Last month I celebrated being on testosterone HRT for six years, and that fact feels kinda wild. I’d had endocrinological intervention before—I received GnRH analogue treatment (more commonly known as ‘puberty blockers’, although I was already into puberty when I received them) before taking T—but testosterone felt exciting in a different way.
How do I feel about testosterone six years on? Well, first some caveats. I can only talk about my own journey and my own experiences. Other people on testosterone may have different genders, gender expressions, sources of dysphoria, sexualities, lifestyles, and just general preferences to me, all of which can change how people feel about their HRT. Different bodies do different things in response to testosterone, and every person may feel differently about these changes.
I also want to add the caveat that, in all honesty, I do not remember the minutia of when particular changes happened to me. A lot of the ‘x time on testosterone’ content I see is for people still very early on HRT (<2 years), and often includes very specific information about changes in emotion/sex drive/body etc. That’s just not information I have. I can vaguely point to when particular changes started—when I started growing actual facial hair for example, as well as when it started approaching what could reasonably be called a beard—but I don’t have a proper log of all the shifts and changes—this post is a retrospective, not a dissection.
My Experience of HRT
My HRT Regimen
I started testosterone at approximately 75% of the normal dose. This is partly because I was a minor (I was 17 when I started T), and partly because I had just spent a year with basically no sex hormones in my body. This was a monthly injection of Sustanon 250, which I took alongside a monthly injection of gonapeptyl (a GnRH analogue). Lower doses of testosterone have the same impact as higher doses, just at slower rates.
By a year on T, I was brought up to a normal dose. I’m still on monthly Sustanon 250 injections, although I now take them alongside a decapeptyl (another GnRH analogue) injection every three months. I’ll continue on GnRH analogue treatment until I have a hysterectomy. While my dose is normal, the way my body processes testosterone means that my levels are on the low end of the male range. I have been asked if I’d like to increase my levels, but I feel content and happy with them as they are.
My HRT Results
My HRT results are pretty standard. I have facial hair and body hair (see left, although that’s a year and a bit old and I am actually a bit hairier now), although it’s worth noting that I didn’t get any significant facial hair until about 3 years in, and it’s only in the past year that I’d say my facial hair counts as a beard. My fat distribution has changed—I was dieting pretty heavily on my first year of T and lost a lost of fat that had traditionally ‘female’ distribution, and while I’ve gained some of that weight back (it’s almost like dieting is ineffective, wild), it’s now in a much more ‘male’ distribution.
My hairline has slightly receded and is now more ‘male’, although I haven’t seen any balding or hair thinning. I never really experienced acne or an increase in skin spots, even during the first year. My voice did drop, but because I had held on to speech patterns from my pre-transition life, I did not have a cis passing voice until I underwent voice training and was frequently misgendered because of it, especially on the phone.
I do not experience periods, although I have had a few cases of breakthrough bleeding that was accompanied by pretty bad pelvic pain. My clitoris/dick has grown on T— I didn’t measure it pre-T so I can’t give exact numbers—although some of this may be accentuated by the fact I have regularly pumped in the past. Vaginal dryness has been on-and-off for me, and in some cases I’ve found I produce more lubrication than I did pre-T.
I had always generally been quite a horny teenager, and I don’t think testosterone made a huge difference for me in terms of sex drive. I have found I get orgasms very quickly—I actually get really surprised when I see cis women in the sex blogging community talk about orgasms in less than 5 minutes as a positive, because a quickie for me is under 2 minutes. I can still have multiple orgasms, but I often don’t feel like it.
Reflections
So reflecting on my six years of being on T, eleven years of being out as trans, and new status as a Trans Elder™[ref]This is a joke, please do not call me a trans elder, I am 23[/ref], what are my main take aways?
Transitioning Eventually Becomes A Bit Boring
I think this is the take that would have most surprised baby me. I think early transition or newly out trans people have so much excitement for their new identities and the new forms their body might take in the future. I wept with excitement the night before I started testosterone. I now find testosterone and its effects extremely mundane. Having to inject it is even an annoyance sometimes. I remember having such a moment of gender euphoria on finding my first chest hair, and now I’m so used to the fact I have a hairy chest I really have any feelings on seeing it at all. The same applies to top surgery—seeing my flat chest for the first time was such an overwhelmingly good moment, and now I honestly forget it was ever not flat. The high points fade to being the background noise of your life, for better or worse.
