My Experience With Testosterone HRT (As an Enby!)

Why I started T, what it's changed, and what I've learned. #TransparentTuesday

Hi friend,

A good number of you responded to last week’s “pre 40 glow up” email, asking for more details about my testosterone HRT (hormone replacement therapy) journey, and since I feel so passionately about this topic, I’m happy to share everything I can!

I have to start with a little disclaimer though, because I am not a doctor (obviously), and I am not giving anyone advice. I’m not suggesting that anyone else do anything, and I’m not “promoting anything.” I’m literally just sharing my experience, so please don’t make this weird, mmkay?

Below are my answers to the most common questions I got!

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Q: What made you want to start testosterone?

A: Honestly, I just like to try shit. I’m a very curious person and I have a very high risk tolerance, so if something sounds even remotely interesting to me I’m probably going to try it. Testosterone (T) had sounded interesting to me for decades, so when I realized it was an option, I pretty much knew right away I was going to do it.

As a personal trainer in my twenties, a lot of my male peers were on T. Not abusing it or anything, and not in the “roid rage” way of the 90s. These were extremely intelligent, informed, risk-aware and health conscious guys who took testosterone as part of the legit hormone optimization protocol for boosting health, recovery, training, and overall vitality…. and I was always so jealous.

Through knowing these men, I got the message loud and clear that when optimized, testosterone is the hormone that makes people feel energized, confident, motivated, resilient, driven, clear-headed, and happy.

So of course I wished I could try it!

My entire life I have been a person who sleeps a lot but never feels rested (I get 10 hours/night on average, and if I didn’t set an alarm it would easily be 13-14), and has struggled with low mood and depression. Plus I love feeling a bit aggressive, and I feel the most “myself” during periods of feeling powerful, exuberant, horny, and bold. So to me, the benefits of T sounded like a dream come true.

At the time however, testosterone HRT wasn’t really being offered to cisgender women, but the more I heard from these guys about how much better T made them feel, the more bummed I felt about the fact that I wasn’t allowed to go on that journey too.

As a person with severe PMDD, a lifetime of being on birth control pills, and gender dysphoria that I didn’t quite have words for yet, I had an extremely negative association with estrogen, and I felt existentially punished by the fact that “men’s hormones” make you feel awesome, and “women’s hormones” make you feel like absolute garbage. (To be fair, I have learned a lot more about hormones since that time, so I now understand that my perspective was deeply wrong and ignorant, but while I didn’t think it would ever be an option for me, my wish to try testosterone was cultivated during that time.)

Anyway, years later when I learned more about gender identity and came out to myself as non-binary, I started to get curious about the possibility of starting testosterone as a pathway to gender affirmation. I’m not a transgender man, so I didn’t want to go through that kind of medicalized gender “transition.” But I was curious if boosting my testosterone a bit would feel gender-affirming to me as a non-binary person, or even if I might just kind of… like it.

Then there was a point during Covid when I was battling a sudden and severe depressive episode, and could barely get out of bed. Fatigue, low energy, and low mood are all symptoms of low testosterone, so as I was starting my journey to find the right antidepressants, I decided to also get my testosterone tested just in case that might help.

Note: all bodies make testosterone, just like how all bodies make estrogen and progesterone—our levels may be different on average, but these hormones aren’t at all “unique to each sex” the way people think.

Anyway, I didn’t realize at the time that there is basically no amount of testosterone that is considered “low T” for women. So my bloodwork came back as “normal,” because the only way for it to not be normal would have been if it was too high. Years later, I would find out that I basically had no testosterone, which absolutely contributed to me feeling shitty and tired, but because the medical field doesn’t consider that a problem, I was told by my doctor that I was fine. (This shit pisses me off so much to even talk about now.)

Then a few years ago I was at a cute little medspa here in Asheville, to get Botox (another random and interesting thing I tried!) when I saw a little sign about their hormone optimization program, and I started asking questions.

Medspas like this one promote testosterone HRT (for both men and women) as a treatment for:

• Low energy or chronic fatigue.

• Brain fog and low motivation.

• Depression and low mood.

• Low libido.

• Inability or difficulty achieving orgasm.

• Difficulty gaining or keeping muscle mass.

• Poor recovery from exercise.

• Low bone density.

Every single woman I met who worked at this medspa was on T, and every single one of them raved about it—-and these were cisgender, hyperfeminine beauty and aesthetics ladies! Looking into their hyper-smooth, uber-shiny, filler-plumped faces, I was like… wow this could not be more different from the “transgender man” vibe I had been imagining when I thought about female bodied people taking T.

Their glowing reviews gave me a feeling of peace and comfort that I could explore lower doses safely and casually, so I decided to dive in!

Q: What dose are you on, and what method do you use?

