WHAT’S YOUR NAME

I had a small group of supportive friends who helped me “try on” a bunch of names. They would spend a couple of days calling me by the names I was working through and I just kept coming back to Noah. It was the first one where I felt calm and settled hearing it. I used the middle name my parents were going to give me had I been born a cis-guy.

It was important for me to keep that part of my connection with my parents. I think it helped remind them that I was still their kid.

WHERE ARE YOU FROM?

Originally from Northern NY – go as far north as you can before you hit Canada. I spent the last 5 years in Central Coast California and just recently moved to Seattle, WA. I lived in very rural (and conservative) areas of both, NY and CA; Seattle is the first place I don’t have to drive 4+ hours each way for a doctor who will work with trans patients.

IS HRT YOUR ONLY MEDICAL STEP?

I had top surgery in 2010 and a TAH-BSO in 2011. I was extremely comfortable with the team that performed my TAH-BSO. Unfortunately, the plastic surgeon who performed my top surgery told me during my consultation that “this makes me uncomfortable but because you have family support I’m willing to do it.” I regret not finding a new doctor at that moment. I wish I had stood up for myself and found a surgeon who was trans-knowledgeable and has experience with transmasculine top surgeries.

There are more trans-knowledgeable and trans-specific surgeons that I shouldn’t have felt like this was my only option. I wish I had someone to remind me that there are lots of options in other areas of the country where top surgery outcomes are fantastic. So this is my reminder to you. Make sure you’re comfortable with your healthcare team – you deserve respect and dignity.

WHAT YEAR / WHEN DID YOU START HRT?

I started HRT (testosterone enanthate) in 2009 when I was 21.

WHAT STEPS DID YOU TAKE TO PREPARE FOR HRT?

Research. I did so much research.

Because the closest LGBTQ+ resources were 2 hours away from me when I grew up, I didn’t really know what options there were or how to go about transitioning. I went to a psychologist to work through some depression (from repressing being trans) and luckily she was supportive. We talked about some things I could do to start transitioning before starting hormones (cut my hair, stop shaving legs/armpits, change clothes, pick a new name/pronouns).

I met Jason Ballard by chance and he hooked me up with his trans doctors (both at the Mezzoni Center in Philadelphia and his primary care physician in Oneonta, NY).

If you have the means to do it, I highly recommend talking to a trans-knowledgeable therapist throughout your transition. (Some will take insurance or work on a sliding scale for payments. Check out college counselors, too). I had a good handle on what would happen physically, but I didn’t really know how to navigate life as I was transitioning (even now I’m still working on finding my authentic voice).

I wish someone told me that when I transition, it’s going to relieve a lot of my anxiety and allow me to feel so much more settled in myself. The thing to remember is I’m going to transition as a trans-man; I’m never going to be a cis-man. A bunch of the dysphoria I still work through comes from comparing myself to other men who are cisgender. There are plenty of male role models who have trans experiences that I can be inspired by without immediately feeling dysphoric.

WHAT DID YOU NOTICE CHANGING FIRST?

Clitoral growth. That happened real quick. I thought there was something wrong with my boxers but nope, just things changing. It took some time (weeks? months?) for the discomfort against the boxers to go away.

After that I felt like I was coming down with a cold: my head was stuffy, and my voice was getting weird/warbly, etc. Turns out that was just my voice dropping. I’m not a singer, but I can carry a tune. I had a bunch of songs I loved to sing, but I’d had to sing them up the octave because my voice wasn’t low enough. As my voice dropped it was cool to hear my voice drop enough to finally be able to sing those parts. I wasn’t expecting my voice to drop so much that I could no longer sing those songs because my voice was too deep now, but hey, I’ll take it.

I was hungry all the time and I had incredible strength. I could do tons of pull-ups out of nowhere. I wish I had gotten into a workout program to actually build supporting muscles that would allow me to use this new strength safely. I’ve injured myself a few times in the past 10 years and (with no evidence whatsoever) I suspect some of them happened because I lifted things I could physically lift but not lift safely.

Get a workout routine. You don’t have to be a weightlifter or spend your life lifting, but do something to give your body a chance to keep up with the new strength. Start with 5 of each per day: push-ups, sit-ups, squat thrusts, squats; walk for 10 mins. Week 2 = 10 of each and 15 mins of walking. As you build strength, start doing pyramids (25 of each, then 20 of each, then 15, 10, 5 all in one session per day).

Just start doing something.

WHAT KINDS OF THINGS CHANGE / WHEN DURING HRT?

