Intro to Testosterone
Beginning testosterone is an exciting and deeply personal step for many trasmasc individuals. It can bring about profound physical, emotional, and social changes. If you’re considering starting T, here’s what I hope is a comprehensive guide to help you navigate this transformative journey. As usual, I am not an expert, these are just things I’ve learned along the way so please always consult a doctor before starting or changing your hormone therapy.
What Is Testosterone Therapy?
Testosterone therapy is a form of hormone replacement therapy (HRT) that involves introducing testosterone into the body to more closely align your physical traits with your gender identity. It’s typically administered via injections, gels, patches, or pellets. It is important to note, though, that being on HRT is not necessary for someone to be trans or non-binary. There are a thousand different ways to express your gender and gender expression, and this post is meant to serve as a guide in case you might think HRT will help you on this journey.
The effects of testosterone can be categorized into:
Masculinizing changes: These include voice deepening, facial and body hair growth, fat redistribution, muscle development, and more.
Other changes: Emotional shifts, increased libido, and skin changes such as increased oiliness.
Preparing to Start Testosterone
Before starting T, it’s important to:
Consult a Knowledgeable Healthcare Provider: Seek out a healthcare professional who has experience working with trans individuals. They’ll guide you through the process, including:
Conducting blood tests to establish baseline hormone levels and overall health.
Discussing the potential risks and benefits of testosterone therapy.
Helping you choose the best method of administration.
Understand the Long-Term Commitment: Testosterone therapy is often a lifelong commitment. Regular monitoring through bloodwork is essential to ensure your levels are safe and to adjust your dosage if needed.
Set Realistic Expectations: Changes from testosterone happen gradually, often over months or years. Patience is key, and every person’s experience is unique. Discussing timelines with your doctor or other transmasculine individuals can help manage expectations.
Methods of Administration
There are several ways to take testosterone:
Injections (within the USA): The most common method within the US are injections that are administered either intramuscularly (IM) or subcutaneously (SubQ) typically every 1-2 weeks.
Injections (outside of the USA): Many countries outside of the US offer IM injections that only have to be administered between every 2-3 months. It works similarly to the IM injections offered in the US, except it’s a much larger dose that has a prolonged-release effect which allows it to hold fairly stable T levels across the 2-3 months.
Gels or Creams: Applied daily to the skin.
Patches: Adhered to the skin and changed regularly.
Pellets: Implanted under the skin by a healthcare provider, releasing testosterone slowly over time.
Each method has its pros and cons, and availability will likely vary depending on location, insurance, and pricing. Work with your provider to determine which is right for you.
Essentials for Injection-Based T
Below are some items that I found to be essential for injection-based testosterone. As with much of the other advice I give throughout this website, it is important to note here that I am not a medical professional and you should always be heading the directions of your doctor at all times.
Syringes: For the shots that need to be administered every 1-2 weeks, I found that this 3cc syringe worked well. For the larger doses of T available outside of the US you’ll need a larger syringe with at least 5cc capacity, depending on the total quantity you’ll be injecting at a time.
Needles: The 3cc syringe linked above includes a 23Ga needle which I found was ideal for my IM injections. If you prefer to purchase the syringes and needles elsewhere, I’d recommend getting a needle between 21Ga-23Ga for injecting into skin and then a larger 18Ga needle for extracting the testosterone from the vile.
Bandaids: For use immediately following the injection I like to use these small square Band-Aids.
Alcohol wipes: For every shot day you’ll need a minimum of 2 alcohol wipes - one to disinfect the top of the testosterone vile before you extract the T, and another to disinfect the shot site on your body just before you give yourself the shot.
What to Expect
I hesitate to even include a general timeline, because everyone’s experience is different and can vary based on factors such as genetics and strength of dosage. Nonetheless, here’s a general timeline of changes based on what is typical for someone who is AFAB beginning a standard dose of testosterone:
1-3 Months:
Increased libido.
Oilier skin and potential acne.
Possible mood shifts.
3-6 Months:
Voice deepening.
Bottom growth.
Fat redistribution.
6-12 Months:
Facial and body hair growth.
Increased muscle mass and strength.
1-2 Years:
Further voice changes and hair growth.
Slower changes such as hairline shifts.
Potential Side Effects and Risks
While testosterone is safe for most, it’s not without potential risks, including:
Increased red blood cell count.
Changes in cholesterol levels.
Acne and skin issues.
Mood fluctuations.
Regular check-ups and bloodwork are essential to monitor these risks.
Community and Support
Starting testosterone can be both exciting and overwhelming. Connecting with others who are on the same journey can provide invaluable support. Consider:
Joining local or online transmasculine support groups.
Following content creators who share their T journeys.
Seeking therapy with a gender-affirming counselor.
Celebrating Milestones
Every change, big or small, is worth celebrating. Whether it’s your voice cracking for the first time or noticing new stubble, these milestones are affirmations of your journey. I encourage you to take note, you may even be surprised by the joy you find in changes you once felt unsettled by. And remember, there’s no right or wrong way to be transmasculine—this is your story to write.
