You folks have been getting a lot of asks about the effects of testosterone, so I figure I’ll help you out by sharing the information printed on the consent form I had to sign when I started it. This info is from paperwork I received in 2012.
I’ve underlined things that I think are especially important for people to keep in mind.
Please note that the timeline for all changes varies from person to person.
(*C)W: genital mention, menstruation mention
Changes that will likely be permanent even if you stop taking T:
- Lower voice pitch;
- Increased hair growth, with thicker/coarser hairs on arms, legs, chest, back, and abdomen;
- Gradual growth of facial hair
- Hair loss at the temples and crown of the head, with the possibility of becoming completely bald (NOTE: hair loss depends largely on genetics and is only likely to happen to you if your relatives are bald/balding); and/or
- Genital changes may or may not be permanent, including clitoral growth and vaginal dryness. (NOTE: for those of you worried about dryness, it can be treated without affecting your T levels! Just ask your provider about it)
Changes that are likely to reverse if you stop taking T:
- Acne (NOTE: a lot of people get really nasty acne from T but that doesn’t always happen. My acne was really bad to begin with, and it actually got better when I started T)
- Fat redistribution (decreased on butt, hips, and thighs; increased in abdomen - changing from “pear shape” to “apple shape”);
- Increased muscle mass and upper body strength
- Increased sex drive; and/or
- Menstrual periods typically stop within 1-6 months of starting T (NOTE: it can take longer than that, and you may get occasional bleeding even after it stops but it’s not nearly as bad as a full period).
The effects of testosterone on fertility are not known. (*IMPORTANT:) It is possible to get pregnant while on T.
Things that will not be changed by T:
- Fat loss may cause a slight shrinkage in breast tissue, but it will not be substantial.
- Voice pitch will likely drop, but speech mannerisms will not automatically become masculine.
Additional things to keep in mind:
- Increasing dosage does not increase rate of masculinization. In fact, extra testosterone is converted into estrogen, which may slow or stop masculinization.
- Testosterone increases risk of heart disease because it changes levels of good and bad cholesterol, increases blood pressure, and increases deposits of fat around the internal organs. These changes and risks do not exceed those of a *(cisgender male).
- Testosterone can damage the liver. Drink alcohol in moderation and make sure you’re being monitored for possible liver damage for as long as you’re on T.
- Testosterone can increase red blood cell count, but generally to a normal male range.
- It is not known how testosterone affects the risks of ovarian cancer, breast cancer, and uterine cancer, [BUT it is speculated that these cancers are estrogen-driven and therefore T probably will not increase your risks of these. If you have a genetic predisposition to any of them, however, don’t think that T will protect you.]
- Testosterone can cause headaches or migraines. (NOTE: I don’t know anyone who has experienced this.)
- Testosterone can cause emotional changes, including increased irritability, frustration, and anger. (NOTE: It will not change your personality, you may simply notice you react to things a little differently. If you don’t have trouble managing anger to begin with, you will not develop them.)
- The right dose or type of medication prescribed for you may not be the same as for someone else.
There are a lot of people who are worried that T will shorten their lifespan or give them heart disease and things like that. As long as you make an effort to lead a healthy lifestyle, follow the directions of your doctor, have routine blood tests done to make sure everything is in order, and check in with your doctor every now and then, your risks are no higher than those of a typical cisgender male.
Some things I’d like to add that aren’t on the paper:
- Taking testosterone is not guaranteed to get rid of any dysphoria you may have. Things are probably going to happen more gradually than you’d like them to.
- If you’re absolutely terrified of needles, you can use patches or gel for T, but honestly subcutaneous injection is a great, easy method that doesn’t hurt very much and doesn’t cause crazy T level swings like intramuscular does. Also, patches and gel cause changes to happen even more slowly than with injections. (*Also, patches, pills and gel are expensive and rarely covered by insurances.)
- A lot of transmasculine people I know have reported becoming “more gay” when they started T, as in they started to take more of an interest in males than they did previously. This is normal. It’s okay. It doesn’t mean anything for your sexuality or gender identity unless you want it to. It also isn’t guaranteed to happen; I also know plenty of people to whom this didn’t happen, including myself.
- You don’t have to ID as male to be on T.
- Your libido is probably going to get really high. It’s okay if that makes you uncomfortable.
- Things are going to happen slowly. That’s okay. They’re still going to happen.
- HRT is really scary to parents, even the ones who are super accepting of you. It was probably one of the scariest things about my transition for my mom. If you’re under 18, be patient with your parents. Educate them. Try to get them agree to a consultation with a local endocrinologist who treats trans people.
- Yes, you may develop a little Adam’s apple. It’s super cool.
- You can’t pick and choose what changes happen. If you’re not okay with the possibility of all of these things happening to you, then you probably aren’t ready for HRT or else it simply is not the right choice for you.
- A lot of people try to “naturally transition” if they can’t get T. Please note that this is often actually more expensive than traditional HRT, and that certain T-boosting supplements are intended to increase the production of testosterone in people who produce it on their own—meaning cis men. If you want to transition naturally for whatever reason, please be sure to research it very carefully.
That’s about all I can think to say. If you have any questions about testosterone (or top or bottom surgery, as I’m fairly well-researched in both fields) feel free to stop by my blog and ask me.
Anything I’ve edited/added is starred, in parenthesis and italicized. (*Like so.)
So many men have internalized the lie that they have uncontrollable sex drives, and no way to control their anger. They aren’t ashamed of their abusive behavior because they see it as a something natural to them and maybe even central to their masculinity. It’s scary as hell.
Maybe the reason social justice bloggers are “getting younger and younger” are because shit mongers are trashing the world around these kids so they’re forced into adult issues based on factors they cannot control about themselves
And if these kids have a better grasp on social issues than some 20 somethings stop shaming them for being passionate about creating a better environment for themselves when they’re adults
you can’t pick which girls get to be a part of your self acceptance movement you can’t say you want girls to love themselves but not fat girls because they need to lose weight or that girls deserve respect but then turn around and not respect trans girl’s identities, you don’t get to choose which girls do or don’t get to be apart of the self acceptance movement, you’re either in it for all of us or none of us