Art of Transliness

Zak: Depending on your age, estrogen blockers might be prescribed before testosterone. If you physically transition earlier in the puberty process, though, you can potentially avoid the need for top surgery by suppressing estrogen before breast development begins. There also may be a potential for growing taller if physical transition is undertaken before estrogen fuses the growth plates. All of this stuff that you could stand to benefit from, though, occurs in the earlier stages of puberty. I’m not a doctor or an expert on this AT ALL, but I would say that the difference between transitioning at 15-17 (mid to late teens) versus 18+ would be negligible, whereas the difference between transitioning at 11-13 (pre or early teens) and 18+ would be more significant. A lot of this would have to do with avoiding an estrogen-driven puberty, not necessarily when testosterone was started. At least this is my understanding (please correct me if I’m wrong!). 

A lot of the cons of starting testosterone earlier center on the more social/emotional issues involved, but the vast majority of these would depend on the individual involved and their situation. 

Zak: I hate to say this because it feels like a cop-out, but every doctor is different. It is likely that you will get blood work done, be weighed, and have your blood pressure taken. If you are going to get blood drawn, they will probably let you know ahead of time since certain tests require you to fast 12 hours before the draw. They may also put off looking at blood work until your second visit or ask you to get your blood drawn somewhere else and fax it in beforehand, this really depends on your situation and your doctor’s policy. The doctor will also probably talk to you about your health history and the potential risks of testosterone and also a laundry list of some of the changes you can expect on T (just to make sure you understand what you are getting into). Depending on the doctor/clinic, you may have to sign informed consent forms that say you know the risks of testosterone and what it will do to your body and want it anyway. It’s usually a lot like a normal doctor’s visit except for a few small details. Whether or not you get your script on your first visit really depends upon a lot of factors (your doctor’s policy, the results of your blood work, if you have your therapist’s letter and/or everything else they require, etc.). Personally I received my script at the end of my first appointment, and this is not uncommon, but it really depends.

As for questions, you may want to ask about your doctor’s philosophy when it comes to prescribing your dose. Some doctors start their patients on a lower dose and slowly raise it, while others start them on a higher dose and see where things go from there. Some doctors also focus more on the outward changes and overall health instead of focusing on testosterone levels, whereas others pay close attention to the numbers and try to keep the patient’s levels in a specific range. Figuring out what your doctor’s reasoning is being the dose they prescribe is good information to have. This is also a good time to ask any kind of trans* health related questions you may have, for example about where your doctor’s patients generally get pap exams. Other than that, just ask about anything you’re curious about and feel the doctor didn’t cover. Good luck! 

Zak: I’m sorry your partner had to go through that frustrating and difficult situation. Testosterone can be pretty expensive without insurance, though buying from online pharmacies can keep the price down a bit. A lot of guys use strohecker’s online pharmacy, where a 10 ml vial is around 60 dollars, which depending on his dose would last him for several months. 

In regard to doctors and obtaining a script affordably without health insurance, clinics like Planned Parenthood are really the only option I can think of. That can be particularly difficult, since not everyone has resources like that in their area and so getting access to those resources can be very expensive. In general transition is expensive and it is difficult to get access to therapy, doctors, HRT, and surgery. 

Zak: A lot of trans* guys have wider hips that can’t be helped by fat redistribution or liposuction because our hip shapes are due to our bone structure. However, hip fat DOES redistribute, though the redistribution of fat on T in general is a somewhat slow process that occurs over the first few years on T. Working out can help move the fat redistribution along. Some trans* guys get liposuction, though I think it’s fairly rare. I know that Dr. Garramone does a “mansculpting” surgery that involves the removal of fat from the hips and thighs, but I don’t know how common it is. 

You’re right about the microscope we put ourselves under when we transition. Many of the “flaws” that guys complain about are not nearly as pronounced or noticeable as they think they are. There are cisgender men out there with larger hips, butts, and thighs, but our trans* status makes us far more self-conscious about these things (though many cis guys are self-conscious of them as well).