Three Years

Posted on October 1, 2010 by Caleb
3 Years on Testosterone

3 Years on Testosterone
voice clip : 3 years

It’s hard to believe how much my life has changed in the past four years.  Then, I could barely leave my house sometimes because of my anxiety and depression.  I couldn’t seem to keep a job, and I was losing hope that I would ever find a way to finish my education.  I hated my body and was struggling with the realization that I needed to transition.

While I still struggle with anxiety and depression, it is nothing like it once was for me.  I am able to get out of bed and function in society pretty much every day.  Just as importantly, I’m about to bounce back from the brief periods where I do have trouble functioning.  I have had the same job for almost three years.  I’ve been accepted into my college’s highly competitive nursing program, and will start the curriculum in about a week.  I still struggle with body dysphoria and the knowledge that there are still steps I need to take to correct it.  While I am not completely at peace with my body, I can honestly say that I love it, and myself as a whole.

My body hasn’t changed much in the past year.  It’s a bit furrier all over, and that’s the biggest change.  I’ve got a good bit on my back, and my tummy fur is darker, thicker, and a bit longer, though I think it looks better and less random than it did before.  I keep most of my body hair clippered. The backs of my hands have a little bit of hair on them now, but it’s hardly noticeable–my arms aren’t very hairy.

facial hair after 3-ish years HRT

My facial hair continues to do its thing.  It’s getting thicker and fuller, and filling in the blanks.  It’s going slowly, but it is happening.  I still keep a short beard, though lately I’ve been less meticulous about shaving the hair around my mouth, even though it’s not really “there” yet.  Since I’ve been so lax, though, I do have a picture to show you my facial hair development at this point.

Before testosterone, I could grow patchy sideburns and two thick patches on my chin.  I knew some guys who envied me for being fairly hairy pre-testosterone.  It might have been some consolation for them had they known that it doesn’t seem to have given me much more than a short-term advantage.  I have more hair than many cissexual men my age, and less than some who have been on HRT a much shorter time.  Fortunately, I am still young enough that my facial hair pattern is pretty typical, and it’s acceptable (if not exactly stylish) for twentysomethings to grow shitty proto-beards in my area.

Most of what I talked about here remains true for me.  I still haven’t disclosed to anybody at school, and I still have no plans to.  When trying on uniforms, I’ve been shirtless with other men in my program, and my chest either went unnoticed or unmentioned.  A few times, it’s come up that I give myself shots to maintain a normal testosterone level.  I’ve never needed to lie or contort the truth; I don’t have to fabricate stories.  I just don’t say “I was assigned female at birth.” and it’s that simple.

Unless something major changes, I absolutely intend to live an increasingly “stealth” life.  I feel more at-ease and friendly with acquaintances who don’t know I’m trans than with those who do.  I feel like I have a more professional relationship with those coworkers with whom I’ve never discussed it.

Basing a community around the assumption that I naturally belong in a category or community with other people who are trans/have transitioned is not only longer useful for me, but it actually seems to hold me back.  Having an area of my life in which I am completely “stealth” has made it easier for me to focus on other things.  I withdrew from spaces where the only uniting force among participants was the idea of transness.  I’ve funneled that extra free time into my hobbies, mainly reading and riding my bicycle.  Besides, most of my time and energy will soon be spent studying and working.

I’ve also become fairly confident that my future holds a hysterectomy (with the removal of one ovary, if not both of them) and radial forearm free flap phalloplasty, but that is the subject of another post.

2.5 years on Testosterone

March 2010

Recent Picture

June 2010

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No-T Diary

Posted on July 30, 2010 by Caleb

On February 13, 2010 I gave myself a shot.  I didn’t give myself another one until June 3, almost 4 months later.  Why?

June 3, 2010

June 2010 : almost 4 months off HRT

  • I was feeling really burnt out on doing shots.
  • I needed to find out if HRT was something that was necessary for me to feel right, or if I felt better without it, or somewhere in between.
  • I wanted to confirm emotionally what I already knew cognitively–that my being perceived correctly (as male) isn’t tied to my maintaining normal testosterone levels.
  • I didn’t want to elevate testosterone above other medications.  While it made my transition possible, at this point it mostly serves a maintenance function in my life and in my body.
  • I was curious about the physical and emotional effects of discontinuing HRT, and how I would feel about them.  I wanted to know (to the extent that I could) what changes in my personality over the past few years were exclusively related to HRT.

I never noticed a drop-off.  It happened so slowly, I suppose, that I just never noticed.  I was neither more nor less tired.  I didn’t experience any spikes in dysphoria, anxiety, or depression.

