Things They Didn't Put on Your Informed Consent Sheet

* The following is from this Tumblr post by user valhallagoon, directed at FtM's who are or are interested in taking testosterone. Valhallagoon (who has since deactivated, unfortunately) shared some of the things learned within the first year of being on testosterone. I thought the post mentioned some pretty interesting things. Some of these I knew already, some I didn't. 

This post mentions food, genitals, menstruation, medication, drinking, injections, birth control, and guns. If you are bothered by any of these things, please read with caution. 

Photo Credit: Zachary Brennan

1. You’re going to fucking stink to high heaven. That’s puberty. Get a good deodorant, shave your armpits or become a hermit. Even then, you’ll still probably stink.
2. Right around 3-6 months on T, you’re going to be in itchy, unbearable agony as your new hair grows in. I scratched so badly that I had welts and blisters that scarred. I’d scratch in my sleep. It never stopped. It was brutal. Hydrocortisone cream and anti-itch powders will help. Avoid having your skin damp for prolonged periods. Avoid excessive heat. Don’t wear spandex. Compression clothing such as tight boxer-briefs or binders will make it worse. Crying like a little baby does not help, but you will doubtlessly try this, no matter how manly you think you are. We are all little babies during this time.
3. Binding causes scars under your arms and on your shoulders. It also causes acne. Cystic acne.
4. T promotes muscle growth and fat loss… and hunger. If you make bad food choices, you will gain weight, no matter how much you think T is a magic weight loss potion. It is not a magic weight loss potion. On that note, you will gain weight. Muscle weighs more than fat. I dropped 3 clothing sizes but gained 30 pounds in weight. 
5. Your genitals will hurt. Your dick is going to rub against your underwear or packer if it’s not properly positioned under your skin. You will master the awkward cowboy walk to the bathroom to fix it in a way that draws the least attention. Crying like a little baby does not help, but you will probably do it anyway.
6. One day, you’re going to wake up and the first thing out of your mouth will sound so unrecognizable that you think you’ve switched bodies with someone else. It’ll be like going from Avril Lavigne to Morgan Freeman overnight. At least, that’s what it will feel like to you. Crying like a little baby is acceptable when this happens.
7. Everything causes acne. Even your acne meds. You can’t fix it. All you can do is live with it until your hormones stop going haywire.
8. Some lucky transmen experience temporary uterine insanity. That is, your uterus goes insane and starts cramping randomly. Some endocrinologists theorize that it’s due to the muscles increasing in size from the testosterone so rapidly that they cut off their own blood supply. The pain level from this ranges from “a bear on PCP ate my toe off” and “I just took a shotgun shell full of lemon and rock salt to my external genitalia.” Crying like a little baby does not fix it, but you will do it. You will probably have random bleeding, painful intercourse and lower body weakness. Go to your doctor. Get pain medication. Try to avoid getting addicted to the pain medication. Don’t send nudes of yourself to Pizza Hut when high on the pain medication (as I have done).
9. Sometimes your voice will break completely in half and you can sing baritone AND soprano. This is great at parties. It gets even greater when you’re drunk.
10. Drinking before a blood test will mess up your results and may lead your endocrinologist to change your T dose when it’s not necessary.
11. 100mg/week is not the gold standard magic-making dose. That’s where most endocrinologists put you until you figure out the best dose for yourself, with blood tests to monitor your levels so you don’t make your heart explode. Sometimes it’s more, sometimes it’s less. It’s trial and error. Don’t inject T into a vein. That’s really stupid. Crying like a baby will not help. You’ll probably hurt yourself and look like a giant idiot in the ER.
12. You will mess up your injections frequently. Golf-ball sized swellings, redness and heat can be common even without infections. Sometimes it will hurt so much that you can’t even walk, sit down, masturbate or shit without being in horrible agony. Cry and move on. Biofreeze will be your best friend. Note: wash your hands after applying Biofreeze, especially before you attempt to use the restroom. Ibuprofen helps with the pain better than tylenol and is less likely to make your liver turn black.
13. People who don’t know you well, such as your favorite barista or your pharmacist, will stop recognizing you at some point. This is normal. Use it advantageously. 
14. T will change your emotional responses to things. A lot of people think that it makes you angry and this is not always true. You may have stronger emotional reactions to things. You may have less strong reactions to things. You may get sad where you once got angry, and vice-versa. This is normal. Adapt. If someone tells you that you’re being an asshole, listen to them. It’s also appropriate to tell them to go fuck themselves.
15. Your informed consent sheet will tell you that your genitals will be drier than the Sahara in the summer. This is not always true. In fact, sometimes the opposite can happen and it’ll be quite swampy. Learn to adapt. Or get Summer’s Eve. Sadly, they don’t make it in Axe scents.
16. If you’re under 21, it’s possible that you might get taller. Remember the growing pains you used to get as a child? Now imagine those but 500% worse. That’s what it will feel like. You will also have to relearn your spatial relationships with the surrounding world. You will be awkward and clumsy. You will knock things over and be in a constant state of bruised.
17. You will be less iron deficient on T if you stop menstruating. If you have iron-deficiency anemia, it may clear up entirely.
18. The copper IUD contraceptive Paraguard can cause your periods to come back. Transgender men looking for an IUD are encouraged to choose Mirena, which is infused with progesterone. Progesterone-only hormonal contraceptives such as Depo-Provera, Implanon/Nexapro, the morning after pill and some daily oral contraceptives are less likely to interfere with your HRT but will likely worsen your acne, cause weight gain and affect your moods. If you are under 25, are on T and have Mirena placed, it is likely your body will reject it. This is very painful and it’d probably be less painful if you stuck both of your feet into a bear trap. You will cry like a little baby. You will also throw up and shit yourself.
19. Do not attempt to STP while intoxicated. If cis guys can’t control their urine streams while intoxicated, you sure as hell can’t.
20. And just to piss you off: Testosterone therapy is a subjective experience. No matter how much you can prepare yourself for the changes, you’ll be surprised by what’s happening to you. After you start T, it’s likely you’ll feel lost. You spent a lot of time and mental effort getting to this point and now there’s not much to do but wait. At some point, your changes will slow down. Some day, you’re going to wake up with a beard and not remember the time you didn’t have one. And neither will anyone else. So just be and stop worrying.

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FtM/Transmen (synonymous terms): A transgender individual who was assigned female at birth, but identifies as male.

Testosterone/T: A steroid hormone used to develop a masculine appearance and features

Binder: A compression vest used to give the appearance of a flattened chest, typically used by those who are FtM.

Binding: The act of using a binder or other materials to give the appearance of a flat chest, typically used by those who are FtM

Packer: A device worn by transmen to give the appearance and feel of a penis. 

STP: A Stand to Pee device used by transmen so they can stand to urinate.

Cis: Cisgender; someone whose gender identity aligns with their assigned sex at birth.