On the part of the form that said “Reason for visit?” I wrote “discuss high cholesterol and the potential health risks of starting testosterone”. The Cardiologist listened to my heart with a stethoscope, took an EKG, looked at my blood work, asked me some questions about my exercise and diet, and asked about the circumstances of my parents’ deaths. I walked out with a prescription for low dose Atorvastatin (20mg once a week to lower my cholesterol) and a follow-up appointment in May.
He also gave me the green light for going on testosterone. He said that if I thought I’d be overall happier and healthier on testosterone then I should start taking it and we’d watch and manage my cholesterol. I should be ecstatic; my cholesterol was the only medical obstacle to starting testosterone. Instead, it sent me into another confused tailspin.
I talked to my Nurse Practitioner at Callen-Lorde. She offered to write me a prescription for testosterone and I told her I wanted to wait. She said to call her when I was ready. My next appointment isn’t until September.
Putting off taking taking testosterone feels different than saying “I’ve decided not to go on it.” Even if the outcome is the same. When I think about never going on testosterone, I get very sad. Crying sad. Raging at the unfairness sad.
It lets loose all of my childhood denial. I’m not really a girl, I can’t really be a girl, there has got to be a fix for this, I’m really a boy, and someday I’m going to turn into one. Somewhere in there I still have hope, even though nothing short of a time travel machine can turn me back into a boy. Starting testosterone won’t do it; it will make me look and sound like a man.
My reasons for wanting to start are straight forward. If I don’t try it then I will never know if it is the right thing for me to do. If I don’t like it, I can stop and call it quits. I want it to lower my voice. I want it to make people stop Ma’aming me. I want it to nudge me along.
My reasons for refraining are also simple. I might not like how I masculinize. Donna might not like how I masculinize. I will have a lot of explaining to do as I change, and I’m not sure what to say about it.
I like my face. I don’t know how it will change. When I look at trans men’s before and after pictures, I don’t always prefer the after picture. Some guys lose their softness and their youthfulness.
I’m not keen on growing a lot of body or facial hair. I don’t want to go bald. I’m already hairy, and the men in my family are hairy. Except on the top of their head.
I’m afraid of gaining weight and bulking up. It took a lot of effort for me to get my weight down to where it is and I don’t want to get husky again. I’m afraid of busting out of the custom-made shirts I bought after I had top-surgery.
I have not found any research on the recommended dosage for post menopausal administration of testosterone or for low dose testosterone. Callen-Lorde follows the Endocrine Society’s guidelines (start with biweekly injections of .5cc (100mg) of 200mg/ml testosterone and increase to 1.0 cc biweekly). This is also the document used by WPATH. It does not take age or estrogen levels into account. If I started, I would start somewhat lower, and probably with Androgel.
I do not know how to get past the sadness and the anger. I do not know if the pain of not being a boy translates into desiring to be a man, or to be seen as a man. I’m content being seen as non-binary, but no one sees me that way. Testosterone is an effective way to change that. Testosterone will not turn me into a man anymore than estrogen made me into a woman. Meanwhile, I’m staying in the middle.
Notes: This post by Dr. Cary Gabriel Costello, from his blog TransFusion, critiques biological and hormonal essentialism in the trans community. He also has a good analysis on why trans men “pass” more easily than trans women, and it doesn’t have anything to do with height or shoulder width.