Testosterone HRT Overview, Guide & Information for All People Seeking It
Hello, we’re a genderqueer person who’s been taking testosterone HRT since 2015. I’ve also worked in a pharmacy and we’ve seen a lot of the roadblocks that comes with people trying to start HRT. Nobody really explains how difficult it can be, even when you get your prescription. Because testosterone is a controlled substance in many places, it creates hurdles. There can be a lot going on, and some folks become very disheartened if their T isn’t covered by insurance. i get that. We wanted to create a relatively easy to digest and succinct post detailing some common hurdles people have to face on the doctor/prescriber and insurance level, as well as after getting their hormones. *please note that a lot of this information is United States centric as that’s where i live, i can’t give information for a country i’ve never lived in, unfortunately.*
If your primary care provider is already familiar and comfortable with prescribing HRT, you can go through them, find an informed consent clinic, or seek an endocrinologist or gender affirming care specialist. Planned Parenthood is a good option for many people. If you don’t have insurance, check to see if your area offers medicaid or other low income insurance plans, T can get pricey in some areas, especially for topical. if you can’t access insurance please look into services like GoodRx that offer coupons and discounted rates for prescriptions.
Your provider will ask you some questions about your experience with gender, any dysphoria, why you want to seek medical transition, if you’d like to seek surgeries, assess your mental health, and then screen you for potential health problems or roadblocks. Your liver enzymes will be screened, as will your hormone levels, blood pressure, and some other things. Make sure your doctor knows to note that you are a transgender patient so that your blood tests are not discarded because your gender says “F” instead of “M” on the paperwork.
In some areas it is required to seek treatment with a therapist who specializes in transgender care to make sure this avenue is right for you. Not everywhere requires this step.
Make sure you talk to whoever is prescribing the testosterone to you about insurance, and if they are aware that testosterone is a controlled substance. A controlled substance is a substance that has been restricted by your country’s government or governing medical organization and has to be monitored carefully. You need what’s called a “prior authorization” from your doctor in order to get your insurance to give you your hormones in most states. Talk to your doctor and pharmacy about prior authorizations for your testosterone and syringes if you need them.
Currently, the only forms of testosterone available for masculinizing HRT are testosterone cypionate (injectable), topical gel, and patches. Topical forms are usually applied daily, injections can be done once or twice a week, or even more or less frequently if a person needs it. There is no pill option available for masculinizing HRT currently.
HRT and Administering Testosterone
When you get a prescription, how things go will depend on if you get your doses administered at the clinic, or if you choose to do them at home. If you are not comfortable self administering, ask if they will at the clinic. many places offer this service.
if you choose to administer at home, if you are using injectable T, note that pharmacies may give you the wrong gauges of needles because they don’t often give out needles for HRT. You need two different sizes- a thicker, longer needle for drawing from the vial, as testosterone cypionate is thick. You will have a large 18g needle for drawing and a small 22 or 23g needle for injecting. Sanitize your injection site and your hands, never using the same needle tips twice for any reason. Never use needles that have touched another surface, and get a sharps container.
Make sure you are injecting in different spots every time you inject. you do not want to inject into the same patches of skin every time, as this can cause tissue damage, tissue death (necrosis), and severe scarring after long periods of time of having to heal but being interrupted over and over again. inject into slightly different spots every time to make sure your skin and muscle tissue can heal.
When applying topical T, make sure you clean the skin before putting it on, and do not shower or go swimming for 2 - 5 hours after application. make sure you cover the skin with some kind of clothing. You want to make sure it doesn’t rub off on other people, as other people can absorb it as well by touching you. Do not ever have someone else apply topical testosterone for you, even if they are also trans, as this can mess with their levels in a bad way.
After starting T you may have to adjust your dose over time to achieve desired effects. if so, you will start on a starter dose and then you can move up to higher doses as your body adjusts. This process is called titration.
Growth and thickening of facial and body hair begins 3 - 6 months after treatment starts and the full effect happens within 3 - 5 years.
Menstruation (periods) stop. This occurs around 2 - 6 months within starting treatment, and is one of the most desired effects.
