What changes will happen?
Your skin will get oiler and you’ll get more acne for a bit.
If you’re older, you might get male pattern baldness/scalp hair loss.
You’ll get facial hair growth, and more body hair.
You’ll also have increased muscle mass/strength, and it’ll be easier to build muscles.
Your body fat will redistribute to more masculine areas, so your facial shape might change a bit, and fat might collect at your stomach instead of hips for example.
Your period will stop, your clitoris will get a bit bigger, and your vaginal walls will get a bit thinner and things may be drier down there. Your libido will likely increase.
Your breast tissue may shrink a bit and get softer but it usually doesn’t change by a full cup size.
Some people experience mood swings, as it is your second puberty. You’re more likely to have mood swings if you’re taking T by injections that are 2 weeks apart or more. Testosterone doesn’t cause “roid rage” or anything like that though!
For more information, read Testosterone Therapy, a complete guide.
What are the potential negative effects of T?
Side effects of taking T mean you’re more prone to the health issues cis men have, like higher cholesterol or increased cardiovascular disease with dyslipidemia, hypertension, increased red blood cell production, clots (legs, lungs, heart brain)- this is rare but it’s a possible side effect.
You will be getting regular blood work to make sure you’re healthy, so your doctor should be able to tell that there’s an issue if something develops and adjust your dose. If you want to reduce your risk of side effects, make sure you eat healthy and exercise. A goal should be maintaining good nutrition (including 3 dairy products a day or fortified almond milk) and doing cardio (for 30 minutes 5 times a week) and lifting weights (3 times a week).
For more information, read Testosterone Therapy and General Health
How can I take T? Are needles the only option?
T can be taken via injection, or gel (some more info on the gel is here!) as the most common options. Some injects are subcutaneous (sub-Q) and some are intramuscular. You can self-inject when shown how to do so, however you can often also get a nurse to do it.
For more information, read Testosterone Types and Delivery
How do I get prescribed T?
This post has more on that! The process can vary; there isn’t one singular route to testosterone.
You have to have permission from your legal guardian to start T if you’re a minor. This post should help with getting the conversation started about that. Note that many endocrinologists don’t allow someone to start T until they’re 16, but this isn’t a law and it’s up to the prescriber’s discretion.
You do have to have started puberty to get T. If you haven’t started puberty yet, you should look into puberty blockers.
All injectable T is taken on a weekly cycle. Some low cycle ones are every week, every 2 weeks, every 4 weeks, or every 6 weeks. Longer cycles would be 10, 12, or 14 weeks. If you have an itchy swelling at your injection site, look here. Gel is taken once every day.
Can I do testosterone on my own?
No, sadly not. It isn’t legal to get a testosterone prescription without a doctor, and it’s dangerous to do on your own; look at The Risks and Dangers of Illegal Testosterone for more on the dangers. Testosterone supplements and “natural transitioning” methods don’t actually have enough T in them to make any changes- in fact, your body will convert low levels of T into estrogen, which is not what you want.
Can T cause weight loss/gain?
It depends. T can cause an increase in metabolism, but also an increase in hunger. It can cause fat redistribution, from hips and rear to midsection. It can also cause muscle gain. We have info on eating disorders here and getting help here if you think that weight gain could be a trigger.
It depends. The younger you are, the better your chances are at growing. If your growth plates have already sealed, you won’t grow any taller on testosterone or without it. We have info on height dysphoria here.
What happens to my downstairs bits on T?
T and your Genitals: A summary is a good place to start.
Your clitoris will grow (that’s called clitoromegaly) and it’ll usually be around 1.5 inches, although it can be smaller or larger, depending. You can see pictures of what that looks like here. Genital growth isn’t something you can opt out of if you take testosterone; again, if you take T, you can’t prevent your clitoris from growing.
T can cause atrophy of the vagina and and uterus, but vaginal atrophy is treatable if you go to your doctor and get a topical estrogen cream or pill for the area. Vaginal atrophy is symptomized as irritation, itchiness, bleeding when penetrated, and dryness.
Testosterone decreases your biological fertility and it stops menstruation. Testosterone can cause polycystic ovaries, so lower abdominal pain may indicate an enlarging or ruptured cyst. You may want to look into freezing your eggs if you’re interested in having biological children. If oocyte preservation is desired, that should be pursued before you start T.
When on T you still need to get gynecologist appointments if you still have your uterus and ovaries. There are possible but as of yet unproven links between cervical and ovarian cancer and testosterone treatment, people are often encouraged to get a hysterectomy but it is not considered necessary.
Can I get pregnant when I’m on T?
You can still get pregnant on T, although it’s less likely to happen than if you were not on T, so you should still use contraception if you’re having the kind of sex that could get you pregnant. You can use an IUD (more info on those here) or a progestin-only pill or a condom, which is the only one of the three that also prevents the transmission of STDs.
It can decrease somewhat in size due to fat redistribution, but generally not to a flat chested extent. It won’t get smaller by a full cup size, especially if you have a larger chest. It may get a bit softer, which might make binding easier (binding is also easier if your chest gets more saggy from the binding).
Not everyone who takes T will experience hair loss, and if it does happen it usually happens when you’re older. But T can cause male pattern baldness, although it’s not guaranteed and relies mostly on genetics. This post has more information on hair loss, and you can see Hair Loss: Information and Treatment Options.
You can look at Dealing with Acne & Other Skin Breakouts to help control the acne.
If you have a personality disorder that is affecting your response to the potential of acne, look into getting a therapist to help find new coping mechanisms and see our distress tolerance DBT skills post and our self-esteem and self-talk post.
I like singing, how will T affect my voice?
T will deepen your voice but as long as you continue to practise and don’t overwork your voice into notes you cannot reach anymore, it shouldn’t harm it. This ask has a link on that.
If you want to retain all the effects of T then you do need to stay on it. In order for optimal health, if you get your ovaries removed you will need to stay on a hormone for the rest of your life, be it T or estrogen. Read about what will revert and what will remain if you stop T here.
When do the changes happen?
This post has an outline of when the changes tend to happen. This is someone’s personal experience 1 year on T timeline. This is mod Lee’s 3 month on low-dose T update and mod Jay’s 1 year on average-dose T update. If you’re on low-dose T, the changes will take longer to happen.
I want X changes but not Y. Help!
How do I know if HRT is right for me? T is not a pick and mix, you can’t get some changes and not others, and as a result you have to weigh up the pros and cons as to how much you want T. It’s all or nothing, although you can take it slow with Low Dose Testosterone and have the changes happen slower, so you can stop when you’ve had enough. Read more: Can you take testosterone and not end up all manly?
I still want to know more!
Check out our #testosterone tag and r/ftm testosterone info and gendercube’s testosterone tags and send us an ask if you have any questions! You can also find a lot of YouTube videos of people documenting their transition on testosterone.
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