You Can’t Control What Changes You Get From Transition (& You Have To Become Ok With That)
When I was starting out, I wanted facial hair, which are things I got, but I also wanted a cis passing voice, which I didn’t get without extra work. Having a particular outcome in mind when it comes to HRT (or just transition in general) can be really helpful for people who are only just starting to step out of the closet, but being tied to specific idealised outcomes can lead to disappointment in the long run. There’s always a level of uncertainty, and if there are very specific changes you want or don’t want, it’s worth looking for backups/alternative methods to get them and/or ways to mitigate the results you don’t want. For example, if you want most changes but don’t want facial or body hair…. permanent hair removal is not just an option, but something the trans community has a ton of knowledge about. If you only want voice changes from T, it might be worth looking into voice training rather than going on HRT, depending on your circumstances.
Be Open To Changes In What You Want
All the above said, I think it’s worth having a little flexibility in what you want out of HRT and allowing yourself to have those feelings change over time. When I started T, I actually wasn’t sure if I wanted body hair and I was a bit scared of bottom growth! Fast forward 6 years, my body hair is my pride and joy and I really love my bottom growth. Change is natural and good, and it’s good to hold space for it.
Transitioning Isn’t Necessarily A Sign You’ve Worked Through All Your Gender Feelings
I think a lot of narratives position transitioning as the end of a gender journey, where somebody has finally unpacked how they navigate the world and want to navigate the world. And… I don’t think that’s true or helpful. I’ve found that I’ve continually rethought and renegotiated my feelings around gender as I age—not that my core gender identity changes, but that my relationship to it and the world has shifted. Part of it is that I started transitioning as an actual child and have simply found more room for nuance in my life because I’ve grown up, but I also think there is an element of my trans status ageing and maturing as well. I think early transition people—and I include my past self here—often want a very clean and neatly defined answer to questions of gender. But the world is messy and complicated, and people are messy and complicated, and gender is messy and complicated. It takes time to work through and unpack it.
As examples, one thing I’ve worked through and accepted pretty recently are my desire for and drive towards masculinity. I think a lot of queer communities have a weird relationship with masculinity, even very overtly queer and/or gender non conforming masculinity. For a long time, these communities where were I primarily socialised and it was difficult to admit that what feels good to me is being masculine. Hell, I’d even say my ideal gender presentation is hypermasculine in a lot of ways— I can only describe it as “man on a power metal album cover meets motorbike riding lumberjack, but if they actually leaned into the homoeroticism of all of those things (and also went to therapy)’. It might have been easier to pretend that my relationship to masculinity was solved by transition, but that just wasn’t the case. It took extra time and care to let myself be something other than a fem twink, even once I’d come out.
My Transition Going Forward
So I’m on T and have had top surgery, and I’m aware that this is the point at which many trans men and mascs decide they’ve had enough intervention. However, I’m planning a bit more in terms of medical transition, and am on the fence about a few other things. I want to have a hysterectomy and bottom surgery (for me this will be a simple clitoral release). I still have very significant voice dysphoria, and voice masculinisation surgery is an option on the table for the future. I am still a little unsure about this, as it comes with uncertain outcomes and is a lot of money, and will continue with voice training for the foreseeable future. But it is still a ‘maybe’. But if I do choose to have it, I’m planning on having an Adam’s Apple implant at the same time.
In terms of legal transition, I honestly have very little to do. All my documentation is in the name I’ve used since I was 16 and my passport says that my gender is male. I currently do not have a Gender Recognition Certificate—while I’ve applied a few times I have always been rejected. I do plan on getting one at some point, as I’d quite like to get married and not have to elope to Scotland to avoid being called a bride/wife[ref]Scotland don’t have the same strict rules on what needs to be said during a marriage ceremony that England and Wales do, so there’s more freedom to not be legally misgendered in a ceremony there[/ref], but it’s not at all urgent and doesn’t impact my day-to-day life.
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