Growing up, I was taught a narrow definition of gender. I never felt like a girl or a woman, but I thought the only other option was being a man. Though I wore pink dresses as a kid, being told I wasn’t a “tomboy” hurt for some inexplicable reason. So, my favorite color changed to avoid being put in the “girly-girl” box. Despite knowing what the word transgender meant, I didn’t think I counted. Could I really be trans if I wasn’t on one end of the spectrum?
At fifteen, I was introduced to a whole world of nonbinary identities by Ash Hardell’s decade-old YouTube videos defining terms that make up the LGBTQ+ community. When I realized the trans umbrella didn’t only consist of binary people, it all made sense. Still, I was afraid of being wrong. I was concerned about how others would view me and if I would hold any regret. In college, I accepted my identity and came out. While repressing ideas of medical transition, I chose a name, adopted new pronouns, and cut my hair. Cutting my hair felt like an easier step in my transition. I could tell a barber exactly what I wanted and get something nearly identical. And a bad haircut can always grow out!
Hormone therapy isn’t quite as simple.
At 25, I only recently started hormones, and it was after a lot more thought about my body and identity. Learning new terminology to express my identity opened up my concept of gender, but I also needed to expand my mindset when it came to transition. Nonbinary people like me often feel uncomfortable being placed in a binary box. A common misconception about transitioning is that all trans people are attempting to “become the opposite gender.” This is a limiting way to look at hormone therapy and leaves nonbinary people in particular in a confusing position. Trans people may take hormones to feel aligned with their identities, experience euphoria instead of dysphoria, or a variety of other reasons. Instead, a better way to look at transition and hormone therapy is to define it based on the personal goals of each trans person.
Hormone therapy–and transition in general–isn’t one-size-fits-all. Though many transgender people seek medical transition, others may choose not to. Every transgender and nonbinary person (like every person, period) has a unique way of expressing their gender. This means hormone therapy doesn’t always look the same.
Though having such a wide definition of transition sounds freeing, for second-guessers like myself, it can also cause indecision. Many nonbinary people struggle to sort through where on the gender spectrum they fall and how they want to express that. Certain effects of hormone therapy might feel too masculine, feminine, or just be unwanted. It’s normal to be scared and unsure. Starting hormone therapy is a big decision and doubting it doesn’t make someone any less trans.
Most of my doubts manifested in the form of never-ending questions. My biggest question–What is my goal?–was a nesting doll of other concerns. What presentation will make me feel euphoric? What parts of my body am I most dysphoric about? How masculine is too masculine for me? For some binary trans people, the goal is passing as a cisgender person. But what would passing even look like for me? As a nonbinary person, I had trouble deciding what effects I wanted from testosterone. Some appealed to me: my body fat being redistributed, my muscle mass increasing, and my voice changing. Others scared me: getting acne and experiencing male pattern baldness. All the other effects sat in a gray area along with my gender.
Worst-case scenarios and the word “irreversible” repeated over and over in my head. My anxiety disorder made it so I barely got a moment alone without obsessive thoughts. Is it worth taking testosterone just to see if it feels right? What if I start hormones and feel dissatisfied with my reflection? What if the only effects I see are ones I don’t want? Is it vain of me to care this much about my appearance?
Anxiety–combined with the media’s representation of transition–turned testosterone into something sudden, irreversible, and daunting. Seeing Instagram reels of decade-long transitions happening in ten seconds made me feel overwhelmed. Though I knew hormone therapy was a gradual, slow process, I had trouble believing it.
For me, a major sticking point was my hair.
As a kid, I had long, red hair that led to lots of compliments and a few broken promises to extended family that I would never dye or cut it. When I finally chopped it off just before coming out, I was super nervous. The first haircut wasn’t great, but I figured out a style that suits me and settled into a nineties middle part that I’ve stuck with since. My hair soon became an integral part of my gender expression. It was the one part of my body I felt like I had complete control over.
Certain hormonal changes are more permanent than a haircut. For testosterone, this includes the voice deepening, body hair increasing, and a receding hairline. That last potential permanent change created a mental roadblock for me. My hair was one of the only sources of gender euphoria in a body that made me dysphoric. The possibility of losing my hair–and control over my presentation along with it–was terrifying. Would I really have to give up my hair to feel better about the rest of my body?
Ironically, this question also served as motivation to pursue my curiosity. Subtly testing the waters with my parents one day, I asked them, “So, when did Dad start going bald?” The answer was around his mid-twenties. My dad always made jokes about not having hair on his head. For a lot of people who are assigned male at birth, they’re prepared for that possibility. I wasn’t. No one had considered I might follow the pattern of all the men in my family, whose hairlines started receding before they hit twenty-six. That timestamp hung over my head like a fast-approaching deadline. Though there’s no such thing as a perfect transition timeline, this conversation felt like a wake-up call.