According to the journal I kept to track the HRT changes, the physical things I noticed were: cessation of menses (period stopped) – best thing for sure; voice dropped; body and facial hair; muscle development; increased sex drive; male-pattern baldness (my crown started really thinning around year 7 on HRT. I decided to shave my head so I wouldn’t have to deal with self-consciousness of balding so young. No regrets so far.); body fat redistributed (from hips/butt/thighs to stomach); clitoral growth; acne (face, chest, back); rougher skin; change in body odor; increased red blood cells; and increased (bad) cholesterol levels.

The psychological/emotional changes were: huge increase in confidence; increased aggression; short fuse; easier to feel frustrated*; and it’s nearly impossible to actually cry anymore.

*I never used to be aggressive/quick to anger. I knew what it was like to feel under control of my frustration so I had to intentionally learn how to regain control it. I think it took about 4-5 years to get back to my pre-T–level of control. If you need to hit something, hit your bed/something soft so you don’t injure yourself; work on counting to 10 and other breathing exercises; talk about things earlier before they become big problems.

WHAT CHANGED THAT YOU WEREN’T EXPECTING?

Hot flashes. Those are the work of the devil. I had them before my mom went through menopause so she asked about them. When she finally started menopause, we bonded over how miserable they are. So that was fun. I didn’t expect to not be able to cry anymore or for my aggression/frustration to skyrocket. All of that was worrisome and I had become really intentional with becoming the man I wanted to be instead of just letting changes happen. I suspected my confidence would increase, but I didn’t know what that would feel like cause I wasn’t ever really confident before. Learning what confidence feels like was pretty cool.

DO YOU DO SUBQ OR IM? (What’s that mean?)

I’ve done both. One of my doctors said there may be some correlations between IM injections and balding earlier. I haven’t done more research into that, but I did switch to SubQ about 4 years ago.

DO YOU HAVE A SHOT RITUAL?

It’s come down to yelling at myself to stop avoiding the shot. During the 1st year, I had so much adrenaline pumping before the shots, I never felt them go in. As the years went on, the adrenaline stopped and now I can feel them sometimes, which isn’t pleasant. So now I find myself avoiding them. Which is dumb. I don’t think I have an actual ritual. I usually end up losing the needle cap so I suppose I always look for that. Sometimes, my wife does the shots for me. It’s fun for her and it changes up the monotony for me.

HAVE YOU ALWAYS BEEN REGULAR WITH YOUR DOSE / WAS THERE A TIME YOU EVER STOPPED TAKING T?

The goal is to always be regular with the dose, but alas, life happens. Before my TAH-BSO I used to inject every other week. I noticed big swings in emotions, hot flashes, etc. so I switched to a half-dose every week and that seemed to temper the swings a lot. For the past 8 years (since the TAH-BSO), I’ve been injecting 0.25cc every week.

The only times I haven’t been regular with my dose is when there’s been an issue at the pharmacy with insurance or having my doctor write a new prescription. Unfortunately, it’s something I’ve had to deal with a couple times per year. I have yet to figure out how to keep it from happening, but by I try to keep at least 3 doses worth of testosterone left when I order the next prescription to help keep a buffer in case things get screwed up.

Dealing with these problems has forced me to advocate for myself and become assertive in ways I never had to be before. I no longer mind calling the pharmacy or doctor every day to find out what’s going on – it’s my health and I’m the only one who is going to put pressure on people to make sure my healthcare needs are met. Make sure you tell people what you need and ask questions if you don’t understand things – it’s literally their job to make sure you’re informed about your health.

DID YOU DOCUMENT YOUR TRANSITION WITH PHOTOS AND VIDEOS?

Yes and I’m so glad I did. I kept journal entries as often as I could when I first started. It’s cool to go back and see what I was noticing or thinking about during the beginning. I also took pictures every time I did a shot for the first year (until I started forgetting to do it) and took videos of every shot talking about things going on in my life. It’s wild to go back and hear/see the changes that have happened over the years. I also took pictures/videos going in and coming out of top surgery. I had a specific shirt that I wore in a picture every year on my anniversary of starting HRT. I did it for the first 4 years and then forgot to follow up on it.

I try to take at least one picture on my anniversary of starting HRT but as far as documenting my transition, that picture is
really the only thing that’s left. I do update my journal every once in a while, when I feel the itch, but I haven’t noticed any changes in the past 5 or so years besides my body/facial hair continuing to get thicker so I don’t feel as compelled to do any more recording.