We are a blog created for people of all ages who have questions concerning their gender identity. Read our FAQ here!
Transgender is an umbrella term that is inclusive of, but not limited to (nor forced upon), trans women, trans men, non-binary people, genderfluid people, genderqueer people, agender people, and anyone who doesn't identify as the gender assigned to them at birth.
I turn 18 next year and I’m not sure where I can get testosterone, I’ve looked at planned parenthood’s website but the only one in my state doesn’t offer hrt services 😭 do you have any advice on how to access hrt?
Lee says:
Happy (Very very) early birthday! If you're still a year away from being 18 you have plenty of time to figure this out.
You should start by talking to your primary care physician and ask if they are knowledgeable about gender-affirming care and are willing to prescribe you HRT themselves. If they are not experienced with HRT for gender-affirming reasons, ask them to look into it and refer you to a healthcare provider who is.
While you're waiting for your appointment (often it can be at least a month away even if you schedule the first available date) use that time wisely and go out into the world (And internet) and talk to people! There must be at least ONE other trans person in your state who is on hormones, right? You just have to find ONE other trans person in your state who is on hormones (and trust me-- there's more than just one trans person on hormones in your state! But all you need is one person), then find out where they're getting their prescription from!
Online platforms can be a great resource for shared experiences and advice so I'd just start by googling "transgender [insert hormone name] in [insert state]" until you find the right key terms. You might also be able to find something on Reddit or through Facebook groups.
Additionally, going to trans support groups and meeting people there and asking your trans friends to ask their friends, etc can all be a good way to find a provider through word-of-mouth.
Another thing you can try is contacting LGBTQ+ centers or organizations in your state and seeing if they have any recommendations. Even if Planned Parenthood's local branch doesn't offer HRT services, they may have a lists of trans-friendly healthcare providers or clinics that do, so it could still be worth reaching out to them.
If you're planning on attending college or university, check if the campus health center provides HRT or can refer you to local resources that do. Some college health centers offer comprehensive services for transgender students, but unfortunately most do not.
Many healthcare providers now offer telehealth services for transgender patients looking to start or continue HRT. These services can be particularly helpful if you live in an area with limited access to transgender healthcare. Providers like Folx Health, Plume, and QueerDoc offer gender-affirming care to patients in many states, all through telehealth platforms.
Finally, I'm guessing that you don't have much experience with adulting which is fine because everyone starts somewhere! I was in the same position as you once. I also started to look into starting T when I was 17 and got everything ready (appointments scheduled for after my birthday, letter of support since it wasn't fully informed consent, lab work done the month before I was 18, etc), but didn't actually start hormones until I was 18.
Everyone has a different path through life, but this may be your first time scheduling doctor's appointments for yourself, signing up for a patient portal, getting your own health insurance (unless your parents support you being on HRT and wouldn't boot your off of their coverage), paying for appointment and prescription and lab work copays, etc.
Since you have a year until you're actually 18, it would be a good idea to start getting prepped for your first dive into the healthcare system as a legal-adult-even-if-it-doesn't-always-feel-that-way and google the basics of having and using health insurance. There's a lot of words you're going to need to learn one day (what's a deductible vs an out of pocket maximum vs an allowed amount etc) and this is as good of a time as any to start learning some of those basics (The advanced level is learning how to appeal denied claims, etc).
You got this anon! You're clearly on the right track by starting to investigate the process of starting HRT in advance, and remember that starting HRT as an adult also comes with adult responsibilities like figuring out how to pay for it! When you're thinking through the logistics of finding an in-network prescriber, don't forget to budget for those things too.
Hey, so I'm a cis(?) guy who really wants to go on estrogen, but i also really do not want to have breasts. Is there any way that i could get all (or most, i guess) of the other effects of estrogen without developing breasts?
Lee says:
Hi my friend! Navigating your gender identity and the decision to undergo hormone therapy can be complicated.
It's sometimes possible to start hormones if you're 100% sure that you want hormones, even if you aren't 100% sure what your gender identity is, but support from a therapist who specializes in gender identity issues can be invaluable.
They can help you explore your feelings about your gender and your body, expectations, and concerns about taking estrogen and the changes it brings, and I would really recommend looking into finding a supportive therapist.
You don't always need to be diagnosed with gender dysphoria by a mental health provider to access HRT if you see a provider who uses informed consent, and not everyone feels therapy is helpful in this area-- it really depends on whether you can find a trans-friendly, competent, and affirming therapist.
But if you don't see a therapist (And even if you do!) finding support from the trans community can be super helpful if you're questioning being trans, or considering medical transitioning.
Looking for local support groups that meet in-person or online can be a great opportunity to hear from people who have similar experiences as you do because they can provide useful insights and helpful information.
You can't anticipate how much chest growth you'll get- some people have minimal growth and others develop a C cup or larger-- so if the breast growth is a deal breaker, estrogen may not be the right option for you.
Because the effects are not fully known, I would assume that there’s a chance that even if you take them you could still have some amount of breast growth, and make your decision based on that assumption unless your provider says otherwise.
