by Mark Van Streefkerk
You’ve probably heard some bogus assumptions about testosterone before, whether online or from well-meaning friends or family members. In a culture that rewards masculinity, testosterone has a revered and guarded status. It’s marketed to cisgender men as a treatment for a variety of ailments, among them depression, lethargy, weight gain, and impotence. It’s lumped in with Anabolic Steroids and filed under Class III of the Controlled Substances Act, at the same level as Ketamine. On the other hand, Estradiol, a form of estrogen, isn’t a controlled substance at all. Of course, gender isn’t determined by set levels of hormones. Each body makes both estrogen and testosterone. Just like if a person is nearsighted, prescription glasses help correct their vision, choosing hormone replacement therapy can be an effective way of treating gender dysphoria.
I’ve been in situations where once I mention being on T, someone chimes in with something weird to say about it. There's a lot of misleading ideas about hormone replacement therapy. Just look at what Trump said about defending his choice to ban trans people from serving in the military: “They take massive amounts of drugs, they have to, and you’re not allowed to take drugs.” Apparently, some people think being on hormones is the same as being on drugs.
These are some other myths I’ve heard about T and the facts that disprove them.
T is the same as steroids and you can get it on the internet.
Anabolic steroids used by bodybuilders and other athletes often have testosterone as one ingredient, but they are stacked with other substances. The goal of testosterone replacement therapy is to get a person’s hormone levels to a range seen in cismen.
The best way to do that is under the supervision of a doctor who prescribes T, and follows up with regular blood tests. Don’t buy T online. There’s no way of knowing what you’ll be getting.
You’ll get roid-rage, mood swings, and T will change who you are.
This is generally false, with some exceptions.
If you’re taking T under the guidance of a trans-competent doctor, they won’t prescribe excessive doses of T that can mimic the “roid rage” of a steroid user. I have known some folks who say they were more irritable when they first started T. Typically however, moods tend to stabilize within a few months of starting hormones.
Personally, my biggest mood swings were when I was on a biweekly dose of T. The first doctor I went to put me on .5ml every two weeks. I was her first transgender patient. The two days before my shot were pretty brutal emotionally.
When I switched to a doctor who treated many other transguys, she prescribed weekly .3ml shots, and I never had those intense mood swings again. On a side note, T doses vary and are different for each person. As far as T changing who you are, most folks report feeling more confident than they did before.
You can’t get pregnant on T.
While testosterone decreases ovary activity, people can and do get pregnant on T. There’s no definitive study of how much T reduces your chances of getting pregnant, but if you don’t want to it’s not worth the risk. Aside from preventing pregnancy, safer sex protects you from STIs. Keep in mind, birth control pills or implants are estrogen or progesterone-based.
(Editor's note: Trans-masculine folks on testosterone can still take birth control. You can take progesterone-based birth control if you are worried about adding estrogen to your system. Anecdotally, professionals report no substantial changes in masculinization when patients use combination estrogen/progesterone forms on top of testosterone. However, no formal studies have been done. If you want to be on birth control, talk to your doctor and make sure to closely monitor your T levels.)
Condoms or other barrier methods are the most effective. Learn more about sexual health for transmen here: http://www.tradesexualhealth.com/sexual-health/trans-health/transmen.html
If you’re on T you have to get a hysterectomy within 10 years.
A person can take testosterone and keep their uterus intact forever. The old assumption that being on T with a uterus increases your risk of cancer only reflects the fact that transmen are less likely to get pap smears. That led some to falsely equate higher cancer risks in transmen, just because they aren’t getting screened. It’s a trade-off: if you have a uterus and cervix, you’ll need to get regular pap smears. If you have a hysterectomy, you won’t have to get screened.
Check out this video by Ryan Sallans for an in-depth look at transmen and hysterectomies:
You inject T in your vein.
Maybe that has something to do with the assumption that hormones are drugs, but nope. The two ways to inject T are Intramuscular (IM), meaning you inject in a muscle (thigh or butt usually) and Subcutaneous (SubQ), meaning you inject with a smaller needle into the tissue just under the skin (mostly done in your stomach).
T is from bull balls.
Gross, and no.
All injectable, and gel/patch-based testosterone is made in a lab from plant sources.
I recommend the amazing Hudson’s FTM Resource Guide for this article on the chemistry of T: http://www.ftmguide.org/bioidenticalt.html
What are some myths you’ve heard about testosterone? Let us know in the comments below!
Other articles by Mark Van Streefkerk: