Six Months on T: The Recap
(Note: This is a long one. Scroll to the second and third section if you’re just interested in a recap of my time on T)
The decision to start testosterone six months ago today happened in a way that can only be called serendipitous. Around the same time I started having “am I non-binary?” thoughts, I found out that I have a rare kind of endometriosis, vaginal cuff endometriosis. It’s endometriosis that grows in the scar tissue of the tissue that’s sewn together when the cervix is removed.
Endometriosis is nothing new for me. I’d already had two surgeries to treat the chronic reproductive disease. I had had a total hysterectomy in 2021. My uterus and cervix were removed, along with a fair amount of endometriosis growth. In 2018, I went to the best surgeon in the country to have excision surgery — a laparoscopic surgery where all the endometriosis tissue and the lesions they cause are removed with margins, like tumors.
After each surgery, I was told that the chances of recurrence were really low. I had amazing surgeons. They performed thorough, meticulous surgeries. But endometriosis is like that ex who goes all stalker after you break up. It always comes back to torture you where and when you least expect it.
When I found out about the vaginal cuff endometriosis, my surgeon wanted to another surgery ASAP. I refused. It would be my fourth surgery in five years (counting the C-section I had to get to deliver my son), and that was just too much. I couldn’t do it.
My surgeon said she understood. She said that we could manage it with hormone therapy for as long as possible and delay surgery. As soon as she said hormones, I nearly threw up.
I’d spent multiple weeks before that having a complete breakdown about my gender. I won’t recap that breakdown here, because I already did that. Check out Gender in Transition, Body Image in Transition if you want that story.
And the idea of taking birth control pills to manage endometriosis was actually the killing blow to my “womanhood.” I knew that I couldn’t put female hormones into my body because I wasn’t a woman.
After some frantic Googling, I found that back in the day, severe cases of endometriosis used to be treated with an androgen medication called Danazol. It basically tells the body to produce more male hormones and less female hormones. Of course, women who took Danazol often weren’t happy about the side effects — voice deepening, increased facial hair, changes to the breasts, clitoral growth… essentially masculinization. And the more I thought about it, the more I didn’t think any of those side effects would bother me.
I knew I wasn’t a binary man. When I thought about being a man it felt just as wrong as still thinking I was a woman. I’m not either. I’m something else under the non-binary umbrella. But I felt surprisingly okay about being more masculine without being a man.
I expected some pushback from my surgeon, but she understood immediately. She asked me for my new pronouns immediately, used them every single time, and said Danazol was a completely fine choice. She even said that she would do everything she could to keep me out of surgery and off female hormones.
Within a few weeks of starting the Danazol I felt right for the first time in my life. Everything shifted a few degrees and I was in alignment for the first time in my life. My symptoms improved a few weeks after that, and everything was great… until I went in for bloodwork.
Danazol has a bad reputation for trashing people’s livers. And it was doing just that to me. My liver enzymes were dangerously elevated. Apologetically, my doctor told me that I couldn’t continue on the Danazol. On a whim, I asked “what about low-dose testosterone?” She asked if I wanted to be on T to medically transition anyway, and “yes” came out of my mouth automatically. I don’t know if I consciously knew yes was the answer before it came out, but as soon as I did, I knew it was right.
She said she’d need to do some research and talk to her mentor, who happens to be a transcare specialist, one of the best in our state. She said I could continue the Danazol until we made a decision.
Because I am who I am — a control freak with multiple chronic illnesses that doctors other than my specialists often don’t understand — I did my own research too. I discovered that there are a few studies about testosterone as a treatment for endometriosis in trans men. None on non-binary folks like me. But testosterone was being used to treat endo. I emailed my surgeon the studies, and she replied that she’d read the same ones.
Starting T
And just like that, I was starting testosterone. Well, not exactly. We had to fight my ridiculous insurance company for a few weeks first. But on July 5th, 2022, I gave myself my first shot of T.
I also decided to start a drug called Finasteride. Most often, it’s used to stop hair loss in cis men. However, it can also be used by AFAB people to stop hair growth when they’re on testosterone. Though there aren’t many studies on trans folks using Fin, anecdotal evidence shows that it can also slow or prevent clitoral growth.
When I was considering starting T, I knew that I didn’t want to present as a man just as much as I didn’t want to present as a woman. I wanted a deeper voice, fat redistribution to give my body a more masculine shape, and muscle growth. But I did not want a beard or a T dick. My research told me that I couldn’t control what effects testosterone would have on my body. How T changes your body is a gamble based on age, genetics, body composition, and random chance. However, many non-binary people described success achieving a more non-binary masculine transition with low-dose testosterone and Finasteride. So, I decided to go for it.
Like when I started the Danazol, starting testosterone gave me that undeniable feeling of alignment loooooong before I experienced any of the actual changes T brings. I felt like me.
At my six-week checkup, I knew that I wanted to increase the dose. I’d started at 25mg (very low dose), and we decided to go ip to 50mg. This is a pretty standard dose increase, but changing doses of any medication can have very different impacts from person to person.
