The What-Ifs of Starting Testosterone

I crave it but I’m scared…

The decision to start hormone replacement therapy which entails weekly intramuscular testosterone injections into the thigh, was the hardest decision I’ve ever had to make.  It also remains the best decision I’ve ever made.  Testosterone makes me feel like my body and mind are running on the correct fuel. 

Explaining to people how, as a transgender person, I feel like I acquired the wrong hormone at puberty and had been operating off the wrong hormone ever since, has been no easy task.  The best way to explain it is:  If your body were a bicycle with a series of gears, having the wrong hormone is like trudging up a hill in the wrong gear.  The bike is moving forward, the wheels are spinning, but without the gears being perfectly aligned, the ride is bumpy, jagged, slightly askew.  You move through life yet something is just always “off”. 

A foggy resentment towards estrogen pestered my subconscious for years, an elusive feeling that was hard to put my finger on in the beginning.  Everything estrogen did to my mind and body, I hated.  Breasts, womanly hips and fat in the wrong places, periods, emotions and crying that were hard to control.  I watched trans guys who had started testosterone develop deeper voices, grow facial hair, undergo body fat redistribution to a more “male pattern”, and gain muscle.  These changes, I craved.

The decision to start testosterone was one interwoven with excitement and longing, fear, reservation, and uncertainty.  When facing a huge decision, a hint of uncertainty will probably always exist.  If you wait for the moment to feel 100% sure, that moment may never come.  Uncertainty about taking a risk, does not make it a wrong decision.  Rather, blindly taking the leap into the unknown brings the greatest reward.

It’s impressive how capable the mind is at concocting a million reasons not to do something.  I worried about regretting my decision.  I deluded myself into worrying, what if I regretted the changes testosterone made to my body but there was no turning back?  Aside from a few changes like voice, to some extent, hair, and any balding, upon cessation the effects of testosterone are reversible.  Of course, at that point, I’d have to admit to everybody that I had made the wrong decision, only reassuring them in their original disapproval, an utterly unbearable apprehension.

Always a highly emotional, intuitive and compassionate person, possessing an emotional depth through which I perceived this world, I feared Testosterone could steal that life force from me, reducing my ability to feel.  Testosterone has in no way reduced my ability to feel emotion.  I still save wounded birds and feed stray cats.  I smile at homeless people on the corner just to make them feel human.  I cry when nobody is looking.  The suffering of the world continues to affect me on the deepest emotional level and in fact, the challenges I’ve faced being transgender, have created an even deeper sense of compassion.  Testosterone only makes it easier to not cry or shove down emotions if preferred.

A weekly injection of testosterone keeps my testosterone and estrogen levels in male range.

On a similar note, I feared testosterone would turn me into a totally different person, either I’d look into the mirror and not recognize myself or my personality would undergo metaphorphosis. 

Would I become an aggressive, macho mutant, who was unable to feel?  I wanted my body to transform, but not beyond recognition.  I wanted to exist as a son instead of a daughter, a brother instead of a sister, a boyfriend instead of a girlfriend, a man instead of a woman; I did not want to lose the essence of what made up my unique personality.  What a terrifying unknown it was to think of my mind and body mutating in awkward distortion instead of becoming more refined but every change has been immensely worth it. 

I am undeniably the same me, just paradoxically a more authentic version. No, none of these fears ever manifested as reality.  In the end, I knew if I did not try testosterone, the idea would plague me for the rest of my life.  That potential burden weighed greater on my heart than any list of fears that my mind invented up to that point. 

I grew facial hair, gained muscle, developed a deeper voice, my facial shape has changed, my Adam’s apple became more prominent, I am consistently gendered as male and I am able to show up in this world, confident that people see the real me, metaphorically skipping rather than treading water.  I feel like a whole person as my outside matches my insides.  Most importantly, my mind feels at peace.  Perhaps testosterone re-wired my brain in the correct way but my genuine self is no longer hiding.

Published by Christian

I am a Certified Life Coach at Out and Proud Life Coaching, LLC. I started out helping transgender individuals and their parents through all stages of transition. As a master of change, I have now expanded to also work with people who have a nagging feeling that they want something more out of life but are hindered by fear of change, transition, or difficult decisions. Please visit to subscribe to my newsletter or sign up for a free 30-minutes session so you can experience what coaching feels like!

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