Before taking the plunge, I wanted to make sure this was the right decision. So, I entertained the idea of not pursuing hormone therapy. A lot of the nonbinary people I knew personally or saw on social media weren’t on hormones. This line of thinking didn’t soothe my thoughts. My dysphoria spiked and I began feeling stuck. So, I circled back. When I started talking more seriously about hormone therapy and my doubts about it, my mom came up with an alternative. She suggested I get a buzz cut. It came from a thoughtful place, but it was the opposite of what I wanted. It was my body I wanted to change, not my hair. Relaying the story to my trans support group got a lot of knowing laughs. A lot of us were probably thinking the same thing: If only it were that simple.
I had been trying for years to present as masculine as possible, but it wasn’t working. It didn’t make me happy and others kept misgendering me. Then it clicked.
I was tired of being perceived as a woman. My goal was to be visibly trans.
My identity is still something that I don’t have a perfect definition for. When asked, I often tell people I’m transmasculine and nonbinary. I know I’m okay with they/them and he/him pronouns, but I’ve never fully connected with any specific label. The one label that feels right is “trans.” So, that’s how I want to be perceived.
This realization brought some complications with it. I imagined how different going out in public might be once I was visibly trans. I worried about my safety. I asked myself, Is it worth trading my cis-appearing privileges to feel comfortable in my body? After some thought, I decided the answer was “yes.”
Throughout the six years I spent thinking about medical transition, I often felt like I was standing still.
It was frustrating to keep going back and forth about whether to start testosterone. Really, I was making slow progress towards finding my goal.
Now I had to figure out how to reach it. Those all-consuming thoughts and questions led to a lot of research. I wanted to know if I could start hormone therapy and keep my hair. Online, I found out about finasteride: a medication that people who produce testosterone use for hair loss. A new fear emerged. What if finasteride alters my transition? It didn’t help that all the articles I found on the medication were written by binary men: both trans and cisgender. A lot of cis men didn’t like that finasteride made them feel moodier. Many trans men expressed dysphoria over their periods returning. This wasn’t something I could relate to. Others thought the manliest thing someone could do was mimic their father’s receding hairline. I didn’t share that belief (no offense, Dad).
Since so many official resources seemed tailored for binary people, I turned to my trans support group, online forums, and friends. It turns out, a lot of nonbinary people have the same concerns. Many nonbinary people who pursue testosterone have a fear of losing their hair or changing too drastically. A lot of people worry about being visibly transgender in public. Everyone seems to have a different way of dealing with these concerns.
No two trans people have the exact same journey. So, every transition has to have a personal definition, which I felt like I needed to open up a conversation about medical transition with a doctor.
Even with a clear definition, I wasn’t one hundred percent sure. Without that complete certainty, I feared being turned away by doctors. To attempt to reach one hundred percent, I made a very detailed chart. Everyone understands gender and hormones differently. That’s probably why if you look up “gender spectrum” you’ll get a wide variety of infographics. No one chart, questionnaire, or other method can help all trans people discover their approach. Some people might click with journaling, while others might want a Venn diagram.
For me, journaling my feelings felt way too abstract. I’m a fan of old-fashioned pro-con lists. So, I jotted down every effect of testosterone and gave it a negative or positive score. Hair loss got negative four: the biggest player on the field. Then I took away any reversible or avoidable effects. In the end, it looked like a net positive…assuming hair loss could be stopped.
So, I wrote down all my questions about finasteride and hair loss that would finally put my mind at ease. Then I made an appointment. At most first appointments, it’s more about establishing goals than prescriptions. I told my doctor all my specific wants and needs with hormone therapy. Most of what I was told lined up with my research. My doctor was able to concretely answer some of my questions. Finasteride was an option to control hair loss and–at the right dose–shouldn’t block any of the desired effects of testosterone. Others were a bit murkier. Transgender research is limited and all bodies react differently to hormones, meaning there are a lot of contradictions in what you’re told. First, I was told that testosterone isn’t a good form of birth control, but it’s also possible that it impacts fertility. Second, I was given a specific timeline, then reminded my body wouldn’t necessarily follow it.
My goal was clear, but my body could always have other plans.
The last five to ten percent of certainty wasn’t there. After six years, I figured it might never be. To discover myself, I would have to be okay with losing a small amount of control. Even if I never got to one hundred percent, I wanted to take the leap.
I was jittery the first time I rubbed testosterone gel into my arms and stomach. It ended up being a bit anticlimactic. It just feels like putting hand sanitizer on. It turns out, my body is on the same page as my mind and taking things very slowly. After three months, it’s difficult to tell what’s new and what I just didn’t notice before. I find myself wondering how much hair I had on my stomach, if I always used to get really warm in the middle of the night, and if the few dots of acne are a symptom of my usual hormonal changes. I almost wish it would happen faster. Six years ago, I would have been shocked by that conclusion. Although I’m eager to see changes, I feel mostly in control.
I still have moments of doubt. When I debate asking my doctor to up my dose, I get nervous that it might have negative effects on my hairline. Because I know how my thoughts can spiral, I came up with a simple solution. I took a selfie in the bathroom. That way, if I have an anxious day, I can compare two reflections of myself in the mirror. If that picture and my own feelings are accurate, I’d say my hair hasn’t changed. It’s too early to know for sure if it’ll stay like that, but I’m trying not to get ahead of myself. My mantra is: “I’m taking it one day at a time.” In the last three months, I haven’t felt any regret.