You may choose to wear a binder for the rest of your life if you get breast growth and remain unhappy with your chest, but you might be swapping one form of dysphoria for another, so you should really consider whether all of the desired changes that you'd get from estrogen are more important to you than the one big change that you don't want.
You could also start estrogen and wear a binder until your chest has stopped developing (at least ~2 years) then undergo top surgery to get a flat chest again if you are uncomfortable with the breast growth from estrogen therapy. This is a significant decision and requires thorough consultation with both your hormone prescriber and a plastic surgeon.
If you feel that having breast growth isn't worth the other changes, you could explore other things.
While estrogen can slow down the growth of new facial hair, it does not typically eliminate existing facial hair, even though facial and body hair may become lighter and grow more slowly. It also doesn't reverse hair loss that has already happened, although it can slow or prevent future hair loss.
So removing facial and body hair with laser hair removal and electrolysis, and reversing and preventing further hairline recession and balding with a hair transplant, minoxidil, and finestride might mimic some of the hair-related changes that you might see from estrogen.
Similarly, facial feminization surgery and body contouring surgery can help to mimic the body fat redistribution that you'd experience on estrogen without also creating the chest growth that you don't want to experience.
However, these surgeries are more invasive than estrogen, so if you're considering estrogen, you may want to wait until after you've been on it for a couple of years before you decide whether you still need surgery or are satisfied with the changes.
If you're confident that you don't want estrogen then you could hop straight to those surgeries, but they may or may not be covered by insurance even with a diagnosis of gender dysphoria; some policies recognize that they are medically necessary interventions and others deem them cosmetic.
As you may have guessed, the vast majority of people who were assigned male at birth and express interest in taking estrogen are not cisgender men. Many end up identifying as transgender women or non-binary people. That doesn't mean that you are trans for sure, but just considering the overall probabilities, I'd say there's a good chance that you have more to explore to figure out about your gender.
But even if you don't end up identifying as part of the community, you can still consider medical interventions even if you identify as a cisgender man. It's your body, and you should do whatever you need to do to feel comfortable in it.
It's okay to look into starting estrogen (or any other medical transitioning step) while identifying as male. Just make sure you get the support you need from your medical providers so you know all the options available to you and the risks of each choice.
How do I ask my mom to get on testosterone? My mom’s pretty supportive and has asked me how she can help me feel more comfortable but I just don’t know what to say to her.
Lee says:
If you're a minor, you will need her permission to start testosterone which may take time, so think of your first conversation about starting T as just that-- the first conversation of many! It can take a number of conversations before she understands why you want T and how important it is for you, even if she's pretty supportive in general.
If you're not a minor, approach the conversation in a way that makes it clear that you've already made up your mind and are starting the process and are taking the time to inform her because she's important to you and you want her to know what's going on in your life but make sure she understands that you've already decided and you're not looking for feedback on whether or not you should do it.
In either situation, there are some basic steps to follow:
1. Choose the Right Time and Setting:
Find a quiet, comfortable place where you both can sit down without distractions. Choose a time when you both aren't rushed or stressed.
If you help clean up after dinner, for example, you could go on a walk together in the evening and then have a talk as you walk which can make it easier to discuss heavy topics because you don't have to be sitting face-to-face.
You could also talk on a weekend if you have an activity scheduled that'll get you out of the house after, like hanging out with friends, which can provide an excuse to have a hard stop to the discussion time if you need to leave at a certain point and seeing friends can help you de-stress too.
This might seem obvious, but don't do it on a holiday day! It might be a convenient time for you if you're normally away at school, but Thanksgiving Day or the first night of Hanukkah something is not the best time to discuss something like this.
2. Start with Appreciation:
Begin by expressing gratitude for her support so far. For example: "Mom, I really appreciate how understanding and supportive you've been about my identity. It means a lot to me."
3. Express Your Feelings:
Share your feelings and experiences. Let her know how you've been feeling and why you believe testosterone is the right step for you. For instance: "Lately, I've been feeling [describe your feelings], and after a lot of research and self-reflection, I believe that starting testosterone could help me feel more aligned with who I am."
If you've been struggling with dysphoria or mental illness, this is a good opportunity to bring that up and request a therapist, which can also be a step toward starting T as some providers will request a mental health letter before starting HRT.
4. Provide Information:
It's possible that your mom might not know much about testosterone and its effects. Offer to share resources, articles, and connect her with other parents whose children have started T (if you know of any-- if you don't, PFLAG is a good place to start). This can help her understand more about the process of starting T and it's also a good opportunity to demonstrate that you've done your research and are prepared and know what to expect yourself.
5. Address Concerns:
Be prepared for questions or concerns. It's natural for a parent to worry about their child's well-being and she may wonder what the long-term health ramifications could be. Address her concerns calmly and provide reassurance, and remind her that your care will be supervised by a medical professional who can answer additional questions at your intake/consult.
6. Ask for Support:
Be direct in asking for her support. You could say, "I understand this is a lot to take in, but I was hoping you could support me in starting testosterone. It's something I believe will greatly benefit my well-being." That way you've asked her to be on your team working with you.