Physically, I didn’t notice much in the way of changes.  My speaking voice didn’t change, although I found it easier to access higher notes when singing, and my falsetto range got better.  My facial and body hair grew just as fast and thick as it usually did, and might have continued to fill in.  I did notice that my skin was softer.

Of course, as I hardly noticed anything, certainly nobody else did.  I didn’t “de-transition” in any way.

My sex drive was definitely lower, though it certainly didn’t disappear.   I wasn’t as into porn, either.  There was no change in my erections.  There were some changes in scent and lubrication.

Overall, I was really into not being on HRT.  I felt less surly, and more emotional, though I think part of that was that I felt so happy not to be doing shots.  It was freeing not to have to think about it, not to have to do it.

Eventually, though, the freedom was replaced by anxiety over when I would menstruate.  I thought about that part of my body more than usual, and I was really dreading the event.  I began thinking about hysterectomy, so that I wouldn’t have to worry about menstruating, or about exams.

When I did eventually menstruate, I was pretty freaked out about it.  It didn’t feel right or tolerable.  I didn’t like the way my body felt, and I felt irritated and mad that I even knew what it was like to have a period.  The inconvenience and angst of menstruation (and of waiting for it to show up) definitely surpassed the inconvenience and angst about shots, so I gave myself a dose the day after i started my period.

That period was about 4 days long.  It took me a few shots before I got back on a regular schedule (I averaged a shot every 3 weeks).  Eventually, though, I started spotting when I was late.  I gave myself a shot then, prevented a full-blown period, and have been consistent with my dose since then.

I also noticed nothing when I began doing my shots again, except my sex drive fluctuates more with my shot cycle than it did before.  I figure that once my body adjusts and my trough t levels don’t go below the normal range, I won’t notice a difference.

On the whole, I’m glad that I discontinued HRT for a while.  As a result, I know that in the future I’ll probably want a low/no-maintenance endocrine system.  Switching to the Testopel implant would be one solution.

Another solution (most likely in addition to the above) might be a hysterectomy, either without salpingo-oophorectomy (removal of ovaries and Fallopian tubes), or leaving one ovary intact.  In theory, that would allow me to discontinue testosterone therapy either temporarily or permanently in the future, if I desire.  Leaving at least one functional ovary might prevent any loss of bone density from lack of sex hormone, although it comes with risk.

I particularly like the option of leaving an ovary intact.  A hysterectomy would be required for the phalloplasty procedure I’m considering, because it requires vaginectomy.

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18 Months Post Op

Posted on May 29, 2010 by Caleb
18 months post-op

18 months post-op

I had intended to post pictures at 9 months, 12 months, or both. I apologize for that not happening. This is what my chest looks like now–a year and a half after my chest reconstruction surgery.

The scars are now almost completely flat.  A couple of areas which gave me the most trouble during healing are still in the process of flattening out.  They have faded to pale pink and white, and seem to be fading more and more with time.  Some sections seem close to disappearing altogether.  Until this point, I have mostly avoided exposing the scars to direct sunlight, though I will probably switch to using sunscreen.

Areolar pigment is still returning–slowly but surely. I hardly notice, really. For a while, I was having issues with ingrown hairs, but they’ve settled down–now I have 5-7 hairs that actually grow through the areola. That used to bother me, but I don’t even notice anymore. The scars from the nipple grafts have completely disappeared, and my nipples aren’t as raised off of my chest as they had been. My nipples look and feel–to my at least–like nipples that had never been grafted.

Sensation is a trickier matter. My chest is not as sensate as the rest of my body, and not as sensate as it was before surgery. I don’t have any particular patches of numbness anymore. I have some sense of hot and cold throughout my chest. I can feel light and firm pressure through most of my chest–though the areas just above my incision lines, just below both my nipples, and right around my left nipple are hit and miss with light touches. Most of my chest can feel pain, though in the number areas it registers as a discomfort i can’t really place, rather than as pain. It’s a very strange feeling, and not one I enjoy.

My nipples aren’t completely insensate, but the sensations I get there are unpredictable, and not usually pleasant. I don’t usually feel hot/cold, and I sometimes can feel both light and deep pressure. At this point, though, my brain seem to just fill in the information I’m not actually getting, so I rarely notice that my nipples–or any sections of my chest–are insensate.

18 months post-op

18 months post-op : left side

18 months post-op

18 months post-op : left nipple

18 months post-op

18 months post-op : right side

18 months post-op

18 months post-op : right nipple

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Injection Cycle Changes

Posted on December 29, 2009 by Caleb

After 26 months on a 10-day injection cycle, I’ve decided to switch to a 14-day schedule.  The few shots that I’ve missed have never had a noticeable effect on me, and I feel like my body is pretty stable… so, I figure, the fewer shots, the better.  I’ve had more than 80 shots since 2007.

