Thursday, July 18, 2024
HomeEmpowered LivingLiving CanvasStarting Testosterone Therapy: What to Expect in the First Year

Starting Testosterone Therapy: What to Expect in the First Year

Starting testosterone therapy is a transformative step for transgender men. This guide outlines the physical and emotional changes to expect in the first year, emphasizing safety and health. Regular medical check-ups, understanding potential side effects, mental health support, a healthy lifestyle, and avoiding self-medication are crucial for a positive experience. Embrace the journey with confidence, knowing that each milestone brings you closer to aligning your physical appearance with your gender identity.

Transitioning can be an exhilarating yet daunting journey, especially when it comes to starting hormone replacement therapy (HRT). As an older transgender woman who has experienced the highs and lows of testosterone replacement therapy (TRT) before transitioning, I understand the significance of this step. This comprehensive guide is crafted with care to help you navigate the first year of starting testosterone. Let’s delve into the physical and emotional changes you might experience, with a strong emphasis on safety, to ensure you enjoy the positive impacts of testosterone without unnecessary risks.

Starting Testosterone: A Guide for Transgender Men

Starting testosterone is a significant step in your journey as a transgender man. The first year will be filled with exciting changes and challenges, both physical and emotional. By prioritizing safety, seeking support, and maintaining open communication with your healthcare provider, you can navigate this transformative period with confidence and resilience.

Engaging with Your Healthcare Provider

If you are considering hormone replacement therapy (HRT), it’s essential to begin by discussing your options with your primary care physician. This conversation is a critical first step in your transition journey. If you’re uncertain or have questions about the process, consider speaking with a healthcare professional who specializes in HRT. They can provide detailed insights and answer any concerns you may have, ensuring you make a well-informed decision.

Moving Forward with Confidence

As you talk to your doctor about starting HRT, remember to express any concerns and ask questions about what to expect in terms of effects and health monitoring. This open dialogue will help you feel more secure and supported as you begin this significant chapter of your life.

Understanding Testosterone Therapy

Embarking on testosterone therapy is a monumental step in your transition journey. This process, often referred to as HRT (hormone replacement therapy), is designed to introduce testosterone into your body to induce male secondary sexual characteristics. For many transgender men, this therapy is not just about physical changes; it’s a transformative experience that aligns your physical appearance with your true gender identity.

Testosterone-based HRT, commonly referred to as masculinizing HRT, is a specific type of medical treatment that utilizes different forms of testosterone to modify both your outward appearance and emotional state. The most common form of this therapy involves an injectable synthetic hormone known as testosterone cypionate. However, depending on individual preferences and medical advice, testosterone can also be administered through gels or patches. These alternatives provide a slower release of hormones, allowing for a more gradual transition.

However, like any significant medical treatment, it’s crucial to approach testosterone therapy with caution, awareness, and a commitment to safety. Understanding the various forms of administration and their effects can help you make informed decisions that best suit your transition goals and health needs.

The Basics of Testosterone Therapy

Before starting testosterone therapy, it’s essential to understand the different aspects of the therapy. This includes the various forms of testosterone available, how dosing and monitoring work, and the importance of prioritizing your health throughout the process.

Forms of Testosterone

Testosterone can be administered in several ways, and the method you choose should be tailored to your lifestyle and medical needs. Here are the common forms of testosterone:

  1. Injections: This is one of the most common methods and involves injecting testosterone into your muscle. Injections can be weekly, bi-weekly, or even monthly, depending on the dosage and your body’s response.
  2. Gels: Testosterone gels are applied daily to the skin, usually on the shoulders or upper arms. This method allows for a steady release of testosterone into your bloodstream.
  3. Patches: These are similar to gels in that they deliver a consistent amount of testosterone through the skin. Patches are typically applied to the back, stomach, or thighs.
  4. Pellets: Testosterone pellets are small, solid implants placed under the skin, usually in the hip area. They slowly release testosterone over a period of three to six months.

Discussing these options with your healthcare provider will help you determine the best method for your body and lifestyle.

Dosing and Monitoring

Once you start testosterone therapy, regular monitoring is essential to ensure your hormone levels are within the target range. Your healthcare provider will work closely with you to determine the appropriate dosage, which can vary based on your body’s response to the therapy.

