My First Three (And a Half) Months on Testosterone!

Zoë Ariel Dunning
Jul 22, 2021
8 min read

Updated: Jun 17, 2022

16 weeks after I started injecting testosterone to transition hormonally, I decided to explain how I started getting transgender healthcare, some barriers to access that I've encountered, and give an update on some of the changes I've experienced.

On the left: the week I began T. On the right: 16 weeks on T as of the end of July 2021.

DISCLAIMER: None of the information in this post or on my blog is intended to supplement medical care or advice. I am not a doctor; I am simply a non-binary trans person sharing MY experience of receiving testosterone doses. I am disclosing my dosage amount as one detail of MY care, not to be used as any sort of medical standard. Talk to your doctor before adjusting your own dosage or care.

Furthermore, please understand that I am choosing to share about this aspect of my life. I am willingly and vulnerably disclosing very personal medical details and care. If you are uncomfortable with needles and discussion of genitalia/body changes, this post isn't for you. None of the information I share is acceptable to be used against me in any way.

On March 23, 2021, I injected my first testosterone shot after I had multiple epiphanies in October 2020 that I've been sitting on a lifetime of deep discomfort in my own skin. Soon after was Easter, which seemed strangely fitting for me since I was raised Christian.

In the non-binary/transgender community, people who are unaware that they are trans are referred to as "eggs". When they begin to realize who they are, they may or may not "come out of the closet", but this process of discovering yourself and rejecting the gender and sex you were assigned at birth is called "hatching".

So for Easter this year, I truly experienced a rebirth and transformation as I hatched from the egg I was confined to. That may sound corny to you, but with my background, that thought is truly profound to me.

Some of my "egg" photos when I was just beginning to hatch, such as enjoying my gender-affirming hairstyles and wearing my first binder.

Starting Transgender Care

Planned Parenthood

Initially, I went through Planned Parenthood to start receiving gender-affirming care because of how affordable their services are compared to most doctors and hospitals. I know that PP is an organization with so much controversy and stigma swirling around it. All I'm going to say is this: abortions account for only 3% of the services they provide annually and, as of 2020, they provide gender-affirming care in 31 states in the US. (Here is their annual public report for 2020.)

I scheduled three video call consultations with a Planned Parenthood doctor. I anxiously skipped the first two consultations I planned before I worked up the courage to attend the third. The process was much so much smoother and more affirming than I expected. After a short intake, I spoke to a doctor who, for the first time in my life, validated my feelings and existence as a non-binary, transgender person as I shared about the lifelong confusion, anxiety, and depression due to feeling trapped in a foreign body that I've experienced.

I was simply just me, and I didn't have to explain or justify myself to get the care I needed.

After an hour of speaking with me, the doctor told me that since I exhibited clear signs of gender dysphoria, she agreed masculinizing hormone replacement therapy (HRT) was a good treatment plan. Then she wrote me a prescription for testosterone cypionate with instructions to inject 0.3 ML once a week. I couldn't believe that after all the years of struggle and emotional turmoil that taking the first step was as easy as a phone call!

Note: PP provides gender-affirming care on an informed consent basis, which means that they inform you of the likely effects/possible side effects and don't require a doctor or therapist note. If you're interested in more detailed information about the HRT I'm doing, see Evolve MD's easy-to-understand masculinizing hormone therapy explanation or UCSF's medical guidelines for masculinizing hormone therapy.

Getting My Prescription from the Pharmacy

A selfie I took the day I took my first T shot. I was wearing my he/him pronoun pin that day, even though I generally go by they/them and he/him, because I was feeling particularly euphoric with those pronouns that day.

At the end of March 2021, I went into the Walmart pharmacy nearest me to get the vials, syringes, and needles. While I waited for the pharmacist to approve the pick-up, I noticed that multiple whitecoats were repeatedly looking at me and whispering among themselves. Eventually, one of them came over and introduced themself as the pharmacist. They seemed uncomfortable and announced what my prescription was loudly enough for other shoppers and employees to hear. Then they proceeded to ask a series of increasingly invasive questions that culminated with,

"Are you taking testosterone to become a male?"

I didn't know what to say back, and my boyfriend at the time was no help as he silently looked on. "None of your business. That's private medical information," I wanted to reply.

Instead, I found myself giving a hesitant, horrified response—"Um, not exactly, but yes"—after they asked a second time, insisting the information was relevant because subcutaneous injections of T are usually for "becoming a male".

I wanted to say, "No, I am not 'becoming' anyone or anything. I am already me...not a man or a woman. I just want other people to actually see me."

To make matters worse, this pharmacist then refused to demonstrate how to do subcutaneous injections (some moral objection they have, no doubt) despite my complete lack of knowledge or experience. So with a hasty explanation that I soon learned was dangerously inaccurate, they sent me on my way, and I turned to YouTube and the online trans community for help.

