Dear Anita

I think that as I save up financial resources for a gender therapist, I will talk to the gender therapist about transitioning and they can refer me to medical doctors who provide testosterone hormone therapy and surgeries. I have been following the forums on Facebook about other transgender people who have transitioned and have seen the effects of the top surgeries and testosterone therapies on them. I know that testosterone therapy will cause a person’s voice to get deeper, get facial hair and also cause redistribution of fat in areas of the body. I am thinking  that with a redistribution of fat to other areas of the body, I won’t have much of a chest because some of the weight will go to other parts of the body and since testosterone therapy makes it easier to gain more muscle tone when working out I hope that with workouts I can achieve muscle tone in my body and look more masculine. In addition, since most transgender men who get testosterone therapy will grow facial hair around the span of being on testosterone on three years, they will look more masculine. Even though testosterone may not create a flat chest and most transgender men also undergo top surgery, I think that it will help alleviate the gender dysphoria because I will have physical traits of a guy like deep voice, facial hair and if the fat redistributes it may make me appear more toned when I workout.

Testosterone will allow a person to exhibit the physical characteristics of a guy, but there are some secondary characteristics that will not change with testosterone therapy. The genitals may become longer and resemble a male penis, but testosterone therapy will not change the person’s genitals unless they get bottom surgery. Therefore, the person will likely have physical traits that look masculine such as a more toned body, deeper voice and facial hair but there are some things that require surgery to change. I think that I would feel better if I started talking with a gender therapist and have them refer me to a medical doctor who can provide testosterone therapy. Some of the physical changes on testosterone therapy will help ease the gender dysphoria and I think it will be okay if I don’t have all the effects of a guy yet. My main goal is to work on building the financial resources to talking with a gender therapist and getting testosterone therapy. Usually it takes three to six months of a gender therapist appointments before transgender people get a referral for medical doctors to prescribe testosterone therapy. If the person has intense gender dysphoria and is certain that there life would improve with testosterone therapy then the wait is usually three months. The medical doctors tell the transgender person about the risks of testosterone therapy such as the person’s increase risk for stroke, heart disease or mood changes and the transgender person signs off that they are aware of the risks and still want to continue to testosterone therapy. The medical doctors will monitor the testosterone levels of the person every five weeks to make sure that there are no adverse side effects and to make sure that the testosterone levels are just high enough for that of a healthy guy which is around 70 mg. After a person has spent three years on testosterone and has lived as a guy and is comfortable with it, they can opt for surgery to help make the changes that testosterone didn’t change such as getting top surgery to make their chest flatter or bottom surgery to construct a penis. I have heard from other transgender men on the Facebook “Binder Boys” group who have transitioned that before surgery, the medical doctors provide people with a picture of what they will look like and how the surgery will go. There may be surgery scars depending on how much of the chest fat is removed to create a more masculine chest and people with smaller chests often have smaller scars. The surgery scars usually heal and fade with time, but if the surgery occurs after the person is thirty or older than some of the scars will still be there. I don’t think that I would mind having surgery scars though because I would be happy to have a masculine chest. I think that my gender dysphoria comes from the idea that I am still saving up financial resources for testosterone therapy and since I don’t have it yet, I feel gender dysphoria about myself. I am consistently wearing looser clothes to make sure that there are no curves that show and I often work out so that I can lose some weight and look more toned and masculine. I have been using meditation to help me deal with my anxiety because there are times when I worry about my body. I think that with testosterone therapy I will feel more comfortable with myself because my body will start to change and become more masculine. I have heard from other transgender men who have taken testosterone therapy that it takes three weeks for the full effects of testosterone such as the deepening of the voice because during the first stages the voice begins to crack in pitch before it starts to stabilize and it takes a while for the fat to be redistributed to other parts of the body bur working out helps with that. I think that I am currently not comfortable with myself and my body because of my physical appearance and sometimes the dysphoria is very intense that it causes me to exercise a lot and restrict certain foods. I am hoping to work on building a daily meditation practice to reduce my anxiety and work on healing my body from the strain I have put on it so that my mind will be able to think about the path and so I will have the strength to go for the testosterone therapy. Since testosterone therapy will allow me to develop some of the physical traits of a guy, it will make me feel more comfortable about myself because currently I still experience gender dysphoria at times with my body. Likewise, testosterone after being on it for six years will cause the person’s menstrual cycle to stop and I think that would be a good thing for me as well because I often feel more dysphoria about myself during those times. Although the changes that are brought on by testosterone therapy will take some time and other changes like chest tone and genitals require surgery I think that I would be comfortable if I was talking with a gender therapist and working on transitioning because just the idea of working towards who I want to be makes me feel better. It is difficult now because I am still working through my college education and working on a career path that will give me financial stability to transition. There are times when the gender dysphoria can be rough and I worry about my body. Therefore I think that learning as much as I can about transitioning from others and looking at transgender people resources has been helpful as I work my way up and meditation helps with the dysphoria. The gender dysphoria will still be there, and I have to find ways to cope with it and heal myself from the strain of over-exercise and food restriction so that I can have a clear mindset to go for my goals. I think that the gender dysphoria will likely fade away when I am in the transition process and I find that currently I can work on taking steps alleviate the stress. I try to express myself as masculine as possible wearing dark, casual clothes that are a bit loose to make sure that there are no curves showing and I also chest bind to make my chest look flatter. The chest binder makes me have to take deep breaths so I can get enough air into my lungs to breathe and sometimes it feels a bit tight. Sometimes I dislike having to put on a chest binder because it makes me feel like I have to hide my chest and it makes it feel like I have to acknowledge the chest there. There are times when I just wish I could throw on what I want and not have to worry about my body not looking masculine. This is why I yearn for testosterone therapy because it will provide me a way to have masculine physical traits and I can feel more comfortable with my body. Sometimes it makes me feel cautious when I am talking to others in person because I want to make sure to not let them know a lot about me so that they might assume my gender because that would make  me uncomfortable. Sometimes I will have a great conversation with a person and then they will go to say Thank you and want to include a gender reference such as sir or ma’am and it always makes me feel anxious when they look at me and wonder about me. Since people don’t really have a habit of asking people what gender references they prefer, I often find myself ffeeling anxious hoping that the person talked to refers to me as sir. I think that when I have testosterone therapy and will have facial hair and a deeper voice, it will be easier for people to see me as a guy without questioning it. Because currently although I express myself pretty masculine with short hair, casual clothes and chest binding there are times when people question it because they wonder about my voice or lack of facial hair. I think that as I have socially transitioned for a while people are starting to not really mind my gender expression and most people have started to refer to me as a guy or they use gender neutral terms such as they/them for me which has been helpful with the gender dysphoria. Since I hope to work on the medical transition first then legally transition there are times when I feel anxious because my legal documents still say my birthname. I think that it is better to medically transition first because if a person wants to change the gender marker on their legal documents they need a gender therapist to sign and they need to be on testosterone for at least a year before they can change the gender marker on their legal documents. So I am thinking of saving money to medically transition and once I have been on testosterone for a while I can legally change my name and my gender marker at the same time and only have to pay the court costs once because you need to go to court to get a legal name change. Hope this helps! Thank you for your encouragement and for providing your advice to help me in life.