  1. Initial Dosage: Your healthcare provider will start you on a low dosage and gradually increase it, monitoring your body’s response to avoid any adverse effects.
  2. Regular Check-Ups: Regular blood tests will be conducted to check your testosterone levels, liver function, and overall health. These tests help ensure that your therapy is safe and effective.
  3. Adjustments: Based on the results of your blood tests and your physical changes, your healthcare provider may adjust your dosage to better suit your needs.

Safety First

Prioritizing your health is paramount when undergoing testosterone therapy. Understanding the potential side effects and knowing how to mitigate them can help you maintain a healthy transition. Here are some key points to keep in mind:

  1. Potential Side Effects: Testosterone therapy can cause side effects such as increased red blood cell count, changes in cholesterol levels, and potential liver strain. Being aware of these can help you recognize any early signs of complications.
  2. Mitigation Strategies: Adopting a healthy lifestyle, including a balanced diet and regular exercise, can help mitigate some side effects. Additionally, staying hydrated and avoiding smoking or excessive alcohol consumption can support your overall health.
  3. Consistent Communication: Maintain open communication with your healthcare provider. Report any unusual symptoms or side effects immediately. Your provider is there to help you navigate this journey safely.

RELATED: Unveiling the Long-Term Safety and Benefits of Testosterone Therapy for Transgender Men

By understanding the basics of testosterone therapy, you’re setting a strong foundation for a successful transition. Remember, this journey is deeply personal, and your experience may differ from others. Patience and self-awareness are key as you embark on this transformative path.

Physical Changes

As you begin your journey with testosterone therapy, the physical changes can be both exhilarating and sometimes challenging. These transformations not only align your physical appearance with your true self but also play a crucial role in how you are perceived and how you perceive yourself. The first year of HRT brings a series of changes that will gradually shape your body into a more masculine form. Here’s what you can expect.

Voice Deepening

One of the most noticeable changes within the first few months is the deepening of your voice. This can be an exciting development, as it significantly impacts how you’re perceived. Initially, you might experience a period of voice cracking and fluctuations as your vocal cords adjust. It’s similar to the experience many cisgender boys go through during puberty. While it can be awkward at times, remember that it’s a sign of the hormone doing its work. Over time, your voice will settle into a deeper, more resonant tone that aligns with your gender identity.

Body Fat Distribution

Testosterone will cause your body fat to distribute differently. Instead of traditionally feminine areas like the hips and thighs, fat will accumulate in more masculine areas like the abdomen. This process is gradual and varies from person to person. You might notice your clothes fitting differently, and your silhouette becoming more traditionally masculine. This shift not only enhances your physical appearance but also contributes to your overall confidence and comfort in your body.

Muscle Mass and Strength

Increased muscle mass and strength are common within the first year of testosterone therapy. You might notice a more defined and muscular physique, which can be empowering. Engaging in regular exercise, particularly weight training, can enhance these changes. Building muscle not only supports the physical transformations induced by testosterone but also contributes to a sense of physical and mental well-being. Remember to start slowly and consult with a fitness professional to develop a routine that supports your goals.

Hair Growth

Facial and body hair growth is a hallmark of testosterone therapy. While it may start as light and sparse, it will gradually thicken over time. Hair growth patterns differ for everyone, so patience is essential. You might see initial growth on your upper lip and chin, eventually spreading to other parts of your face. Body hair, including chest, stomach, and leg hair, will also increase. While this change can be thrilling, it’s important to manage your expectations and give your body time to adjust.

Skin and Acne

Testosterone can cause your skin to become oilier, leading to acne. Establishing a good skincare routine can help manage this. Consider using gentle cleansers and moisturizers to keep your skin balanced. If acne becomes problematic, don’t hesitate to consult a dermatologist. They can provide treatments that will help you maintain healthy skin while you undergo these hormonal changes. It’s all part of the process, and with the right care, you can keep your skin looking its best.


