December 28, 2015

Testosterone (part one)

I finally made my decision to go ahead with androgen treatment, hormones, medical transition, testosterone, T, primo, the oily Dionysian liquor, fountain of youth, the Holy Grail of transformation manna of the Gods, bearer of all that is man a couple of months ago.

Testosterone’s magical properties are widely reported on and sought after like a heavenly elixir. Just think: it has the power to transform woman to man, rendering him completely indistinguishable (except in tiny details) from men with an SRY locus.

To plough fields of skin and fertilise them with a forest of thick, bushy hair. To turn the voice from a sultry low alto to a querulous high tenor. To strengthen the bones and gird the muscles. To vitalise the elderly and provide the sexual energy that Viagra will then convert into the form of a perpetual, rigid, virile phallus like a primordial ancient statue. To turn an athlete into an übermensch. To provide the energy to write treatises, conquer countries, reform intellectual thought.

To render him a violent, sex-mad beast, a maddened Minotaur, a wild man with wild eyes. A pig, a filthy, narcissistic creature concerned only with power and privilege. A sweaty, stinky, hairy, fat, balding Lord of wealth and excess. Of chauvinism and sexism and misogyny and hatred of all that is gentle and soft and feminine and loving.

Here are your two faces of men; the hero and the villain, the lusty youthful prince and his craven corrupted uncle the usurper.

This is the power of testosterone.

You can imagine, given this, that I was terrified. Turning into a sexist, stinky, balding, hairy, fat, sex-mad, violent crazy man is not exactly inspiring. A feeling of greater strength and bulk in my shoulders and upper arms and the look and sensation of facial hair and being treated like who I actually am on the other hand sounded great.

But the irreversibility. The inability to turn things back if this was a horrible mistake. The fear and hostility in the eyes of a quarter of the people I introduce myself to as Tom’.

And my extended family who are incapable of conceptualising anything different whether it be being single or interracial marriage or inter-caste marriage or inter-religious marriage or de facto relationships or extramarital sex or premarital sex or children out of wedlock or disability or mental illness or changing religions or political difference or men who cook and do the dishes or women who eat at the same table or homosexuality or bisexuality or transsex or transgender or genderfluidity or intersex or divorce or abortion or anything that deviates from the established social order in which you, at the correct age find or have found for you a spouse of the opposite sex and with whom you create two to four picture perfect children and live in a house and then they go forth and do exactly the same.

I remember though that my heart would sink every time I said I haven’t decided’ or hormones are not an option for me’. That dragging, grey dysthymia, the dysphoria of lying, the shitty feeling of a painful existence.

What happened was that I quit the pill. It wasn’t really controlling my periods anyway and my breasts had gone from a C-cup to a DD and I was feeling flat and had no sex drive or any drive of any kind whatsoever. I had a Mirena put in instead- and God that hurt at first! A searing pain in my abdomen and intense cramping that settled after 24 hours to a dull pain on and off for a week and then finally went away. I stopped the pill soon after. Some minor bleeding around the time of the procedure but that was about it.

After a couple of weeks I felt stronger, physically stronger, especially in my upper arms. Some of the sneaky virilisation of PCOS, unattractive as it was, came back but that was actually alright. And that was when I knew that I had made my mind up.

It was while I was recovering from the flu and I was writing a presentation for work at about 3am and I was sleep-deprived. It was the right decision but I burst into tears because it was picking the least worst’ of two options.

And then timing became the issue. In the end I realised I had to really do this stuff earlier rather than later so that I could be obviously male for both the clinical exam (if I pass the written exam) and the interviews because of how difficult changing in the midst of all that would be and because there would never be a good time again given that we have 1 year contracts.

I told work who sort of knew anyway but who let my workmates know. I found out that I could not be Tom until I had changed my name officially with the government and with the medical board. I got a referral to the endocrinologists at the Andrology Clinic at Concord Hospital. I had to do a lot of paperwork and chase up a lot of documentation from the past 3 years to prove that I was living in New South Wales (I have no idea what happens if you are unlucky enough to have moved interstate in that time). I had to wait until I had more money.

My workmates have been pretty great, overall. Seriously! And I would say that to my surprise, the least judgemental and most accepting and respectful people have often been people from non-Western cultures.

I was extremely stressed by the time I got to my appointment. Because by that point not only had I made my mind up, I had a set of deadlines in my head. And I was scared I would get knocked back for medical reasons.

In reality it was very straightforward. I had a consultation, my endocrinologist took a history, examined me, explained the risks (balding, acne) and treatment effects (hair, voice, muscle mass, fat redistribution, clitoral enlargement) asked me what I was worried about (cardiovascular risk: probably disproven; insulin resistance: improves it very slightly or no difference; osteoporosis: improves), and wrote me a script, booked me in for an appointment in 2 months with a bone scan.

Leaving, I felt completely and utterly relaxed. Content. Not euphoric or transcendent or excited. Just… relaxed and content and relieved. It was a fantastic feeling. I caught up with a friend and his friends and we played some PS4 in his work auditorium and had dinner and chatted. I got up early in the morning to drive back to work and I still felt great. I got lost in Sydney but managed to finally work out where I was going and drive home. The weather was lovely and I listened to all the random songs I have on my phone, various radio singles from the last 25 years.

I got my prescription with a minimum of fuss (though the pharmacist had difficulty reading the handwriting) and went home after work and injected myself (very slowly with a smallish needle) in the upper outer gluteus. It was pretty easy and did not hurt that much.

So far nothing dramatic has happened. Which is a relief too. My libido has not gone through the roof (the most likely thing to happen early on). I have not sprouted jungles of body and facial hair yet. My pink bits are the same. Unfortunately I got some bleeding but apparently that is also quite common and not a huge deal (it takes about 6 months to stop menstruating, apparently). I am not violent or angry or aggressive.

But! My dreams (literally, the dreams I have while I sleep, rather than my daydreams or hopes) have changed. Quite a lot of my dreams have been romantic dreams featuring generic fictional dream-women. Some of my dreams have been about physical changes or being physically male or wearing a binder (I do not wear binders usually). I can feel my brain rewiring itself to incorporate all the information and changes that have come from making a decision and making changes in my life.

I will take photos roughly every time I take a shot (every two weeks) to document the changes but I am not expecting anything very rapid.

Most importantly I feel more confident and happier and more relaxed and content because a huge load of stress has been relieved. For now, that it is enough.


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Testosterone (part two) *In those with male hypogonadism/transgender men and given at normal therapeutic doses. Does not apply to anabolic steroid abuse or use in men who