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The Rocky Road of Hormone Transition

Perhaps this feeling is a consequence, at least to some extent, of the near-ubiquitous before-and-after pictures of hormonal transition. These photos omit the difficult middle, offering instead an arbitrarily selected “after”.

by Mizy Clifton


I was privileged enough to be prescribed testosterone by a private endocrinologist on my twenty-second birthday. The prescription had to be signed with wet ink, he said, so I would have to wait until I received a physical copy in the post before I could march to my nearest Boots to procure the holy ointment. 

I sat by my window every day until it arrived, my ears and eyes pricked for the Royal Mail delivery cart. When the letter finally did – embossed with a second-class stamp, which felt almost offensive in its ignorance to my urgency – I clutched it tightly in my hands, walked to the aforementioned Boots, and requested Tostran 2% gel, if you please. Four pharmacy rejections later, and it dawned on me that there just so happened to be a nationwide shortage of that specific brand. 

With an increasing feverishness, I called ten pharmacies in central London and eventually found myself jumping on a train to chase – as if against the clock, or another unsuspecting trans-masc – the last remaining bottle of the stuff that a small Boots in Muswell Hill had crusting away at the back of a shelf. Long story short: I got the T. 

I’ve only been on testosterone for three months, so I’m still in the earliest stages; I joke that I must have a similar hormone profile to my best friend’s thirteen year-old brother. I have no regrets about my decision.

Applying the strangely coloured gel – the look and feel of which can only be described as approximating that of semen – has become a taken-for-granted part of my daily routine. My voice has dropped, I’m rapidly sprouting chest hair, and if I’m not careful to wear antiperspirant my scent resembles that of an unkempt man (a fact that I’m rather jubilant about). 

What is rarely talked about, however – except perhaps in the depths of r/FTM – is that hormonal transition is a rocky road, one in which good feelings are by no means guaranteed. I was warned that it would not provide a catch-all solution to my dysphoria, and that navigating the world as an increasingly male-approximate but nevertheless still gender ambiguous figure would likely render me more susceptible to both homophobic and transphobic violence. 

But I wasn’t warned that taking testosterone would at times exacerbate my dysphoria, giving rise to obsessive self-scrutiny that, if unchecked, can be just as debilitating. I have to stop myself from rushing to the mirror every morning to inspect whether or not my mustache hairs have matured from vellus to terminal (the fact that I now know the difference is a testament to precisely this hyper-fixation) or incessantly recording my voice on pitch-checking apps. And when I see friends that I haven’t seen in months, I often get more self-conscious, worried that they are expecting me to have undergone a full body transplant. If they don’t struggle to recognise me, something has gone wrong. 

Perhaps this feeling is a consequence, at least to some extent, of the near-ubiquitous before-and-after pictures of hormonal transition. These photos omit the difficult middle, offering instead an arbitrarily selected “after”. Arguably, there is no final destination to transition, and so this “after” is simply an image that its subject feels satisfied enough with to share; regardless, these images play into the sensationalised trajectory of transition, in which one day we miraculously materialise as bearded men.

Looking at them, it is easy to feel like a “before” picture – my incessant anticipation of that imagined future makes my present feel like a past, a past that I am nevertheless presently stuck in. Beyond taking the pragmatic decision to avoid these pictures – difficult, because they stir up feelings of hope, which is precisely what leaves me vulnerable to disappointment – and to avoid scrutinising every aspect of my body for signs of change (that future incarnate), this feeling is difficult to avoid. 

Stock image of a man looking in the mirror

The other unfortunate truth is that when people do not know that I am taking testosterone and thus do not expect changes – such as the person who works in my local off-license, or the man who just moved into my university accommodation – I also feel nervous. Perhaps the changes are imperceptible to those who don’t care enough to be attuned to them, but I worry nonetheless about the confusion that any perceived changes might generate. I worry about being the one who causes the confusion. This is ironic, because I once relished the confusion that my gender provoked. 

To repeat: I do not regret my decision to start taking testosterone. But I want to caution against the lofty assumption that transition generates only good feelings. No doubt these words risk being seized by trans-antagonistic commentators as evidence that transition is a pathological pursuit, but I am willing to take that risk, in the hope that my account of what it feels like to be trans in the here and now might provide some relief to those who may be experiencing something similar. It is also a matter of exercising my right to feel bad (a right that trans people are rarely afforded) and to be allowed to sit with the complexities and ambivalences of transition without rushing to resolve them. 

National Lottery Community Fund Logo and LGBT+ Consortium Logo

This article was funded by The LGBT+ Futures: Equity Fund in partnership with the The National Lottery Community Fund.