that I can do whatever I need to do.

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  7. The Little Butch That Could (TLBTC)

    Sometimes when I find myself in a difficult position, decision wise, I imagine what the worst case scenario may involve. If I decide I could live with or overcome those consequences, I generally go ahead with whatever I was contemplating. Luckily, all those terrible things I imagine happening never take place.
    I don’t know if that helps you or not but you really don’t strike me as the kind of person that wants to be full of regrets. You know, one of those ‘woulda, coulda, shoulda’ people in their old age. 🙂
    Hope you, Donna and Gracie are all doing well. Cheers.

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    1. Jamie Ray Post author

      I often do the heads or tails trick and see if I feel disappointed at the result (not a good way to decide if you want to go on T).
      I think I will muddle into a decision sooner or later, but I need to get all of the “shoulds” out of my system and really allow myself to choose.

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  8. Tea With Ess

    The restlessness have been a big worry of mine. My whole life I’ve been searching, on my way to something… else, and I’m afraid that, even though I feel like I’ve arrived “home”, will continue searching when my transition is over. I really hope that my restlessness is over now, but I don’t dare to believe it. I wonder if I’ll ever be at peace.

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  9. txbridgefarmer

    As you know, I’ve watched you go through this journey of yours for a while now. Sometimes I comment and sometimes I simply absorb what you say and mull it over. The reality is that I’m not transitioning and have no desire to. However, I am always going to be the biggest cheerleader (I’ll let the image of me with a skirt and Pom poms sit in your mind for a sec) for anyone that chooses that path. The bottom line is this; you will probably struggle with this decision for a very long time, simply because you are not the type to take life changing decisions lightly. You may even make a decision and regret it later. That is how life always manages to kick us in the butt. Whatever you choose, I hope you make the choice based on what makes YOU feel as whole as possible. None of us ever really feel like we’ve plugged the hole inside of us, but if you can find a place where that void feels a bit smaller and you feel more like the outer shell matches the inner heart, then you are one step closer to being there.
    I don’t envy you in this position but at the end of the day it’s about what will make you feel like YOU.

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    1. Jamie Ray Post author

      I’m still trying to figure out how to be butch and trans at the same time – which kind of precludes a full blown transition. I’ve also spent way too much time around middle age guys at work, and it is a really unappealing prospect. Yet I don’t want to hide or suppress myself. It is a perpetual conundrum.
      I wish it was easier and a clearer path (with less conflict and more room to play around) but it is serious business and hormones are potent. I’m glad I’m not 25 and impatient/impulsive.

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  10. xyz

    in a similar boat, but coming to the opposite conclusion. i’ve still got my mother berating me in my head, too. my therapist is having me practice recognizing what my gut tells me instead of my head. my recommendation is this: does thinking of being on T make you feel panicky or nervous or tense or sick-feeling in the stomach? then you might want to hold off. if it’s only the negative-voice that makes you feel bad, and not the idea itself, then you can learn to separate these conflicting desires. (in theory!)

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    1. Jamie Ray Post author

      Thanks for reading and commenting on T. I’m conflicted and still sorting it out – but I’m trying to depathologize it at the same time. Taking T is so loaded, and I am clear that I don’t want to go a binary transition route. Part of the problem is that there is so little medical information out there on low dose T; and not much more on non-binary transition or choosing not to go on T but to still ID as trans.
      In general I am a slow poke at making up my mind, and I’m not in a big rush.

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