What is the process for getting onto testosterone?
The first visit is always a consultation you won't get T day one. It's a process. Many doctors' offices require a letter from another doctor's office but usually from a mental health provider.
Second appointment is usually blood work and you should fast to allow for accurate results but follow your doctor’s recommendations.
Third appointment they call you back and discuss your results.
Fourth appointment. They teach you how to inject yourself or schedule your first dose. Congratulations!
After this you are on your own you need to schedule appointments to continue to check your testosterone levels and to make sure that your transition is going smoothly.
Not everyone passes right away.
While passing is not an all or nothing game, not everyone passes as soon as they start socially or medically transitioning. It's okay for it to take time and for you to choose the pace of your transition.
There is no such thing as a standard dose of T.
Your dose of T is based off of your lab work. Your provider knows what testosterone levels are safe for you but you can always talk to them about adjusting your dose.
“Stealth” isn’t an all or nothing.
Some people can be out to friends while they are stealth at work or at home. You are not being deceptive by not being out to the world. Your safety comes before anything else.
You can change your name again.
You may find a name that fits better after you thought you had one. Not everyone will be patient with you always changing your name but finding a name that you find fits you is important.
Your body fat does not shift.
Starting testosterone is great. You build muscle. The downside you also gain more fat. Your body fat shifts around a bit but ultimately you gain more weight. This is normal though you will now need to work harder to manage your weight. Just check with your medical provider to make sure you are staying healthy.
A picture of a peach
Butt hair
It's unfortunate, but it doesn't happen to everyone. For those that it does happen to, you don't really have much you can do except keep it trimmed or leave it alone.
There is nothing wrong with detransitioning.
There is a stigma in the world about detransitioning. That it's wrong or that you transitioned for the attention. Some may say that transitioning was a phase or that you were lying. This is simply untrue and it is a stereotype we should break down. Not everyone can afford nor wants to stay on hormones for their entire lives. Transitioning is a personal experience, gender is not static and therefore your transition should not need to be a static or linear one either.

Questions about Testosterone

What is T? Is it synthetic?
Testosterone & yes.
Can I do my own shot?
This depends on your provider and you. Some doctors will have a nurse on site to teach you to inject yourself. Other providers may have you come in biweekly to attain your shot.
How often would I inject?
It depends. Testosterone is most often given once a week to help balance the rise and fall of testosterone levels in your body.
Is testosterone right for me?
That is a personal journey. Finding a gender therapist can help you make this decision if you are questioning hormones.
How often do I need to have follow-up appointments?
It is recommended that you start to meet with your doctor every 3 months the first year, 6 months the next year, and then once a year.
Will T make me a different person.
No. While testosterone can make you happier and more confident it does not change your personality. Being aware of how testosterone effects your body and your mood is important but it is not as large of a factor as rumored to be.
If I double my dose will the changes happen twice as fast?
No. Doubling up is not only dangerous but can slow down your transition. Testosterone thickens your blood which can lead to blood clots and heart problems. Your body may also turn extra testosterone into estrogen as a safety against testosterone poisoning.
Can I decide which changes I will get?
No. As much as we would love to pick and choose the effects of testosterone on our bodies we cannot.
Do I have to stay on hormones my entire life?
No. Hormones are a large decision and while most effects of testosterone are permanent some of them are not. You can stop testosterone at any time with the assistance of a doctor to make sure that you are safe. Most effects of testosterone are completed in the first two years of hormone replacement therapy and from there people using hormones continue on a maintenance dose.
What happens if I stopping taking T? What is permanent?
You will start to lose muscle mass and your face may start to appear more feminine after stopping testosterone. You may also get your period again. Always talk to your medical provider before stopping any medications.
What are the different types of testosterone and how do I take them?
Intramuscular Injection – most common.
Subcutaneous Injection – longest standing.
Transdermal Application - gel, cream, or patch.
Both intramuscular and subcutaneous are scheduled injection. How often you get a testosterone shot depends on you and your doctor. Most people start with biweekly injections.
Transdermal testosterone has been shown to be less effective at causing changes but is more effective and holding testosterone levels consistent in a person body. Transdermal testosterone can be applied to the skin in gel, cream, or patch form. These are harder to have insured.
How long do I have to be in therapy before I could start testosterone?
More providers are moving towards an informed consent model. Those who require you be in therapy usually require a letter. WPATH has no standard time period for any individual to be in therapy before receiving a letter for hormone replacement therapy.
What does the letter from my therapist need to say?
The recommended content of the referral letter for masculinizing hormone therapy is as follows:
  • The client’s general identifying characteristics;
  • Results of the client’s psychosocial assessment, including any diagnoses;
  • The duration of the referring health professional’s relationship with the client, including the type of evaluation and therapy or counseling to date;
  • An explanation that the criteria for hormone therapy have been met, and a brief description of the clinical rationale for supporting the client’s request for hormone therapy;
  • A statement about the fact that informed consent has been obtained from the patient;
  • A statement that the referring health professional is available for coordination of care and welcomes a phone call to establish this.
For providers working within a multidisciplinary specialty team, a letter may not be necessary, rather, the assessment and recommendation can be documented in the patient’s chart. From WPATH.

Guide to Intramuscular Injections

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Tips for Reducing Injection Pain

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