Most transgender men experience a cessation of menstruation within the first few months of starting testosterone. This can be a significant relief for many, as it often marks a major step in aligning your body with your gender identity. However, if menstruation continues beyond six months, it’s important to consult your healthcare provider. They can adjust your dosage or investigate other potential issues to ensure your therapy is progressing as expected.

Emotional and Mental Changes

Transitioning with testosterone doesn’t just bring physical changes; it also affects your emotional and mental state. Understanding and preparing for these changes can help you navigate this period with confidence and resilience.

Emotional Fluctuations

Starting testosterone can bring about emotional changes, including mood swings. Initially, you might feel more emotionally sensitive or experience unexpected bursts of emotion. Understanding that this is a temporary adjustment period can help you cope better. Keeping a journal or talking with friends and family about your feelings can provide an outlet and help you track your progress. Over time, your emotions will stabilize as your body adjusts to the new hormone levels.

Increased Confidence

Many transgender men report an increase in confidence and overall well-being as their physical appearance aligns more closely with their gender identity. This positive change can enhance your mental health and social interactions. The changes you see in the mirror can boost your self-esteem and make you feel more at home in your body. This newfound confidence can permeate other areas of your life, improving your relationships and daily experiences.

Anxiety and Depression

Be mindful of your mental health. While many experience improved mental health, others may face challenges such as anxiety or depression. The stress of transitioning and adjusting to new social dynamics can make these feelings worse. It’s essential to seek support from a therapist experienced in transgender issues to navigate these emotions. They can offer coping strategies and a safe space to discuss your concerns, ensuring you maintain your mental well-being throughout your transition.

Navigating Social Changes

Transitioning is not just a physical journey; it’s a deeply social one as well. As you begin testosterone therapy, you’ll likely find that your interactions with friends, family, colleagues, and even strangers begin to shift. These changes can be both affirming and challenging, and it’s important to approach them with awareness and support. This section delves into the social aspects of transitioning, offering guidance on coming out, dealing with passing and misgendering, and navigating evolving relationships.

Coming Out

Starting testosterone often coincides with coming out to friends, family, and colleagues. This can be a monumental step, bringing a mixture of relief, anxiety, and anticipation. Coming out allows you to live more authentically, but it can also expose you to a range of reactions, from acceptance to resistance.

Having a strong support system in place is crucial. Seek out transgender support groups, both in-person and online, to connect with others who understand your experiences. These communities can offer invaluable advice, empathy, and encouragement as you navigate this significant aspect of your journey.

It’s helpful to plan your coming-out conversations thoughtfully. Consider the timing, setting, and your emotional readiness. Prepare for a variety of responses, and give yourself grace to process these interactions. Remember, coming out is a personal decision, and you have the right to choose when and to whom you disclose your journey.

RELATED: 5 Tips on How to Come Out to Your Family As Transgender

Passing and Misgendering

As your physical appearance changes, you may find that you pass more easily as male. Passing can reduce instances of misgendering and increase your comfort in social settings. This change can be incredibly affirming, enhancing your confidence and sense of self.

However, it’s important to remember that passing isn’t the ultimate goal; your comfort and authenticity are what matter most. While passing can alleviate some of the social pressures and dysphoria you may experience, it’s essential to focus on what makes you feel most aligned with your true self.

Despite physical changes, there may still be instances of misgendering. These moments can be disheartening, but having strategies in place to handle them can help. Practicing self-compassion, asserting your correct pronouns calmly, and seeking support from understanding friends can make these experiences more manageable.


Your relationships may evolve as you transition. Open and honest communication with your loved ones is key to fostering understanding and support. Sharing your journey can help others grasp your experiences and needs, paving the way for stronger, more empathetic connections.

However, not all relationships will transition smoothly. Some loved ones may struggle to understand or accept your changes. These challenges can be painful, but they are a part of the broader process of asserting your true identity. Patience, education, and support can help bridge gaps, but it’s also important to set boundaries to protect your mental and emotional health.

Consider seeking guidance from a therapist or counselor, especially one experienced in transgender issues. Professional support can provide strategies for managing strained relationships and building new, supportive connections. Therapy can also offer a safe space to process the emotional ups and downs of your social transition.

