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Sunday, September 24, 2023

One Month On T

I'll begin with some context-setting. If you want to skip to the main event, start at "It's now been about one month."

First, a caveat: I did not start with a baseline female endocrine profile when I began taking testosterone. I'd given birth two and a half months earlier, so my most recent memories of what it was like to inhabit a female body were of a postpartum body, and before that a pregnant body. I suspect that if I'd started T at a different time, some of the contrasts would not have seemed so stark. Still, pregnancy and postpartum felt to me like they turned up certain parts of my experience, not like they added something completely new. I do think that from baseline, I would have noticed the same things, just to a lesser degree.

Second, what was my relationship with HRT, going in?

I have in my head a sort of caricature of a pre-T trans man. The character I have in mind thinks of himself as a man, suffers so much from being trapped in the wrong body that he's constantly depressed and anxious over it, can't stand being misgendered by other people, and is confident that "medically transitioning" will solve his biggest problem. When it does turn out to solve his biggest problem, and his life is dramatically better, and he's transformed from a miserable wreck into a self-actualized and flourishing version of himself, he is not at all surprised, and neither is anyone who knows him.

I worry that I've described this person in a way that's somehow trivializing; I don't mean to. I think many such people actually exist. What I'm trying to do here is point at one extreme end of a spectrum, where the other end is "cis by default"—someone who really just doesn't care about their sex or gender, either from the inside or with respect to how others treat them.

I have never been at either extreme end of this spectrum.

I was sure about enough things that HRT seemed like it was the right choice for me, on net. But very little seemed obvious or straightforward. I made my decision largely through reference class forecasting: Changes I'd previously made to my body and social situation that tend to help transmasculine people turned out to help me as well, and starting T was the next obvious thing to try. I wasn't sure that I "am a man", or that I'd feel more like myself on testosterone, and I had some pretty big concerns.

I was hesitant for three reasons. First, I was afraid of having a higher sex drive. Depending on my mood, I either see sexuality as a somewhat nice diversion, like popcorn at a movie, or as a tragic distraction from the things that actually matter to me.

Secondly, I'm not the best at coping with change, in general. For example, I have sometimes cried after getting a haircut, even when it was exactly the haircut I wanted and I thought it looked really good, just because it was so rough for me to suddenly look different.

And third, maybe I'd miss biological femininity! Although my money was actually on feeling freer to openly express the feminine aspects of myself once my masculinity felt more secure, it was only a guess. For example, I was once a stripper, someone who performs feminine sexuality professionally, and I loved it. Not everything about it—any job has its downsides—but I enjoyed playing those characters on stage, and I enjoyed the way people responded to me when I did. Seems like at least some evidence that T would make my life worse instead of better, no?

So overall, my attitude going in was that the situation was complicated and uncertain, but it seemed likely that I'd be better off with a male endocrine profile than with a female one, even though the change probably wouldn't solve any big problems immediately and might cause some new ones. By sticking with the female endocrine profile indefinitely, I'd be failing the reversal test.

It's now been about one month. I've been injecting 80mg of testosterone cypionate intramuscularly once a week for four weeks. What has resulted so far? Lol um well, it immediately solved my biggest problems, actually, and suddenly my life is dramatically better.

I am surprised. This was in my hypothesis space, but I definitely did not expect it, especially not so quickly.

What exactly have I noticed? What has changed?

1. The very first thing I noticed was something I've described as "heat" in my body. I gave myself my first injection in the morning, and by that night, I was feeling something emanating from my torso that reminded me of gently glowing embers. It was strongest for the first couple of days, and then it subsided, but has not completely gone away.

It seems closely tied with my experience of "having more energy". I've been enjoying exercise more, feeling more motivated, more eager to go places and do things. It's not an uncomfortable restlessness; just a pleasant internal fire that drives me forward toward action.

2. The second thing I noticed was a cognitive change away from neuroticism and toward clarity. This was apparent by day three.

When thinking through a problem, reading, studying, or considering a project for work, my cognition seemed far more direct. It's not that there was an addition of directness, no impatient craving for a clear answer or anything like that. There was just an absence of many obstacles I'd previously spend at least half of my thinking time contending with. Obstacles like self criticism, considerations about how other people might perceive my thoughts/beliefs/preferences/emotions, a constant meta-level weighing of whether what I was doing was any good and whether I should continue, and what sort of evidence my thoughts were about whether I'd succeed or fail.

With testosterone, I immediately found that I could just... think. On the object level, directly, without paranoia diverting me at every step, without spending a lot of cycles ameliorating and mitigating all those protective filters.

It's a quantitative difference more than a qualitative one. My brain is still doing all of the same things. I still seem to care about what my thoughts mean about my future and so forth, and I'm still sometimes distracted by that sort of thing when I'd like to focus completely on something else; but it's mostly only when I'm tired, very hungry, or sick. By default, my thinking feels so much more clear, engaged, uncomplicated, quick, focused, decisive. No more weird twisty mazes of intrusive neuroticism.

3. The increased stability isn't limited to intellectual tasks. By the end of the first week, emotional regulation had become quicker and easier in general.

On September 2 (day 6 of T), I wrote, "Today I was emotionally rattled by something in a way and to an extent that I think would have caused a lot of prolonged distress in any other period of my life. I would have been unable to sleep, and it might have dominated my thoughts and made it really difficult to accomplish anything for at least a day. Instead, after half an hour and a bit of yoga, I was pretty much emotionally re-centered, I had a game plan for how to deal with things practically, and I was ok. And on the first day of my period, no less."

