T Update: Low Dose Testosterone, and Starting and Stopping

Yes, I made a Video

Please watch the video. My hair isn’t perfect, the lighting leaves something to be desired, and once again the camera was way too close. But I made an effort! And you can see my frog. Say hi to the frog.

Please read the post too. It says pretty much the same thing. But obviously I had it written down already.

Intro

I started testosterone about 2 years ago. However, in that time, I’ve started and stopped several times, and have been mostly on a low dose. Because of that, most trans people look and sound very different than I do after 2 years on T.

I have been on T inconsistently and at a low dose primarily because I’m not a man. I’m not a trans guy, I don’t feel like a man and I don’t want to look like a man. I’m non-binary, or what others refer to as genderqueer. Specifically, I identify as neutrois, which can best be described as gender neutral.

In this post I want to address some of the more common questions I’ve gotten about T, namely the effects of being on a low dose, and the effects of starting and stopping.

Low Dose Testosterone

For the better part of two years, I’ve been on a low dose of testosterone. How low? About 1/4 of a “regular” dose, which is 1cc of 200mg/mL, so my dose has been .25cc of 200mg/mL. Needless to say, there is no actual “regular” dose (just a majority average), and dosage varies greatly from person to person. Moreover, the numbers aren’t really comparable when talking about various methods of application, such as injectable vs cream vs gel.

I started on cream. Once I worked up to the maximum dose for cream, the effects plateaued, meaning I wasn’t gaining any new changes, so I switched to bi-weekly injections. There aren’t many differences between the two in terms of effects or how they make me feel (as far as I can tell). The stand out is that I had to put on the cream every single day, whereas when I inject I don’t have to worry about it again for two weeks.

Effects of Low Dose T

The biggest effect of being on low dose is that the changes are really, really slow and gradual. Sometimes too slow, especially those times when I’m really excited about seeing changes! Some changes are gradual enough that I barely notice them until I remember how my body was a few weeks back.

The advantage of this is that it buys me time. Time to think. Time to process. I realized I need a lot of time to take in what is going on with my body, time to adjust and get used to it. I don’t suddenly see a different person in the mirror every day, and that is very comforting. (Not that you would see this on a regular dose, but the time to adjustment is much narrower.)

It also gives me a lot of control. If I start to question my decision to be on T again, I don’t have to stop. I can take my next shot and use those 2 weeks to think and see what happens, knowing that not much more will significantly happen in those two weeks.

Why I’ve been on and off

When I started testosterone, I was unsure of my dosage. It turns out I was on a “regular” dose for the first 3 months. Which means I saw a lot of changes really fast. Too fast. I freaked out and had to stop.

Stopping gave me some time to breathe, to make a plan.

I had to reevaluate my goals, figure out whether I still wanted to be on T, why I wanted to be on it, and establish how far I’d be willing to go in terms of physical changes, where I would need to pause and consider stopping again.

Most of the times I’ve stopped have been for this reason. To pause, and think.

Whenever I start back up, it’s because there’s a remnant, nagging feeling, a subtle need to masculinize just a little bit more. It is still frightening, because I honestly do not know when, if ever, I will stop this cycle.

Effects of Stopping Testosterone

Whenever I’ve gone off T, it took about 6 weeks for my body to get completely rid of it. This is obviously a very subjective feeling (I didn’t have any official blood tests) but every time it has been similar, I still feel the effects of testosterone in my body for about 6 weeks.

Let me preface this by adding that, for the most part, it has been hard for me to accurately track changes of individual factors, given so many extraneous variables that have been at play (like stress, varying eating schedules, erratic fitness routines, weather, and lots of trips).

I’ve outlined in previous articles the permanent and the reversible effects of hormones, so I won’t go into much detail about that. Obviously, the permanent effects do not go away, and my body eventually reverts back to those changes that are not permanent. But to what degree?

Muscle Mass

Since muscle mass is a reversible effect, I very gradually lose some of the strength and muscle I gained. This is invariably the first effect I notice when I start taking testosterone; it becomes easier for me to gain muscle, and I start to feel slightly stronger at a much quicker pace than usual. It is noticeable, but I don’t think it’s too significant on a low dose. I am not a bodybuilder or an athlete, and my workout regimens have been too erratic to accurately measure this, but if I actually committed to a solid exercise routine I think I could maintain the muscle I lose when off T, but I could also gain a lot more muscle when on T.

Body Fat

My body fat eventually redistributes to pre-T proportions, as this is a non-permanent effect. There’s a bit more fat on my hips. It’s very subtle; it’s one of those things that nobody else would notice except me, because I am so familiar with my body. It’s also been hard to keep track of this, because I’ve been getting fit and losing weight recently.

Facial Hair (and hair in general)

Any facial hair or leg hair I’ve gained doesn’t go away (thankfully I’ve only seen chest fuzz come in, but no hair yet). However, when I am off T, the facial hair will stop coming as fast. For example, I had to shave my face about every 3 days. When I went off T, I only had to shave every 7 days. The facial hair started coming in thinner as well. As soon as I start T again, the facial hair goes back to growing in a little thicker and more frequently. Additionally, being on T means I am sprouting new facial hair.

Voice

My voice does not change. It doesn’t go back to a high-pitched voice, and it never will. However much it dropped, it stays at that pitch. However, I do feel that after stopping, it levels out a little. I might lose the slight drop I had gained in the last weeks.

