Jude Samson

By Jude Samson

Inevitably some of the side effects mentioned sound worse than the reason to take the drug in the first place or even seem to counter the reason you’re taking it. Anti-depression medication may cause increased depression or suicidal thoughts. Medication for that ulcer you have may cause an stomach upset. Eye medication may cause blurry vision. Testosterone may cause increased dysphoria.


Wait… what? That’s right, testosterone may cause trans men to experience increased dysphoria, but this is not something that you’ll ever find on the label and it is rarely talked about among the trans male community. Despite the enormous amount of research I did prior to starting my HRT I did not, even once, come across someone warning me that I could experience enhanced or increased dysphoria while on testosterone – the one thing I thought would quell my dysphoria until I could eventually afford surgery. It wasn’t until I experienced it and then took to several message boards for other trans guys that I realized this is, in fact, a more common effect despite it never being discussed or listed as such.

While there’s an ever-increasing amount of resources available to the trans community there’s still a lot that hasn’t been studied pertaining to Hormone Replacement Therapy (HRT). That, combined with the fact that everyone responds to HRT differently and takes different types of HRT at different doses and it’s nearly impossible to find out how it will impact you and within what time frame. During my initial research I was reading that facial hair could start as early as three months or not start until well over a year. Voice dropping happening as early as the start of the second month or, again, not until after the first year mark. On top of that, the side effects that are listed are pretty broad with a lot of “this could happen” or “depending on genetics this might happen,” such as early male pattern baldness, weight (or muscle) gain, acne, when menstruation will stop and so forth. At no point did anyone tell me “Hey, by the way, the one thing you’re hoping to settle might actually get worse the further along you get…”


While many of us understand that gender is not simply a binary system, most of society hasn’t caught up to the concept and, as such, still use certain cues, even subconsciously, to help them identify and label something. We do this all the time in our lives, so it is to be expected that it will be done when we attempt to identify someone’s gender. We are not a society that has yet to ask preferred pronouns, or even realize that there are more than he/she pronouns available. While we will continue to work together to provide the world with education, for the time being we have to – not accept, but at least understand – the system we’re currently in. As such, we need to understand that people will take cues from our appearances and surrounding clues to determine gender. This isn’t a matter of “should” they do this – they do it and we need to be aware of it when we engage with people around us once we get started on HRT.

The longer you’re on HRT such as testosterone, the more your body will begin to present as male and the more society will start to reference you as male. But people are stuck within the binary confines and will revert back to mis-gendering despite what their other cues are indicating. I lived entirely as a male, had a full beard and mustache, and my voice passed for male (albeit I was told sometimes I sounded like a gay male – but a male nonetheless). People would freely refer to me as a male immediately using he/him pronouns. In the summer months or any time where I didn’t bind or conceal my chest, people would ignore all those the “male” cues and a split second flick of the eyes to my chest meant they immediately reverted to female pronouns. To the world at large – breasts meant female.


What society perceives and how they refer to you can feel like a harsh slap in the face. It’s a sensation that feels like it’s negating your existence and then you begin to feel like no matter how hard you try you just won’t ever “pass” until you can get surgery – but surgery isn’t always an option for everyone (and some don’t want it even if they could afford it). Despite how hurtful this is, what your mind does it even worse. When you’re dressed for the day and you look in the mirror you feel good. You see the scruff, you hear the voice, and you are starting to feel comfortable in your own skin. But at some point you will need to use the bathroom, you will need to shower – you will need to confront your own naked body in the mirror. You will see two different images staring at you and odds are one or both are in complete conflict with the image you have of yourself in your head.

While HRT can be life-saving because it begins the transformation of the physical features it can, for some, be just a stepping stone or even just a temporary band-aid. For some, such as myself, surgery is the next option and until that happens you expend a significant amount of energy concealing yourself in any way possible. Two years on HRT and I pass entirely for male and have developed some mechanisms for concealing my chest but, most importantly, I developed the attitude and an air of confidence that typically doesn’t allow people to second-guess my gender any more. Still, it would have been nice to have a warning label or some advanced notice from resource sites that the dysphoria can increase and be more difficult to handle the further along the journey one goes. So, for those who are starting out and don’t know yet – some side effects may include increased dysphoria.


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