7. Offer to Involve Her:
If she's open to it, suggest that she accompany you to a support group or medical consultation (if you're a minor). This can help her feel involved and provide her with a better understanding of the process.
You should be direct in explaining what you're looking for when you invite her to be involved. If you just need her consent, tell her that you've already researched it and found a good provider who is in-network with your insurance, and is accepting new pediatric patients for HRT, so you don't need her help scheduling the appointment but need her to accompany you.
If you don't know what the next step is, you can ask her to take the lead in the process and work together with your to find a provider.
8. Be Patient:
Even if she's supportive, she might need some time to process the information. Give her the space to think and come back to the conversation later if needed.
Again, this isn't the final conversation you'll have with her on the topic, so be ready to discuss it again whether or not she says no or yes or maybe.
9. Seek Professional Guidance:
Consider suggesting a joint session with a therapist or counselor who has experience with working with trans folks. They can provide both of you with guidance, support, and resources, and may help you if you need to get a letter for HRT.
10. Just do it!
It's hard to know how to say it, but sometimes you just have to bite the bullet and go for it. Your mom's primary concern is likely your happiness and well-being, but that doesn't mean she will necessarily immediately support medical transitioning without any reservations or hesitation even if she supported other aspects of your transition, and knowing that and being prepared for it will help you be prepared to deal with that possibility if it happens.
You're opening yourself up for rejection and getting hurt emotionally if she doesn't respond the way you hope she will, so make sure you have a support system ready to help you out if you need it. Tell your friends about your plan and make sure someone will be available to process what happened after the conversation is over. Treat yourself and remember that you're super brave and doing what you need to do to be happy in your body.
If you're emotionally mature enough to deal with talking with your mom about something tough, and you show that you're responsible and would be able to handle taking a medication, and that you're consistent and persistent in your identity and request to be on HRT, she may realize that you're growing up and you're ready to have a vote when it comes to your own care.
I only just started using tumblr again after maybe 6 or 7 years (i stopped around 2016), and it's a pleasant surprise to see that this blog is still going! I actually used to rely on a lot of resources here when i was a teen, and I'm happy to report that I started hrt 4 years ago and have been doing great.
I just wanna say thank you for keeping this blog alive!
autumn says:
grats on 4 years. thats like a whole bachelors degree worth of time on HRT! thank you for the love :)
While on T in the US, would getting a blood test be required no matter what to check the liver or wtvr? I finally have the opportunity to bring up being trans to my doctor, but I'm worried about having to get a blood test before I can start, I already don't like needles but anything on my arm from elbow down is an absolute no for me, just the thought freaks me out and makes me cold 🥴
It's a "1 thing I want most vs 1 thing I fear most" situation for me, I don't know what I can do
autumn says:
Heya, this is a really common issue amongst folks and doctors know how to handle it. Unfortunately, you are definitely going to need to get your blood drawn for HRT, however, you are not the first person to hate needles. Tell your doctor and or the phlebotomist about your fear and they usually have protocols to help you through it. In some cases, they bring in another nurse who is good at talking, and they talk to you the entire time and before you know it, its done.
You got this, unfortunately it is kinda a part of informed consent and making sure your hormones are at a healthy level, but your fear doesn't mean you cant go on T.
Idk if this is still active I haven't checked it regularly since I was a teen, i know this is meant for teens
My GF is on e, she's 28 and she's thinking about leaving her because she fears it won't do anything because of her age and i wanted to seek other people's experiences or ask about resources to comfort and reassure her
autumn says:
the myth that HRT doesn't do anything when you start "later" in life is bullshit and and a lie created by transphobes to stop people from transitioning. E (and by extension T)'s effects don't really care about what age you start, E is gonna do its magic. I know so many trans women who started E even later than she did and they are the most gorgeous people I've ever had the pleasure of meeting. Don't let the transphobes get to her.
I’m really nervous to call Planned Parenthood and get started on testosterone. I’ve just recently came out but I’ve kinda known since 8th grade. Any tips on how to overcome the uneasiness of the transition? It all just seems so big and scary.
Autumn Says:
The best thing to do it rip off the metaphorical bandaid. Grab a friend for support, and make the appointment. You got this. It gets so much easier if you can get the rock rolling down the hill.
why is it so hard to get hrt when your pronouns are nb ones and you identify as your nb every doctor I’ve gone to has refused surgery even though I have proper letters and my insurance has refused on one occasion also because: ???????
Autumn Says:
Ugh. That really does not sound like fun.
Are you in the US? If you are and over 18, see if you can find an informed consent clinic, they will probably be able to give you hormones with little pushback. For insurance, I know something that me and my friends have had success will is asking your doctor to submit something to insurance as a general "endocrine disorder" and insurance didn't flag it.
If you're not in the US, I don't have much advice for you I'm sorry :(
If you feel comfortable not being fully out to your doctor as nonbinary, potentially not being fully transparent with your doctor about your nonbinary identity can get across the finish line.
I'm not surprised you've never seen this mentioned-- unfortunately, there isn't enough open discussion of this type of thing in the trans community.
I think that's partially due to a lack of institutional knowledge; there aren't many studies on these issues so doctors/providers aren't able to tell you the average percentage of people who experience mild/moderate/severe atrophy per time spent taking testosterone.