As you navigate these social changes, remember that you are not alone. Many have walked this path before you, and there are resources and communities ready to support you. Embrace the journey with confidence and self-compassion, knowing that every step forward brings you closer to living authentically and joyfully.

Safety Tips for a Healthy Transition

Transitioning with the aid of testosterone therapy is an incredible journey, but it’s crucial to prioritize safety to ensure a healthy and positive experience. As someone who has been through the complexities of hormone therapy, I understand the importance of taking every precaution to avoid negative impacts. Here are some essential safety tips to guide you through your first year on testosterone.

Regular Medical Check-Ups

Consistent medical check-ups are vital. Regular blood tests will monitor your hormone levels, liver function, and overall health. Any abnormalities can be addressed promptly, ensuring your safety. Your healthcare provider will check various parameters, including your hemoglobin and hematocrit levels, to ensure they remain within a healthy range. Regular monitoring helps in adjusting the dosage if necessary, preventing potential complications, and ensuring your body adapts well to the changes.

Understanding Side Effects

Educate yourself on the potential side effects of testosterone therapy. These can include increased red blood cell count, changes in cholesterol levels, and potential liver strain. Awareness allows for proactive management. Being informed about these side effects helps you recognize any early signs of complications, enabling timely intervention. For instance, if you notice persistent headaches or unusual fatigue, it might indicate elevated red blood cell levels, which need medical attention.

Mental Health Support

Transitioning is a major life change, and having mental health support is invaluable. Therapy can help you navigate emotional challenges and provide strategies for coping with stress and anxiety. The emotional rollercoaster that accompanies physical changes can be overwhelming. A mental health professional experienced in transgender issues can offer the support you need, helping you process your feelings and maintain a positive outlook. Additionally, support groups can connect you with others who share similar experiences, providing a sense of community and understanding.

Healthy Lifestyle

Adopt a healthy lifestyle to support your transition. A balanced diet, regular exercise, and adequate sleep can enhance the positive effects of testosterone and contribute to your overall well-being. Eating a nutrient-rich diet supports your body as it undergoes significant changes. Regular exercise, particularly strength training, can amplify the muscle gains induced by testosterone. Moreover, adequate sleep is essential for recovery and overall health. Avoid smoking and excessive alcohol consumption, as they can interfere with hormone balance and overall well-being.

Avoid Self-Medication

Never self-medicate or adjust your dosage without consulting your healthcare provider. Self-medication can lead to severe health complications. Trust your healthcare provider to guide your therapy safely. It might be tempting to make changes based on how you feel, but altering your dosage without professional advice can cause significant harm. Always follow your prescribed regimen and report any concerns to your healthcare provider, ensuring a safe and effective transition process.

RELATED: DIY Hormones: The Risk You DON’T Want to Take

The Bottom Line

Embarking on testosterone therapy is a monumental step in your transition journey. This process, often referred to as HRT (hormone replacement therapy), is designed to introduce testosterone into your body to induce male secondary sexual characteristics. For many transgender men, this therapy is not just about physical changes; it’s a transformative experience that aligns your physical appearance with your true gender identity.

However, it’s important to recognize that HRT is not a defining requirement for all transgender individuals. No one needs to take HRT to be trans. Transness is expansive, meaning some trans people seek out medical transition and others don’t, all of whom can still fall under the trans umbrella. This inclusive perspective ensures that each person can find their own path in affirming their gender identity, whether it includes hormone therapy or not.

Like any significant medical treatment, it’s crucial to approach testosterone therapy with caution, awareness, and a commitment to safety. The decision to start or forego HRT is deeply personal and should be made based on individual needs, circumstances, and discussions with healthcare professionals who are knowledgeable about transgender health care.

Transitioning is a unique and individual experience. Whether or not it involves HRT, what matters most is finding the path that best suits your journey to living authentically as your true self. Your journey is a testament to your strength and authenticity. Embrace the changes, seek support when needed, and trust in your path. Welcome to the first year of the rest of your life—a year of discovery, growth, and becoming the man you were always meant to be.

Founder of TransVitae, her life and work celebrate diversity and promote self-love. She believes in the power of information and community to inspire positive change and perceptions of the transgender community.


Recent Comments