1) I've never been tested for insulin resistance, but T did not affect my A1C levels at any point in my transition. Definitely ask your endocrinologist about this! They'll be able to give you a much more accurate risk assessment.

2) I did have a progesterone IUD for many years both before and after starting my transition—I believe the specific brand I was on was Skyla, followed by Mirena. The hormone aspect of the IUD did not affect my transition progress in any way, but I did eventually start having complications due to vaginal atrophy.

My uterus was not happy to begin with, and within the first year of my transition, my body began treating my IUD like a foreign body. This was eventually resolved by removing my IUD, switching to a different form of birth control, and eventually getting a hysterectomy (which I already wanted and had been fighting to get for a looong time, not as a complication of the IUD).

Now here's the thing—in those first couple years, the vaginal atrophy I experienced made my already severe uterine pain go from bad to worse. But AFTER my hysterectomy, which included the removal of my ovaries, my vaginal atrophy not only stopped in its tracks—the amount of self-lubrication and the health of my tissue in general SKYROCKETED. All of my pelvic pain and dryness vanished, and since then my vaginal health has been better than it's ever been before in my life.

The issue was my estrogen/progesterone, not testosterone. I truly can't put into words how much every aspect of my pelvic & vaginal health improved once I was only on T, rather than relying on whatever fuckery my PCOS was up to.

I can't give you specific advice on whether to switch to non-hormonal, because that's more a matter of whether cramping and heavy bleeding is already a big problem for you. Copper IUDs are known to make that worse. I can say for sure that you can stay on the hormonal IUD and not have it affect your visible transition progress, but beyond that, I'd speak to your doctor.

If you do transition and start experiencing worsening cramps/pelvic pain, don't wait like I did: definitely consider a switch to the arm implant or other forms of birth control. Don't ignore your pain until your uterus is so angry that it gives you a cancer scare.

My Transition

Start of transition, Sept 2021 → Oct 2024 (3 years on T)

Okay, so on to my transition results in general. I'll start off with giving you a little more background on the body + genetics I was starting off with, because they factor in as well as my PCOS:

I have been overweight my entire life, as have every member of my family going back about two generations. I was VERY pear-shaped, carrying almost all my weight in my hips, butt, and thighs

I started off with a three octave vocal range (G2 sharp to G5 sharp), which is loosely considered a baritone/contralto with an abnormally high upper range

I have clitoromegaly, vaginal hypospadias, PCOS, and possibly some other underlying intersex conditions that haven't been fully investigated

I became disabled after transitioning. I have gained about 70lbs over the course of the last 5 years as a direct result of my disability, NOT due to testosterone

my father is a big fuzzy bear

my father has a very full head of hair, but a unique, exaggerated widow's peak hairline that looks like it's allllmost starting to recede, but isn't

my siblings and I have all been told our entire lives that we look just like our father

That said, I now look like a younger (and gayer and hotter and kinder and vastly more fashionable) carbon copy of my father.

This is not a bad thing! This does not mean that you will end up looking just like me. I would say that you should take a look at your father (and your maternal grandfather, especially if you already resemble your mom) and base your expectations off of them.

You'll still be in control of things like fashion, fitness, grooming, and so many other factors of your appearance that have nothing to do with genetics—but looking at your specific family will give you a better blueprint than only looking at other trans guys.

Alright, now all this said—I do believe that, because of my PCOS, my transition has gone BETTER than it has for many of my trans friends.

I'm GNC, and never really set out to pass as cis. But especially this last year or two (3-4 years into my transition), I frequently get literal jaw-drop reactions when I tell people I'm trans. I pass very, very well, even though that isn't always my goal.

Timeline

Disclaimer: Memory issues are a part of my disability. I'll be doing my best to recall my earlier transition as accurately as I can, but I'll be limited in how much detail I can give. That said, I think my early transition was weirdly slow to begin with, and I don't think it necessarily reflects what you'd experience.

Beginning:

Aug 2021, 1 month before starting T

I started my medical transition in Sept 2021, at the age of 23.

I started off on a moderate dose, which we gradually increased over the following months. For most of my transition, I've been on the moderate to higher end of the scale, usually in the 0.3-0.45ml range (out of a possible ~0.0-0.5ml range).