When there's no Official Statistic saying "only 5% of people have severe atrophy within the first year of taking T, but 95% of people have X, Y, and Z symptom of severe atrophy after 15 years on T," (that is an example!) it can be hard to provide guidance about how often these things occur because the community-level knowledge is mostly based on personal anecdotes and word-of-mouth.
The general stigma around discussing sex and sexuality in relationship with trans bodies makes it even more difficult for people to bring up the topic because it seems some people worry that they will be invalidated by others in the community if they assert their identity as a trans man, for example, while also saying they like to be vaginally penetrated.
The final barrier in having these discussions besides the straight-up issue of lack of knowledge is people's (understandable) reluctance to talk about parts of their bodies that may make them feel dysphoric.
In my opinion, that's the hardest barrier to overcome. Encouraging more research into how testosterone changes the body (for example, how much clitoral growth is average) and addressing the way toxic masculinity and transphobia intertwine to create self-policing/gatekeeping and stigma within the community are both things that people can campaign to do, but it's hard to try and make people discuss something that is deeply uncomfortable for them to acknowledge because of dysphoria, and it's important to respect people's boundaries on that.
But it's still an important issue, and I'm a big proponent of being open about health issues that affect people who have medically transitioned, so as y'all know, I've been on T myself for close to 5 years now and I have been prescribed localized estrogen for atrophy that affects my sex life, but I haven't had any issues with atrophy in my day-to-day life.
I've been lucky enough to have open and frank conversations with several folks who have been on T for more years than I have, and the majority of folks I've talked to have had similar experiences to my own, but there is some variation.
Some people do end up experiencing symptoms of vaginal atrophy like dryness, itching, and UTIs that bother them on a daily basis and they find it helpful to take localized estrogen to treat those symptoms even though they aren't having sex that involves being vaginally penetrated.
Other folks find that the atrophy they're experiencing is less severe, and they only have discomfort when they are penetrated vaginally, so they wouldn't necessarily need localized estrogen if they chose to not have that type of sex and would rather explore other sexual acts instead of taking localized estrogen.
And there are some folks who don't feel like they have an issue with atrophy even after years on T, or have such minor atrophy that using plenty of lube during sex resolves the issue, so they don't need localized estrogen at all.
There are also some situations where a person with atrophy may want to take localized estrogen, like in preparation for a vaginally-assisted surgery. For example, some hysterectomy techniques are vaginally assisted, and recovery time may be quicker if the vaginal tissue is more robust and not atrophied.
So not everyone needs to take stuff for vaginal atrophy if they don't use their vagina for sexual intercourse, but it will depend on the individual in question as there are certain situations (like severe atrophy or pre-op surgery prep) where it might be recommend.
Or if you stop taking testosterone while you're younger (aka pre-menopause) and still have your ovaries (aka haven't had an oophorectomy), then atrophy shouldn't be a major problem for you because it is a reversible testosterone change and should eventually revert back after you stop taking T.
But atrophy does occur to even cisgender non-intersex women with ovaries once they've gone through menopause, so you'll likely end up with some level of atrophy at some point in your life anyway. It just tends to be more severe for trans people on testosterone because our T levels are higher and our E levels are lower than the average post-menopausal woman.
Of course if you've had a vaginectomy as part of your bottom surgery, you obviously don't have vaginal atrophy issues anymore due to not having a vagina.
Followers, if you've used topical/localized estrogen for vaginal atrophy, feel free to weigh in about your experiences and what symptoms prompted you to try it!
Since people have been asking us how much clitoral growth people tend to experience on testosterone, I’m looking to collect some informal data on people’s personal experiences.
There is a lot of misinformation and misconceptions about the effects of testosterone on the body, so it’s important for us to find a way to educate ourselves and each other so people can make informed decisions and know what to expect!
Personally speaking, I started testosterone as soon as I turned 18. And as you all know, I did a lot of research beforehand! But there were some things that I couldn’t find statistics for online, which is why I later went on to create this survey.
I was given information by the provider who prescribed my HRT which said “your clitoris will grow bigger” but when I asked for something more specific, like what size range I should expect, or what the average amount of growth was, the nurse couldn’t answer beyond saying that I should expect “clitoromegaly” because she didn’t know either.
When I had just started testosterone, being told “this is what you should anticipate” is something that would have really helped me temper my expectations as someone who had assumed I’d magically get an unrealistic amount of clitoral growth (and later switched my plan from getting metoidioplasty to phalloplasty when I realized that the photos I had seen online were not “average” and I would end up being fully 100% average).
I’ve noticed that people who tend to post pictures of their genitals after being on T tend to be more well-endowed than those who choose not to share their photos in the same public manner, and people who choose metoidioplasty might be more likely to be on the larger side than those who choose to get phalloplasty, so just as looking at pornography doesn’t necessarily paint a realistic picture of what the average cisgender body is, neither does looking at some of the NSFW images posted online because of this self-selection bias.