A: I initially opted to use the “pellet implant,” which is a little device the size of a grain of rice that they place into your butt cheek with a teensy little surgery in-office, which then releases testosterone slowly over the course of three months. I started with the lowest “starter” dose they recommend for women (which I can’t remember now, maybe 100mg?) and the results were subtle but undeniable: I felt better immediately.

Within a month of that first pellet, I felt my mood and emotional resilience improve more than antidepressants had ever made happen (and with no side effects), and I knew I was in.

The results were always more subtle than I wanted, and I experienced a super steep and dramatic decline in the benefits toward the second half of each pellet’s timeline, so I slowly went up in dose every three months when I got a new pellet. The last pellet I got was 300mg, which is apparently a super high dose for women, but my bloodwork has continually confirmed that my body needs a high dose to get a moderate result.

Also, the context for this being considered “super high” is that this medspa’s typical customer is a cisgender ladies who would freak out at any “unwelcome” side effects like acne or hair thinning, because their idea of “optimal” is still our culture’s “feminine beauty ideal.”

That concern doesn’t really apply to me though, because I’m a non-binary babe who values how I feel way more than how I look.

Plus my body seems to just be gobbling up and discarding the testosterone I’m giving it, because not only have I had zero side effects, but my actual bloodwork on this “super high dose” still shows that I am still squarely in the middle of an “average” testosterone range for women.

And despite adding a testosterone cream to bolster the pellet, I’ve still been getting a steep decline in mood and energy benefits as the pellet wears off, so I very recently decided to switch to injections instead of pellets and cream! Next month I’ll be starting with injections instead, and it’ll probably take another few more months to figure out the correct dosage to keep my blood levels stable, and find out if injections are indeed the right fit for me.

So it’s still very much an experiment in process!

Q: What were your levels, and what’s normal?

A: There are two different numbers that matter when talking about

testosterone.

One is the total testosterone, which is the amount that’s just hanging out in your blood and available for your body to use.

For women this changes based on age, but it’s around 10 to 60 for women who are pre-menopausal. When I first got tested, mine was 22. Most recently it was over 1000—which is obviously extremely high, but based on the next number, you’ll see that it being available doesn’t mean my body is using it.

The second number you need to know about is called “free testosterone,” and this is the small percentage of testosterone that is “unbound” by other proteins, and therefore biologically active and “useful.”

The range of normal for free testosterone also changes based on age, but the normal range for pre-menopausal women goes from .3 to 4.2. When I first got tested, mine was .4—so basically as low as it can be. Most recently I got tested while my testosterone was peaking on my highest dose pellet, and my free testosterone was 3.6.

During the few weeks that my free T was that high, I felt absolutely fucking incredible. Zero depression. Zero fatigue. Just mental clarity, creative flow, spiritual bliss, deep sleep, great workouts, great orgasms, emotional resilience, and a deep and profound satisfaction with my life. No side effects either, unless you count an increase in random sexual thoughts. (Which I don’t.)

For the record, I’m on a birth control pill as a treatment for PMDD, and that does have an impact on a person’s hormone levels and interactions overall, so if you’re curious about how my T fits into my overall hormone profile with estrogen and progesterone, I unfortunately don’t really know!

Q: How has this affected your gender identity, if at all?

A: To be honest, I don’t know. I love feeling stronger and more powerful, and I am so grateful that T is helping me rebuild my physical strength and fitness, as well as my business and my friendships, because I just have a bigger capacity for doing more stuff every day. I would also be absolutely thrilled to put on some muscle mass, because looking a bit jacked and masculine makes me feel hot AF!

But beyond that, I don’t think my experience is particularly gendered in the way we normally think about gender identity with regard to HRT.

There are plenty of masculinizing effects of testosterone that I wouldn’t particularly mind if they happened to me, for example, but it’s also not like I actively desire them. So I don’t see myself ever exploring “transition levels” of testosterone. (Although who knows, life is long!)

Instead, I just see myself continuing to tinker with the dosage and the

method in order to feel more like my best and favorite version of myself—the version that is happier and more at peace, which testosterone brings out. The version that is more energized and alive, more ambitious and creative, more present and dynamic. More spiritually connected and fulfilled. More here. More me.

None of those things are specifically related to gender identity, of course. But also… maybe they are?

Q: What about sex?

A: I’ll tell you what… this wasn’t an area I was looking to improve, but it’s been incredibly fun to notice changes to my libido, pleasure, and experience of sexuality on T.

I already had a high libido, and I do feel like a horny teenage boy now sometimes, in the absolute best way. I can absolutely see how/why they offer women T as a libido and orgasm booster, and I could actually write a whole other post about what T has taught me about sexuality and gender, because it’s been fascinating and illuminating!

So let me know if you’re curious about that, or have any further questions about my experience!

I’m a complete open book on this topic, and I hope these details are helpful, but please know that if you ever want to do a single coaching call to explore questions around this kind of thing, I’m down for that!

Big hug,

Jessi