I've been taking a depression test called the "Edinburgh Postnatal Depression Scale" every week since the middle of pregnancy. The test says, "A score of more than 10 suggests minor or major depression may be present. Further evaluation is recommended." Before T, I'd never seen a number below 5, and I considered 5 to be "as good as things can actually get". My scores for the past month have been 1, 1, 2, and 1.

4. Over the course of the month, something has changed about my experience of pleasure.

This cluster of perceptions is a little tricky to untangle, perhaps because it seems to have something to do with sexuality, but not in an obvious way. I'll describe it as three separate things, but I'm strongly inclined to claim that it's really all one thing.

4.1 Eudemonia. By the end of the first week, I'd noticed a general sense of wellbeing that subtly (and sometimes overtly) permeated my experiences. I just felt... good. Sometimes there was happiness, joy, excitement. But mostly it's more subtle than that.

I feel it right now, so I'll pay attention to it and try to describe it to you.

There's a gentle, pleasant buzzing in my body. I feel it in my head, my lips and mouth, the front of my chest, my arms, my lower abdomen, my legs, and my feet. It's a sunny grounded feeling. It resonates with phrases like, "Things are ok," "Life is good," "I like being here, now, doing exactly what I'm doing."

I've been happy before. I've even been elated, triumphant, lovesick. I've been physically healthy, I've been vibrant and generative, I've been pleased with the way my life is going. But I don't think I've ever felt a persistent sense of wellbeing. I've never just felt good, in general, for weeks on end.

I mean, it's not like every experience I've had all month has been great. I had a period, I got a stomach bug, I spent most of my time at a caloric deficit because I'm trying to lose pregnancy weight, I slept poorly for most of last week while over-socializing and felt exhausted and pretty much like crap.

But all of that stuff seemed to go on top of "being ok". And whenever the crappy stuff dissipated, eudemonia shone through like the sky behind parting clouds.

4.2 Enjoyment. During weeks two and three, I'd started to notice a change in what it's like for me to enjoy things.

You can see some of it in that description of my immediate experience of wellbeing above. Did you notice how much I talked about my body? I've always been an exceptionally embodied person, but testosterone seems to have turned that up even more.

This month, I enjoy things more acutely than I have at any other point in the previous year. For the most part, I don't enjoy different things—it's still poetry, music, working out, learning, sunshine, leaves, excellent writing, chocolate, etc.—but I enjoy them both more and differently. How is my enjoyment "different"? There's more "excitement" in it, it's more embodied, and "pleasure" is a more apt description of one of the central components of enjoyment than it's ever been before. My enjoyment of things used to be relatively distant and intellectual. More like "appreciation". Now it is very often visceral, physical, embodied.

Take for example "Snow" by Louis Macneice. This is a brilliant free verse poem I encountered for the first time during the past month. When I read it, my chest flutters and leaps. The words drop into my lower abdomen and smoulder there. The buzzing of wellbeing that I described earlier intensifies until I feel almost like I must have been drugged. The delight is in my chest, in my stomach, in my genitals, in my legs and arms and head. My appreciation of poetry has taken on a blazing full-body power.

4.3 Sex drive.

It did not become apparent until the fourth week that my desire for and enjoyment of literal physical two-person sex had increased. It was a gradual dawning. First there were the changes to enjoyment generally, which I suspected were somehow tied to sexuality. Then I noticed a greater interest in some of my kinks, and a larger impact from thinking about them.

I noticed that I was masturbating more often, a change from a couple times a week to one or two times a day. I was doing this with an exploratoratory attitude, and it wasn't until week four that it became clear to me I was in fact craving sexual experience, and that some of it even took the form of a desire to have sex with specific other people.

I would not have described myself as asexual before. I do sometimes experience sexual attraction to people. But most of the parts of attraction that have to do with sex in particular seem to largely go away by the end of the infatuation period for me; and even at the best of times, it's not really been clear that I enjoy sex itself. During pregnancy, I hated almost everything about sex, and it didn't feel like all that big of a change from baseline. I was mostly just less able to tolerate sex. Usually sex has been an instrumental goal for me, something I do in order to accomplish something else (such as the BDSM components of the experience, or social power, or intimacy with my partner).

Now I straightforwardly desire sex with at least some of the people I'm attracted to, and I straightforwardly enjoy it when it happens. I still have sensory sensitivities to contend with, and I have to keep track of that and communicate about it in order to have a good time. But having a good time during sex is actually possible now.

Having a higher sex drive is really different from how I imagined it would be. Sexuality has never felt integrated for me before. There are things I enjoy greatly, and there is sexual stimulation and orgasm and so forth, and I've never really been clear on what those two things have to do with each other. So I think that when I imagined having a higher sex drive, I mostly imagined turning up a certain kind of discomfort. The discomfort of physically craving orgasm.

Instead, it's been something that doesn't really come apart from my ability to enjoy art, and learning, and the excitement and satisfaction of engaging with the world as myself. I do crave physical sexual stimulation more strongly and more frequently than before. But so far, it feels like just another part of being more brightly on fire. If this is the kind of sexuality I'm turning up by taking testosterone, I think I'm ok with that.

Overall, it so far seems likely that taking T will turn out to have been literally the best decision I have ever made. I completely love it.