Aveed (the new name for Nebido/testosterone undecanoate) is still stuck in FDA limbo, and I’ve slowly started to prefer the idea of the implant to long-term injections.  Namely, Testopel would minimize highs and lows in my testosterone levels, and after the initial start-up cost, I suspect that the cost and maintenance would be about equal to (if not less than) Aveed or Cypionate.

However, I’m waiting to explore these options until this summer, when things with school and work have calmed down significantly.  If the doctor in my area won’t treat me, I’m fairly positive that the urologist in the next town over will.

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Stealth

Posted on December 7, 2009 by Caleb

Two years ago, I couldn’t imagine wanting to be “stealth” in any part of my life.  Being trans occupied a lot of my time and energy, and it was a really important part of my identity.  Neither of those things are true now.

Back then, though, I couldn’t escape it.  Every time I got dressed, or answered the phone, or introduced myself, I had to think about it.  Whenever I met someone new, I had to weigh the pros and cons of telling them.  If they knew, then there was a chance that they might respect my name and pronouns.  If they didn’t, I wouldn’t have to worry about being on the receiving end of transphobia, or suddenly being asked to do Trans 101.  That’s a lot to deal with when you  really just wanted to do some local volunteering.

Because it was such a big part of my life, and because cis people couldn’t really relate to most of the things I was going through, finding community with other trans people was a huge priority.  It was really affirming to go someplace and be asked what pronouns I use, or to not have people assume they heard me wrong when I introduced myself (“Kayla?”).

At the time, the most ideal situation I could imagine was to have somebody know that I was trans, and respect my identity anyway.  Today, things are completely different.  When I’m getting dressed, I don’t have to squeeze myself into a binder; I don’t think about whether the pattern of my shirts minimizes the size of my chest.  People automatically assign me the correct pronouns, and no one is surprised by my name when I introduce myself.

At first, it felt like I was getting away with something when people respected my identity.  I felt like I was “passing” as male.  Once the novelty wore off, though, I was simply left feeling comfortable.  Much of my social anxiety disappeared.  I still let most people I met socially know that I was trans, but it was primarily just out of habit.

I’ve gotten really used to being treated simply as male, without any scarequotes or footnotes.  And the longer I live this way, the more right it feels for me.  My transition is over for the foreseeable future, and my body dysphoria has lessened significantly since my chest surgery.  At this point, my trans-ness exists as a treatable medical condition that is essentially no different from male hypogonadism.

Eventually, disclosing my trans status (or having my trans status disclosed) to acquaintances started feeling less comfortable.  I began noticing that I was treated differently by folks who knew my medical history–and not in a way that made me feel more understood and respected.  I started to feel like it actually limited people’s ability to understand me.  For example, most folks (who don’t know I’m trans) attribute my femininity to my queerness.  So do I.  I look, speak, and act like an effeminate queer man because I am one.  Instead of taking my gender expression for what it is, many people who know my trans status assume that it’s really some sort of residual femaleness.

In actuality, I don’t feel that I ever was female, and I don’t think that most things have anything whatsoever to do with my transness.  But as soon as most cis people are made aware that my birth assignment isn’t what they had expected, they relate pretty much everything back to my being trans.  Learning “the truth” tends to bring them further away from really understanding and respecting me than they would’ve been had they not found out.

When I enrolled in school back in September, I enrolled without disclosing my history to anyone. It hasn’t come up, and it hasn’t felt relevant to bring it up.  Sure, there are lots of opportunities to tell people.  I just don’t see a reason to.  I get plenty of chances to talk about being a survivor of family violence, too, but that’s hardly ever relevant, either.  People can get to know me professionally and personally without ever knowing many intimate details of my life.  They might be surprised if they learn some of those things later on, but people are always finding out what happens when they make assumptions about other people’s experiences.

Not so very long ago, I thought that it’d be dishonest for me to interact closely with someone and not disclose–that I’d be hiding something, or lying about my past or present.  Instead, I feel like I’m being seen for who I am, without other people’s misconceptions about gender or transition getting in my way, for the first time in my life.  It feels great.

As my life has gotten busier, my involvement in local and online trans community is taking a backseat to other considerations.  I don’t know to what extent I’ll be “out” or “stealth” in the future, but I suspect I will always keep my medical history private at work in school.  At this point, most of my close friends know my history, but I can’t even remember the last time I disclosed to a cis person outside of an activism setting (actually, it was probably when I corrected my Social Security information).  If this trend continues, I might eventually find myself almost completely stealth.  It’s still not something I’m particularly looking for, but I’m certainly not opposed.

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