Year 1 - 1.5:

Dec 2022, 1 year on T

My transition results started off very slow. I lost the upper portion of my vocal range, but didn't gain much on the lower end—which was unexpected, but fine, because my lower range was already quite deep.

I experienced only a little bottom growth beyond my preexisting clitoromegaly.

Body weight redistribution was very, verrrry slow to start. I saw the clearest change in my arms and legs, as they became significantly more toned and muscular. However, I still carried my extra weight in my hips.

I did experience a significant changes to my facial structure, amount of muscle growth, increase in body and facial hair, and an absolutely batshit libido. While I wasn't experiencing the dramatic and sudden changes that my partner had when he transitioned, I was still easily able to see myself changing month by month, and I loved what I saw.

Years 2 - 3:

Mar 2024, 2.5 years on T

As soon as I started gaining weight (again, unrelated to T), that's when my body weight redistribution finally took off. My hips narrowed as weight shifted to my abdomen, and my overall silhouette became much more masculine. Sadly, this came at the expense of my luscious, luscious butt 😔🪦

Every aspect of my transition that was slow to start really took off during this time. My voice continued to deepen, my face continued to change, I gained more bottom growth, built more muscle, and overall began seeing BIG results that I'd begun to worry that I wouldn't reach.

I ended up with plenty of body hair, including a lot of fuzz over my stomach and chest that slowly spread. When I first started my transition, body and facial hair were some of the things I was most hesitant about—I don't need to tell you how much being teased about those things sucks as someone with PCOS—but they very quickly ended up becoming one of my favorite things about transitioning. The shame vanished, the euphoria set in, and every inch that it spread made me love my body more and more.

Near the tail end of the three year mark, I started growing out my beard. The first time I attempted it, I only kept the stubble for a couple months because it became clear that I still had some patchy spots that weren't ready yet. I shaved it off again, waited another six months, and tried again.

By that point my stubble was much fuller, and I helped it along using a dermaroller and minoxidil. Within 3-4 months I had a respectable beard going, and was suddenly passing everywhere I went. I LOVED IT. I've had it ever since, and don't plan to shave it off Ever.

Year 4 - present:

Oct 2025, 4 years on T

I have a full chest of hair. I have a full beard. I've developed my father's hairline (but know for a fact that I can move it back to where it was before using dermaroller + minoxidil, if I ever choose to do so). My body shape is distinctly masculine. All of these are things I believe my PCOS helped with, even if they were also due to genetics.

My voice is continuing to deepen a little at a time. I have plenty of bottom growth, even if most of it is girth. I do feel like having PCOS/clitoromegaly might be why I didn't see as dramatic an increase in length as I've seen with some other trans guys—I went into it expecting to get a ton of growth based on how big I started off, and instead wound up pretty average compared to the pics I've seen on reddit's r/GrowYourTDick.

Overall, I feel like having PCOS prepped my body for transition. It might have started off slow, but my transition is waaaay ahead of what I see most other trans guys reach by the 4 year mark.

Once I had my hysterectomy and switched over to a completely testosterone-based system, my progress skyrocketed. I feel like my body was already prepped to accept masculinizing hormones, because it sure as hell did not like relying on estrogen.

I'm a full-fledged Man now. Everything about my transition continued its "growth spurt", both spreading and simultaneously... setting in. Maturing. Deepening. It's so hard to describe, but the changes have stopped feeling transient / superficial. I wasn't only approaching masculinity, I've suddenly found myself looking MORE masculine than many of the cis men around me.

I feel it, too. I'm not in the process of transitioning—I'm here. All the hesitation is gone. My body is MINE, and even if I were to be forced off T tomorrow, nobody can take these changes away from me. All they'd do is give me my butt back.

Jokes aside... love, I really can't tell you how good this feels. This is 4 years in. I have another 60+ years ahead of me. I am going to get to watch myself grow into a Big Handsome Bear. I will get to be a forty year old gay man. The rest of my life, I'll get to see these changes keep maturing and deepening along with me, and it will truly only get better from here.