I quickly realized that this is a reality that the vast majority of trans people in the US face. Trans people have historically relied on each other for support, advice, and solidarity because doctors and professionals from all fields are largely ignorant about trans care and/or deeply bigoted. So trans people have to tread carefully and research doctors in advance or risk neglectful, misinformed care.

After a childhood friend showed me on a video call how to inject using an orange, my then-boyfriend injected my first shot for me at home because he had prior medical training in the military.

Warning: image showing needle and injection below.

Subcutaneous T shot in my abdomen

I administer my own shots now.

EvolveMD

I get my care now through Dr. Anthony Strickland with Evolve MD, which is an online service that I very highly recommend. Dr. Strickland is a trans-affirming cisgender doctor in the Kansas City area who operates this charity program with a non-binary staff member because he believes that trans care shouldn't be difficult to access and that it should be affordable. EvolveMD is definitely the most affordable option for transgender medical care that I’ve found so far at $50 a month for appointments, unlimited texts and calls with the doctor, on average just $25 more for labs every 3 months, and primary medical care as well. (#notanad)

Changes on Testosterone So Far

Mental and Emotional Changes

As the fluid from my first T shot began circulating throughout my body, I felt immense relief and calm wash over me like I'd achieved homeostasis. I know that's such an autistic way to describe that lol, but that's truly what I experienced: equilibrium. I knew that I could finally relax knowing that my body was beginning the transformation I needed after years of dealing with such agonizing dysphoria and being unable to understand why I felt that way or what I could do about it. So, finally, I relaxed and rejoiced!

I have noticed a night and day difference in mental and emotional stability since then. Of course, I still deal with depression, anxiety, and anger, but most of that initially was from daily abuse and the continual fallout/triggering reminders of trauma. I don't recommend being in an abusive relationship/living situation while deconstructing your entire sense of self and vulnerably starting a second puberty...definitely restricts the transformation and makes it more stressful.

Now that I'm out of that, my mood swings from my body adjusting to my changing hormone levels are much more minimal and manageable. I feel so much peace, joy, and excitement for the future knowing that my body is on track to match my mind.

Some trans joy and gender euphoria

Physical Changes

Some of the main effects/expected timetable for both feminizing & masculinizing HRT.

Two of the first changes I noticed were bottom growth and an increased sex drive. "Bottom growth" refers to clitoral hypertrophy, or the clitoris growing in length and width. Although the chart from Planned Parenthood estimates this growth begins at around 3-6 months, most transmasculine people seem to agree that bottom growth (and growing pains) begins rapidly and as soon as 1-2 weeks after the first dose.

Your appetite is supposed to increase quite a bit too, but I've been battling an eating disorder and loss of appetite from stress and trauma, so I have yet to see that really take effect.

My skin got much oilier quickly, and along with that came more acne. My skin has also become thicker. When I inject now, I feel like I have to press harder each week to get the needle to push through my skin!

My first two months on T, my vocal cords were constantly swollen as they started growing, often making my throat and voice hoarse. I get gender euphoria when I distinctly hear how my voice is deepening. Every time my voice cracks, instead of feeling embarrassed, I feel a surge of joy because THIS is what I wanted out of my puberty. I made fun of boys' voice cracks growing up, but really, I was jealous because I wanted my voice to be changing like that!

A month on T or maybe even sooner, I started noticing that my muscles feel swollen and sore sometimes, seemingly for no reason. My hand grip and muscles have been strengthening despite my health issues.

Of course, I have soooo much more hair everywhere! Before starting T, I already had a unibrow, mustache, and plentiful body hair that I struggled to "maintain" like cisgender women are supposed to.

First pic: Stache and unibrow pretty early on T and barely grown out.

Second pic: The first time I shaved my whole face with a razor!

My hair continues to grows faster, and even if I wanted to remove it, I wouldn't be able to keep up with the pace it grows at as it crawls farther across my skin with each passing week. Although I once hated and frantically removed all the body hair that I could, I now embrace it! I love running my fingers over my leg hair and mustache.

The typical start of facial fat redistribution is 3 months in, and I think I've started seeing some minor changes recently!

Takeaways and Moving Forward

Most of all, I see so much more life in my face and behind my eyes already. The more changes I perceive, the more I actually see myself in the mirror.

For most of my childhood (especially during/after puberty), I would look at pictures of myself or catch glimpses of my reflection and think, "Who the fuck is that?! Is that really me?"

The constant incongruence between the face I present to others and how I conceive myself has been incredibly disconcerting and disorienting. My eyes are constantly welling up now as I'm overwhelmed with joy when I catch glimpses of the true me more and more often.

I get a lot of looks in public for having such an obviously gender non-conforming body, but people's perception and treatment of me bother me far less than they used to. I continue to release the shame that has so long been projected onto me and that I've internalized simply for being.

I'm finally happy with myself and the path I'm on to pursue the fullest, most authentic expression of myself, and that's all that ultimately matters to me anymore. I will happily inject myself once a week with testosterone for the rest of my life if that's what it takes to feel comfortable in my skin.