At times, my voices has sounded low enough to me, as low as I would like it to get. However, I still get mostly “ma’am” on the phone, which means it’s probably not at a male range yet. (Also, as a quirky sidenote, since my voice dropped I’ve continually felt that I speak way too loudly (which I sometimes do anyway). My voice just reverberates in my head. Also, I don’t recognize my voice when I hear it outside of me. At all. I’m starting to sound more like my brother!)

Hair loss

Since I’ve been on a low dose for a relatively short time, I haven’t experienced any hair loss (thank goodness) but should you stop T, any hair you lost will not grow back.

Psychological Changes

I don’t feel any effects directly from T (other than the consequences it has on my gender presentation). Many people report increased anxiety while on T, decreased anxiety while on T, a harder time crying, being less emotional, more aggressive, and just a myriad of other mood changes. I don’t think I get any of this, or at least I don’t feel it, so I can’t speak to the effects of that. (It’s possible I might get slight insomnia while on T, but it’s hard to say.)

Period

As far as periods go, I cannot speak to this either, because I had a hysterectomy last January. My guess is that my dose is too low to stop periods, or at the very least it would make them irregular.

Going Back On T After Being Off

It’s really just the same as the first time. Your body picks up where you left off.

When going on testosterone, I always recommend building up to whatever your full dose is going to be (which is very hard to do when on an already low dose, but you can do it).

Stopping Testosterone, Summary

  • Going off T is not the end of the world.
  • Starting and stopping T multiple times is not the end of the world. You should do it if that’s what you need to do.
  • Know that you are in control. As soon as you feel uncomfortable with the changes, you can stop.
  • As long as you still have your ovaries and are producing estrogen, there is nothing else you need to do when you go off T except let your body resume its endogenous hormone production.

Keep in mind that my hormone regimens have been fairly consistent within themselves. I don’t sporadically miss shots or apply whenever I feel like it. When I’m on T, I’m on it for at least 2-3 months or more, same when I’m off. It’s important to give your body time to adjust, and not to jolt it into an unpredictable hormone imbalance.

Hormones control a lot of processes in your body. It is not advisable to oscillate so much. This is why it is in your best interest to find a doctor who can monitor your progress. I just went in for my latest blood tests, and everything’s fine!

10 responses to “T Update: Low Dose Testosterone, and Starting and Stopping

  1. Micah, this video is so concise and really speaks to your journey on T. You make it absolutely clear that this is about your process and the control you have over your ultimate goal, to feel who you know yourself to be. I appreciate the latitude of room you give yourself to this very personal experience. It is very easy to box oneself in to expectations and in doing so lose the magic of the journey. This is not the case with you. You live in the magic of the moment. “Micah Magic”. I think I will eat a bag of M&M’s (without nuts) today in honor of you. Thanks for posting.

    • Dan you really know how to give a guy a virtual hug!
      I guess it is all about finding your own magic spot. I’ll send some M&M’s your way.

  2. I read the post first, and then viewed the video. I found the post+video format to be a great combination. While the post is comprehensive and achieves an admirably balanced level of detail (not too much, nor too little), it felt like you covered a few things in the video which weren’t in the post. I couldn’t tell you what exactly, so perhaps it’s just a perception (or a matter of nuance!). The post offered all the benefits of the well-written word, plus the links to relevant content.

    While you’re the expert on your video hair, I didn’t find the camera to be too close, and the lighting was fine.

    Thank you, and Hi to the frog.

    • Aw shucks, thanks. Frog says hi back. I have a few other frogs (used to have a big collection!).

      I thought about it, I’m not one for making or watching videos seem to like watching me speak, or they hate reading, or they just like to listen. So a bit of both is a good thing. Also I can always update or edit the post later with new information, while it’s hard to do with video. In the future I will try to make more videos.

  3. I’ve been very nervous about starting T in the future, but the video reassured me that it’s going to be okay and I’m probably going on a low dose too and now I just feel so good about myself and my transition plans and ahhh. :–)

  4. Hola, eres la única persona que he visto por aquí que piensa exactamente como yo. Llevo 9 meses de testosterona con dosis baja, he parado, he regresado. No muchas personas lo entienden, muchas me juzgan. No creo ser un hombre, ni tampoco una mujer, podría decir que soy trans* no binario. Me parece fabuloso que publiques este tipo de puntos de vista para que entiendan que no a todxs les apetece el mismo tratamiento. ¿De dónde eres?

    • me da mucho gusto que me hayas encontrado! en general hay poca información y visibilidad sobre esto, por eso documento el proceso.

      soy originalmente de México. saludos!

  5. Thank you for this! Like you say, not many people talk about this, so I really appreciate the information. When you say “It is not advisable to oscillate so much,” are you saying that your own practices aren’t technically medically the best idea or have you been consciously calibrating your dose in a way that mitigates the effect of the oscillation? What IS the risk of hormonal oscillation on your body? Are you saying that the risk is worth it for you in terms of your gender expression? Thank you.

    • This is just my un-professional, un-medical opinion. Hormones regulate a lot: sleep, mood, appetite, metabolism, energy, how oily your skin is, even stuff you can’t see like red blood cell count and liver health. Moreover, testosterone and estrogen production interplay with each other. I imagine it’s just not healthy to continually force your body to adjust to random bursts of hormones.

      I’ve previously experienced hormonal inbalances due to mistreated thyroid issues, and I felt like total crap. On the other hand, I’ve felt perfectly fine despite being on-and-off T. But as I said, I don’t take random doses, and I do get frequent blood tests.

  6. Pingback: Low Dose Testosterone | Neutrois Nonsense·

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