And I won’t lie, changing my dose was a wild ride. I flew into a massive depression, this rage built up in me that I didn’t have any clue what to do with, and my mood swings rivaled any 13 year old’s. It was bad. I was so miserable that I was pretty convinced T was a mistake.
Luckily, I have trans people in my life that I can reach out to, and I did. They told me that big emotional changes are normal when you change T doses, and they pass. They told me to hang on for a few weeks and reassess.
I’m so incredibly grateful they told me that because they were right. After about three weeks on my new dose, everything went back to normal in my body and my brain, and I felt that authentic alignment again.
So, if you’re new to T, consider this your PSA. Things will get crazy. Ride it out, with good support from a therapist, your people, and your doctor, and it will likely pass. Going a bit wild when you start T or change your dose does not mean that T isn’t right for you. I mean, maybe it isn’t. But don’t make that call while you’re in the middle of a dose change. Ride it out and decide later. Unless you’re in danger, of course. I only made it through because I have an extremely supportive husband, doctor, therapist, and friends.
The Changes I’ve Seen in Six Months on T
When I was trying to decide whether or not to go on T, I scoured Reddit and Google for people’s experiences in an attempt to understand what I could expect. Of course, everyone’s experiences are different. Everyone gets changes at different times. But it was incredibly helpful for me to see how people changed at different intervals. So, I’m gonna share what I’ve seen in the past six months.
Before I saw any physical changes, I felt internal changes. It’s really hard to describe, but like I’ve said a few times it was right and I felt authentic aligned for the first time in my life. That happened within a week of my first shot.
The first change I physically saw was ACNE. My skin was always pretty nice, in spite of multiple hormonal issues. But within weeks of starting T, I started to see pimples. It took me a while to find the skincare routine that works for me, but my acne is now mostly under control. I use Salicylic Acid wipes and CeraVe hydrating AM moisturizer with sunscreen in the morning and PanOxyl benzoyl peroxide facewash (4%), CeraVe acne control gel (2% salicylic acid), and CeraVe hydrating PM moisturizer at night. I tried Proactiv and Differin routines before that, but both of them irritated my skin. I need a really gentle routine that’s tough on acne not on my skin. So far, this is working for me.
I also got SWEATY real fast. Like pouring sweat just standing in a warm room. Like had to change my clothes after any exertion sweating. I have no solutions for this so far. I’m just a sweaty mess anytime I move.
Slowly, my face started to change as well. I’ve been blessed with gorgeous cheekbones. Even as a fat person, my face has always been pretty angular, but long and fairly heart shaped. A few months after starting T, I noticed that my face seemed to be getting wider and my jawline was more visible. Obviously, bone structure doesn’t change, but the fat in your face does redistribute to slightly change the shape of your face. Now, at six months on T, my face is solidly square shaped.
Around four months on T, I started to notice that my clothes fit differently. I thought I’d lost weight, but when I stepped on a scale at the doctor’s office, I realized I hadn’t. After spending some time in front of the mirror, I realized that my body shape was starting to change. I’ve always had a very distinct hourglass figure, but the dip between my waist and ribs was starting to fill in. I don’t know how fat redistribution works because I am not a doctor or a scientist. But what it looked like to me was that the fat from my stomach was widening out, filling in my waist.
That redistribution has continued for the past couple of months. I used to have a pretty flat flop of fat that hung over my pelvic area, and a really distinct dip between my hip bones and my ribs. Now the dip is much less noticeable and there’s less fat on my stomach. It’s settled higher on my torso as well. It’s settled into a beer gut… just without the beer. My measurements showed that I’ve gained about an inch in my waist and lost about 2 inches in my hips.
I’ve also built some muscle. I lift 2–3 times a week, train martial arts 2–3 time per week, and teach four yoga classes a week. So, I’m really active. And I’ve noticed that activity feels a lot easier, and I’m definitely stronger than I was before.
The Finasteride has done exactly what I wanted it to really well. I haven’t seen any body or facial hair growth. In the past week or so I’ve started to notice the tiniest amount of extra peach fuzz around my jawline, but it’s barely noticeable and I’ve always had a bit of very light face fuzz. I also haven’t seen any clitoral growth.
There are a few more NSFW changes, but I’m not sharing those with the words. If you know me and my husband you can ask and we’ll decide if we want to talk about it.
My voice has dropped a little. Most noticeably when I’m signing. I can no longer sing along with female singers, or even some male singers with really good range. My voice has always been a little lower than a “normal woman,” so maybe that’s why I haven’t noticed a lot of change. But I can tell there’s a change. A couple people really close to me can too. But for the most part, people haven’t noticed a voice change.
Some people have said that being on T kind of “deflated” their breasts and made it easier to bind, and unfortunately, this hasn’t been my experience. My breasts are as huge and dense as ever and binding is a huge challenge. I can’t wait for top surgery, but it’s going to be quite a while before I can make it happen.
That’s it for changes so far. But for six whole months, I’ve been transforming into the person I always knew and never knew I was. I can’t wait to see where I am six months from now.