Voice deepens. The vocal cords thicken, which can cause uncomfortable sensations in the throat for a time, such as a scratchy feeling, dryness, tightness, pressure, and a ‘sore’ throat that isn’t sore in an illness related way. This begins 3 - 6 months after treatment starts, and the full effect happens in 1 - 2 years.
Body fat redistribution begins 3 - 6 months after treatment starts and the full effect happens within 3 - 5 years.
Growth or enlargement of Adam’s apple.
Clitoris grows larger, and vaginal lining can thin and become drier. Some experience vaginal atrophy and/or painful levels of dryness, while some maintain a healthy level of vaginal fluids without problem. This begins 3 - 12 months after treatment starts, and the full effect is usually seen within 1 - 2 years, though some experience growth over a long period of time if their dose is low.
Change in body odor and increased sweating occurs within 1 - 3 months of starting treatment.
Muscle mass and strength increase, this will begin within 6 - 12 months and the full effect will be seen within 2 - 5 years.
Possible libido increase, though some report no changes or even the inverse.
Potential but not guaranteed balding or receding hairline, which is treatable, and not seen in everyone.
Potential increase in energy in general, some report an almost antidepressant like effect.
Possible increase in red blood cell production leading to high blood pressure, which is treatable via medications and donating red blood cells when appropriate and safe.
Do NOT become disheartened if you do not see the effects you want to see right away. It can take several years for the full effects of certain aspects of medical transition to show themselves. Stay patient, talk with your provider, talk to other trans people.
There is not really a guide book to masculinizing HRT and medical transition, most of the information there is is passed along between each of us. We will continue to edit this post as we think of more important information.
@lgbtqcreators creator meme: [5/8] lgbtq+ celebs “I had to free my own mind of what, at that time, what I felt like masculine adrogynous energy looks like. I was living in my own binary, and I was like there’s no way that I can be androgynous with bigger boobs now. How I feel inside is the thing that I needed to work through.” — JANELLEMONÁE
never let kids get into stories about shapeshifting first theyre pretending to be wolves on the playground then theyre getting radicalized by animorphs then theyre realizing the human body is an impermanent and malleable thing then theyre discovering you can take a potion to change your gender in real life
I literally don’t have the space for any more physical books, but I’ve downloaded every Underrealm book on Kindle. I read The Alchemist’s Touch specifically because of this post and I seriously can’t recommend the Underrealm books enough. they are absolutely fantastic.
I don’t really read anymore, not like i used to. And of i get a masters this year like i am planning to then that isn’t going to change. But hell yes I’m going to go and buy these books because THIS is exactly the kind of thing that i want to support!
YISSSSSSSSSSSSSSSSSSSSSSSS
One day I will have a job and a bank account and I will have money from the job in the bank account and I will use some of the money to purchase these books
Hey did you
did you know
did you know we have a podcast now and you can literally listen to the books for free.
(You probably didn’t. That’s okay because it’s very new).
It’s slower than buying and reading them, but it’s great if you have no book budget but you do have some listening time!
do you ever sabotage your own free time? like wtf is that about? i want to play this game or read or do something specific but instead i will just stare out the window or scroll mindlessly???
why do people in dnd each occupy a 5ft by 5ft square, how far apart do you think people need to be? why are dnd minis afraid of touching
dnd minis standing five feet apart in a dungeon cuz they’re not gay
look, if the guy to my left has to do the turbo-macarena while charging a bolt of flesh melting while the guy on my right is doing every bruce lee move at the same time and the guy in front of me is flourishing a broadaxe like hes doing yo-yo tricks im going to give each of them enough floorspace to not liquefy myself
fuck a “personal bubble”, stay out of my
BLOOD CIRCLE
So glad that non-scouts can appreciate the term blood circle properly.
The slow growing plant Pelargonium ‘Freak of Nature’ (geranium) needs to be grown in good light conditions. The appearance can be variable but the stems are white with green and cream leaves. Any fully green shoots that appear need to be removed. This cultivar was first recorded in 1880.