So while looking at pictures and videos online might be one way for people to get an idea of what things will look like “down there” after having been on testosterone for a while, that type of content isn’t always representative of the full spectrum of bodies, or even something that everyone is comfortable looking at— it’s certainly not something that a minor could look at on a school or library computer, for example.
I know that this survey is a bit subjective— different people might be measuring their bodies in slightly different ways— but if enough people do it and the sample size is large enough, I believe it also should still average out to provide a more-or-less accurate depiction of what type of changes will happen happen on T.
I believe that this is genuinely an important issue and that is why I’m asking folks to push past their dysphoria and awkwardness, pick up a ruler and head to their bedroom or bathroom, lock the door and measure their clitoris for science!
~
This survey only applies to people who were assigned female at birth; however, you don’t need to be on testosterone to respond.
People who are eligible to take the survey include:
Trans people who were AFAB and are pre-T or non-T
Trans people who were AFAB and used to be on T but stopped taking it
Trans people who were AFAB and intersex
Trans people who were AFAB and are currently taking T
Cisgender women who have detransitioned/reidentified and used to take T but have stopped taking it
Cisgender women who are intersex and have not taken testosterone
Cisgender women who are not intersex and have not taken testosterone
The reason why pre-and-non-T people who were AFAB (including cisgender women) can be included in this survey is because their data can be used as a baseline for pre-testosterone clitoral size. However, you must be over 18 to respond!
People who are not eligible for this survey:
People who were assigned male at birth and currently have a penis
People who were assigned male at birth and had vaginoplasty/gender affirming surgery to create their clitoris
People who were assigned female at birth and had their clitoris “buried” as part of phalloplasty/gender affirming bottom surgery (unless they specially measured their clitoris before surgery and kept a note somewhere with the measurements)
~
I initially made this survey in 2018 when I was only about 1 year on T and before I had gotten lower surgery and I believe I had (badly) traced one of my own actual photos to create a drawing to demonstrate how to take the measurements.
Now Tumblr has now banned NSFW content and they took the link to the original reference photo set down as a result (despite my appeal!), so there is no visual to demonstrate how measurements should be performed, and I’ve since had lower surgery so my set-up is different than what people’s now.
If anyone has artistic talent/literally any drawing skills and wouldn’t mind donating their time to work with me to illustrate the procedure for taking measurements, I would really appreciate it if you sent an ask!
I also have the feeling there are probably a good number of ways that I can improve this survey so I’ve put a question at the end to ask for feedback on what y’all think of the survey and how I can make it better.
~
While reblogs are both welcome and encouraged, I’d also appreciate it if you shared this link on any non-Tumblr social media that you may have; I don’t really go on the Reddit forums or the Facebook groups or whatever, and it would be cool if this survey made its way to those spaces as well.
Here’s a description that you’re welcome to use when posting this:
“Hello! My name is Lee. I’m a transmasculine person on testosterone and I’m conducting a survey on the effects of testosterone on clitoral growth. The purpose of this survey is to gather data that can help inform the expectations of transgender people who are considering taking testosterone regarding the average size of the clitoris after a period of time on testosterone. I am particularly interested in hearing from people who have been on testosterone for over two years, or who have stopped taking testosterone. If you were assigned female at birth, you may be eligible to take this survey. The link to the survey is here: https://bit.ly/T-growth ”
I haven't seen this answered before, but I apologize if this has been asked already. I've seen a lot of people say that they started testosterone at a low dose, but their dose is way higher than mine, and I'm confused about dosage levels? I've seen "low dose" being described as being around 20-50ml by some people and 200ml by another person. I've been on t for six months and I'm only at 0.3ml? I thought that was a normal starting dose, but now I'm confused. Is my dose abnormally low or...?? I plan on asking my doctor about it, but I won't be able see them for a few weeks, so I was hoping you might be able to clear things up a little until then.
Lee says:
200 mL of testosterone is definitely not a dose that people can take.
Imagine someone trying to inject the contents of this water bottle! You'd need an IV infusion!
[Image description: A mini-water bottle being held be Lee. It says that it contains 8 fluid ounces of water which is equivalent to 237 mL. /End ID]
Even taking 20-50 mL of testosterone isn't possible.
Most people on weekly testosterone injections are injecting less than 1 mL because that is the amount that's typically safe and comfortable for someone to self-inject with.
Large-volume injections of 3 mL or greater are rare, and are not typically not administered in an outpatient setting.
0.2 mL is different than 2.0 mL is different than 20.0 mL. So when we start talking about doses, remember that the decimal point is really important!
Anway, moving on!
If you told me that you're taking 0.3 mL of testosterone, and I told you that I'm also taking 0.3 mL of testosterone, you might assume that we're taking the same dose.
But the frequency of testosterone injections will affect dose comparisons!
If you're injecting 0.3 mL of testosterone subcutaneously every week but I'm injecting 0.3 mL of testosterone every other week, that means that my dose is half of yours because I'm on the equivalent of 0.15 mL weekly.
In the USA, most people doing testosterone shots are doing a subcutaneous T injection once a week, or doing an intramuscular T injection every other week.
So if you're discussing your dose with someone else, and they say that they're taking 1.0 mL biweekly, that would translate to 0.5 mL weekly.
