We've gathered up the top 9 myths you've heard about testosterone HRT, so you can know what's what.
I remember when I was first weighing up whether or not to start taking testosterone. It was 2015 and I had just come back from a five week trip abroad in Australia, riding on the fumes of a new name and gender. Instagram was still an app with a handful of sepia-toned filters that you used to make your photos look edgy. I would stay up late nights sucked deep into the wormhole of Youtube, accidentally stumbling upon detransition videos that I would never be able to un-see. What I would have given to have a resource to show me what was possible for my gender.
Deciding to finally take the leap to start hormone-replacement-therapy (HRT) can be a daunting, if not an utterly terrifying and somewhat exhilarating process—a mixed bag really. Cultural transphobic narratives about the biological effects of hormones paired with the lack of research and trans-competency in the medical field can make the process of deciding to go on hormones confusing. That’s where FOLX comes in. We’ve compiled a list of the 9 top myths you might have heard about testosterone HRT and worked with our vetted clinicians to debunk each one of them. No more getting sucked down the rabbit hole of the deep web, here is everything that you need to know is true and not true about taking T.
This is one of the most popular myths on the market. And it’s a pervasive one, not just for people who haven’t thought critically about gender before. It’s been proven time and time again that the biological link between higher levels of testosterone and aggression or violence is weak, if not completely nonexistent. So why do so many people still believe in this correlation? When it comes to testosterone, there is this idea that masculinity is innately violent. Instead of understanding why it is that some men and masculine people might act out of anger or aggression and perhaps healing or holding those men accountable for their actions-- it becomes so much easier to reduce toxic masculinity down to biology—something inherent.
But we know that gender doesn’t work that way. Nathan Levitt, one of our clinicians at FOLX, puts it this way. “Sometimes new emotions come up as we start to become more comfortable with ourselves, and this could include any emotion, even anger. Everyone is different. I’ve been on testosterone for 15 years and this hasn’t been my personal experience, nor an experience I’ve heard often from patients. Hormones do affect mood though, so sometimes you might feel irritable when you’ve missed a shot or your levels change.” If you are worried that taking testosterone is going to give you a personality transplant, the good news is that it won’t.
Another common myth is that testosterone will prevent you from being able to cry ever again. Some people might find it more difficult to cry, but there are many factors at play. Rocco Kayiatos spoke with us about the changes he experienced after going on testosterone. “I had two emotional experiences before I started testosterone: anger and frustration. After I started hormones and my body and face started to match my mind's eye version of myself, I started to feel a full range of emotions and found myself able to access tears more often and more easily.”
It’s important to remember that for everyone, this will be different and nuanced. We all have a wide variety of emotions and processing styles that may or may not intersect with our gender expression. You might find it easier or harder to cry at various moments in your life depending on your circumstances, your healing journey, or the world at large. My personal favorite is the trans masc dry-cry, which I swear I experience on the daily. You know...when you watch that video of a firefighter rescuing a kitten from a burning building and you get the same feeling of crying, but no tears come out. Classic dry-cry.
While taking testosterone often halts the process of menstruation, depending on the dosage, you may find that monthly bleeding comes back periodically, especially if your levels decrease. Many people notice they stop bleeding between 2-6 months when first taking T; however, being on testosterone does not completely guarantee that it will never happen again. This goes hand-in-hand with the next myth on our list.
This is another misconception that even some doctors are uninformed about. On T, it is still possible to ovulate (even if you aren’t bleeding) and, therefore, it is still possible to get pregnant. Unless you have had a hysterectomy, it’s still important to use birth control or condoms when having the types of hot and steamy sex that might result in pregnancy.
Testosterone gel is just as effective as injections! Gel works differently as it is absorbed into the body but works the same depending on the dose; it’s just a different route of taking T.
You might have heard the tea, that T makes you gay. This both is and isn’t true. Some people find that once they take testosterone, the experience of being seen as more masculine and/or a man can change their relationship to who they are attracted to. But there are a variety of reasons why our sexualities might change over the course of our lives, some related to gender and others not. And some people find their sexual attraction remains the same after taking hormones. Remember, if there is one takeaway from Diane Sawyer’s interview with Caitlyn Jenner in 2015, it’s that gender and sexuality are like apples and oranges (aka two different things).
Taking testosterone will not outright give you cancer. There is limited data available on the incidence of age-related conditions, including cancer, because of the lack of investment more broadly in trans healthcare. However, trans people on HRT should keep up with routine cancer screening protocols, same as cisgender people.
It’s important to know that HRT is just one component of transition and gender expression. Some people find that staying on hormones at a steady dose works best for them. Some changes are more permanent than others, but, for many people, their experience on hormones is not a one-directional journey from point A to point B. Once you start, you can always reduce your dose or come off HRT completely. Whether you are already on T or considering taking it, you should feel empowered to have all the information you need to make the best decision for you. Remember that everyone’s bodies and timelines are different, and comparing yourself to other people is a sure fire way to feel shitty. Take the pressure off, be patient with yourself, be generous, and give yourself as much time and space as you need to figure it out.