That means you have to be careful about a direct comparison about the volume of testosterone when you're having a conversation with someone!
Ok, now let's move on to another hypothetical.
If you told me that you're taking 0.3 mL of testosterone every week, and I told you that I'm also taking 0.3 mL of testosterone every week, you might assume that we're taking the same dose because we're injecting the same volume of testosterone at the same frequency.
But the concentration of the testosterone will affect dose comparisons!
Most testosterone vials in the US have a concentration of 200 mg/mL. That means if I'm injecting 0.3 mL of 200 mg/mL testosterone weekly, I'm taking 60 mg of testosterone per week.
But not all testosterone comes in a concentration of 200 mg/mL.
My mother is taking testosterone because she has low hormone levels, but because she is cisgender and not looking to have masculinization occur so she's on what you could consider a truly low-dose of testosterone.
Her testosterone cypionate comes from a compounding pharmacy, and the concentration is 50 mg/mL.
So if she's taking 0.3 mL of testosterone every week, that means her dose is 15 mL weekly, which is four times the dose I'm taking.
(At this point, I should note that this is hypothetical-- while my mom and I are both taking testosterone, neither of us is taking 0.3 mL and I'm just using that number as an example).
Ok, so here's another example:
While there are different forms of testosterone, at this point let's just say that we're both taking a more-or-less equivalent form of testosterone like testosterone cypionate and testosterone enanthate.
So if you told me that you're taking 0.3 mL of 200 mg/mL testosterone enanthate every week, and I told you that I'm also taking 0.3 mL of 200 mg/mL testosterone cypionate every week, you might assume that we're taking the same dose because we're injecting the same volume of testosterone at the same frequency and you'd be right.
So now that we've established that we're taking roughly equivalent doses of testosterone, we'd have to get into the blood work.
Equivalent doses don't always produce equivalent results at the same rate.
Two people on the same dose of T might have two different T levels after their first bloodwork, and one of them may have to do a higher dosage while the other may decrease their dosage, but in the end they’d both end up with the same levels even though they’re taking different amounts of T.
People who have a higher dose of T don’t necessarily experience changes faster than people on a lower dose- it all depends on how your body processes the T. The important bit is what your blood work shows your T levels to be, not the dose of T.
So if you and I are both injecting 0.3 mL of testosterone, but my testosterone levels are in the low 200's and yours are in the high 800's, that means that 0.3 mL is a low dose for me and an average dose for you.
There is no particular magic dose that is considered a "low dose" for everyone.
Low-dose T is taking a lower-than-typical dose of testosterone so your T levels are above that of the average cis woman’s, but below the average cis man’s.
If you’re on too low of a dose then there’s some risk that your body will just convert the T into estrogen and you won’t get any changes, or that there could be other health risks, but if you are being monitored by a provider who you’ve discussed taking low dose T with it should be safe.
If you take low-dose T, the changes associated with being on testosterone will take longer to happen but you will end up with all of them except possibly the stopping of menstruation, which happens for some people but not all.
Again, taking low-dose testosterone will still cause genital growth, and all of the other changes listed in the Testosterone FAQ- but your period may continue unless you use birth control, or have a hysterectomy, etc.
People often take low-dose T so they can get used to the changes slower and have time to adjust, or because they don’t want to overshoot their goal of androgyny and end up in the masc side of things.
In my opinion, the term "low-dose testosterone" can be confusing because it gives people the idea that there's a particular dose that counts as low-dose for all people, but sometimes something that's a low dose for one person is an average dose for another person.
Sidenote: While I would prefer a term that addresses the testosterone levels instead of the dose, I do use the term "low-dose testosterone" because while it isn't perfect, it does describe the gist of what we're discussing-- someone being on a low dose (in terms of their own body) and I prefer it to the term "microdosing" which has recently been recently been popularized as an alternative to the term "low dose". The term "microdose" doesn't improve on what I see as the issues with the term "low dose" and it adds a connotation that the term low-dose doesn't have, but that's another discussion.
Anway, I've said a bunch of stuff that doesn't really answer your question.
If you're looking to a way to compare testosterone doses, this table is what you're looking for:
As always, I'd like to note that your testosterone dose should be determined by your testosterone levels, your level and rate of masculinization in relation to your goals, and your overall health (cholesterol levels, kidney functioning, etc), and that is very individual and it means that there may be a reason why your dose is not the same as the dose of the people you've been talking to.
Anyway, with all the caveats listed above, 60 mg of testosterone per week is not generally considered to be a low starting dose (assuming that you're on 0.3 mL of 200 mg/mL of testosterone which would be 60 mg).
I started testosterone on a low dose of gel which was 12.5 mg of testosterone gel daily. This is because I wanted to be on a low dose. I eventually changed my mind, about my goals as I've discussed here, and I eventually went up to an average dose of testosterone gel and then switched to injections.
Now I'm 4 years on testosterone and I'm taking 80 mg (0.4 mL) of 200 mg/mL testosterone enanthate weekly but my primary care provider said my T levels are too high on that dose so I might be moving down to 70 mg (0.35 mL) or 60 mg (0.3 mL) of testosterone soon.
You can (And should!!) bring up any concerns or questions you have about your testosterone dose with your testosterone prescriber.
Since I don't know how often you take testosterone or what concentration you're taking, it's hard to answer questions about your specific dose/situation
60 mg of testosterone weekly is a pretty normal starting dose, and not abnormally low. If your T levels are in the right range when you have your next blood work done, and you feel content with the changes you're experiencing, there's a good chance that you might not even have to change your dose.
But if you were on 60 mg of testosterone biweekly (AKA 30 mg weekly) then that would be a lower starting dose, which isn't abnormal either but it does mean that you likely have room to move up your dose at your next appointment if you aren’t satisfied with the rate of changes you’re getting.
Comparing your dose to other people‘s might be an interesting way to pass the time, and it’s good to be informed on your medical care and check the chart above to see if your dose falls in the low/average/high range so you can ask the right questions about why that is, but it doesn’t mean that someone else’s dose is better than yours if it’s higher, or worse than yours if it’s lower. As long as you’re happy with your changes and your blood work looks good, then don’t stress about the dose!
ok so I don't know if this question already sent so sorry if it did but is informed consent basically just walking in (with an appointment?) and asking like ive been led to believe?? like even walking into a place and doing that sounds terrifying but is there any notable hurdle I would (COMPLETELY THEORETICALLY) have to get over?
Some providers/clinics that provide HRT via informed consent will have an "information session" which is basically a presentation of the changes that will happen on HRT and the potential risks.
The "information session" might be a semi-informal individual consultation-style appointment where you discuss the effects of hormones one-on-one with the provider who will be prescribing them and they verify that you understand the changes that hormones can cause and you assert that it's something you're interested in.
The "information session" could also be a group presentation where a group of people planning on starting hormones attend a meeting where the provider does a PowerPoint-style presentation and then takes questions at the end.
Or you may not have a formal "information session". Instead, you might just have an appointment where they give you a packet of info that lists the changes and side effects that you can expect from hormones, and then you sign on the last page indicating that you understand the effects and consent to getting hormones.
Often informed consent does allow you to start HRT within only 1-3 appointments. First, you’ll have to schedule an appointment with said provider who is ideally in-network with your insurance. Then you'll have an initial consult/intake (which may be combined with your information session) where you discuss your goals and get blood drawn for labs. Finally, you'll have your information session if you didn't have that done in your intake, and you'll get your prescription.
Even if you don't have an informed-consent provider and they require you to have a WPATH letter from a mental health professional before you can get your prescription, you still may have to attend an information session or read a packet and sign papers asserting your consent.
But yeah, the way informed consent works varies a lot by the particular clinic or provider, and there isn't a standardized order of appointments or steps that every single provider follows so the way I got testosterone may or may not be the way you get your HRT.
I tried to google this and got several different answers: does E make it impossible to get someone pregnant? One source said that it might not, and a couple were sure that it would. I'm confused. thx
Roxie says:
The real truth here is a bit of both -- if you’re on E, that’ll will make you way less likely to get somebody pregnant (especially the longer you’re on it), but this is actually more to do with the lack of T than the presence of E as far as I understand it. Eventually, you’ll reach a point where it’s impossible to get somebody pregnant. There’s some evidence and studies now that suggest if you stopped taking E and antiandrogens, you might be able to regain fertility somewhat, but that’s beside the point and not what you asked; just an interesting note.
Regardless, the fact that HRT will make you less likely to be able to impregnate somebody should not be used as a reason to not use contraceptives -- there’s no absolute guarantee, and unless you’re getting like daily checks on your spermcount it’s way too big a risk. The studies behind what happens to people w/ testes who are on Estrogen are not very extensive. To clarify, I’m bolding and italicizing, Estrogen is not a contraceptive and shouldn’t be used as one -- you should be using contraceptives.
can I still take T shots while I have a Nexplanon implant in?
Lee says:
You’ll have to discuss it with the doctor who implanted your Nexplanon, and the doctor who prescribed your testosterone!
As long as both doctors are aware of the medications you’re taking so they know how the hormones may be interacting with it, and both agree that it’s fine, then yeah, it’s usually okay to keep the Nexplanon implant while you’re also taking testosterone because it’s a progestin-only implant and shouldn’t interact negatively.
In general, you can leave it in if you want to and from what I’ve heard, most trans people don’t report negative side effects from doing so.
So while I’d normally say yes, you can still take T shots while having an implant, I can’t give you medical advice about your particular situation because I’m not your doctor and it’s important to talk to your doctors about your body and needs; some doctors prefer to remove it to simplify things if you’ve got a complicated medical case.
Options to reduce the likelihood of pregnancy if you’re on T include:
Progestin-Only Hormonal Methods (progestin-only contraceptives are usually ok to use even if you’re on T, but talk to your doctor!)
(Testosterone isn’t a contraceptive, so if you’re on T, you’ll still need to do one of the above or you could get pregnant even if you don’t have a period anymore)
Not sure if you've answered something like this already but I've been on T for a few months (coming up on about 6) and I havent gotten my period this last February for the first time is this normal? (Theres no way I'm pregnant or anything like that)
Lee says:
Our Testosterone FAQ lists an average timeline of when you should expect to see certain changes on testosterone.
As it says, typically people notice that menstruation stops between 2 and 6 months on testosterone so you’re right on schedule!
So yes, it’s 100% normal to have your period stop after having been on testosterone for 6 months, and typically after a little bit of irregular cycles and spotting, it will stop for good and more-or-less stay gone for the rest of the time that you’re on T as long as your hormone levels stay in the right zone and you don’t miss any doses.
I’m considering going on T. Which way of taking T has been most effective for the mods? I know that different ways are better for different people but I want to hear peoples experiences before I decide to go on it
Lee says:
The most effective method of T really depends on the person. Maybe your lifestyle is different than mine and you want to do your T once and forget about it for a few months while you go camping; maybe you want to do it daily to minimize hormone fluctuations which can be an issue for some people with certain mental illnesses.
In general, I’d recommend considering the likelihood that you’ll be able to actually be compliant with your HRT treatment with each method knowing yourself and your abilities and so on, consider the practicality, and consider the cost.
1: What method are you able to use?
If you decide to do injections but you have a needle phobia and you avoid doing your shot and go for months without doing it because you’re too anxious, then injections are not going to be the most effective method for you and you should try gel
If you decide to do gel, but you’re not able to consistently apply it every day because you forget or you’re too busy, and you end up only putting it on once or twice a week when you remember, then gel (which requires a daily application) isn’t the best option for you and you should try injections
If you want to do injections but you have motor control issues or other disabilities that mean you can’t hold a syringe and inject yourself safely, and you don’t have reliable access to a caregiver who can do it for you or don’t want to be reliant on someone else, then maybe injections aren’t the best option for you and you should try implantable testosterone pellets
2: What method is best for your particular body?
If you use patches and develop an allergic reaction at the application site, maybe patches aren’t the best option for you and you should switch to gel or injections
If you’re using gel and you don’t experience enough changes and have low T levels, maybe switching to injections is better for you
If you’re on injections and find that having high testosterone levels at the start of the week and low levels at the end of the week/injectable cycle causes mood swings/exacerbates your mental illness/cause PMS-like symptoms from fluctuating hormones, then maybe injections isn’t the best option and switching to gel is better for you. With gel you’ll have more stable T levels that mimic cis men’s levels, and there’ll be a slight high in the morning when you put on the gel and a slight dip at night but overall fewer big swings.
3: What method is most affordable with your insurance?
If your insurance doesn’t cover testosterone gel and you appeal and they agree to cover it but the generic still has a $300/month copay for you, then maybe that is not affordable for your situation and you might end up not being able to pick up your prescription every month because you run out of money and can’t pay for it, so you should do the cheaper injections and pay like $15 per month instead
If you want to have pellets placed, but travelling to the doctor’s office for appointments every 3 months is prohibitively expensive because you can’t afford appointments that often or the office is too far away for you to easily get to without paying a million dollars in uber fares, then maybe pellets aren’t the best option for you
If you want to do injections but want to use an autoinjector instead of your typical syringe and your insurance won’t cover an autoinjector, then maybe you should consider using a typical syringe or switch to another form of T
If you want a longer-lasting injectable form of T that only requires injections every 6 weeks instead of every other week but your insurance doesn’t cover that form, then decide if it’s worth it, etc
I might say that the form of testosterone that was most effective for me personally is weekly subQ injections because I was depressed when I started T and didn’t shower often enough so the gel built up in a gross layer on my skin and didn’t absorb, but if you know that you’re someone who could never stab yourself with a needle on a weekly basis then daily gel is going to be better for you than missing two out of three or four injections every month.
And you don’t necessarily need to stick with the form of T that you start with. Say you start with gel and find it isn’t effective for you. Then you can talk with your testosterone prescriber and raise the dose! If the higher dose works, then great! If it doesn’t work, talk with your testosterone prescriber and switch to shots, or patches, or whatever else you want to try!
It can be a bit of a trial-and-error process to find the right for of medication for you, and it’s pretty typical to switch forms of T at some point on your T journey. So you aren’t necessarily permanently locked into using the form that you started on forever.
There are different pros and cons for each type of T, so there’s no one “best” and most effective way to be on T. How effective it is depends on your body’s reaction and you can’t predict that in advance, you have to find it out as you go along and experiment.
So all things aside, if every form were equally accessible in price and availability and practicality, there still wouldn’t be a universal “best” and most effective option because different people have different bodies.
That being said, most people tend to have good results with injections after finding the right dose so it’s a good place to start if you are comfortable with needles— but some folks are allergic to the carrier oil and need to switch from cypionate to enanthate for example, and there is more than one type of injectable testosterone and more than one way to inject it (intramuscular vs subcutaneous, and even if you choose one type of injection like SubQ there different sites like thigh vs stomach) so even saying “do shots!” leaves you with a lot of choices too, and none are clearly superior, just different.
The various options for testosterone are listed in our Testosterone FAQ, and as always, talk to your healthcare providers about what they recommend for you!
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