[Image: Self-portrait of Pax wearing glasses with red and black frames.]

Content note: Medical issues, including needles.

When I started on testosterone therapy in January 2014, my partner Ziggy and I were both trained to do the intramuscular injections. You can see the general procedure in this instructional video, created by and for transmasculine people:

https://www.youtube.com/watch?v=2PDqLDjMDtA

I had intended for Ziggy to do my injections, but decided I preferred to do them myself; I felt confident enough in the technique, and had never been afraid of needles. This worked out pretty well… until yesterday.

This failure had been building up for awhile. For the last couple of months I’d grown increasingly anxious, starting the day before my biweekly injections, sometimes even sooner. When the time came, I would fill the syringe and then sit with the needle poised above my thigh, unwilling to pierce my skin and plunge that much-needed solution into my muscle.

I tried various techniques that had worked in the past, such as deep breathing and singing. But whenever I got ready to inject, my heart would pound and a wave of nausea would overtake me. This would go on for up to half an hour before I was finally able to inject, and then during the injection my hand would shake, sometimes violently, causing my thigh muscle to spasm and literally tearing me up inside.

Yesterday morning, I just couldn’t do it. The anxiety and nausea were too much. I threw out the syringe, wasting a dose, and sent Ziggy a text, asking him to help me when he got off work late that night. He readily agreed, and everything went very smoothly. But I felt sick and ashamed the entire day about needing help, as absurd and uncharacteristically “macho” as that might seem.

The nurse practitioner who trained us had warned me about this. She said some trans folks inject for years without a problem, and then find themselves unable to do it. Some won’t even consider injections in the first place; they use hormone creams, which are much more expensive, harder to control the dosage of, and need to be applied daily.

There are a couple of other options for testosterone therapy, which I’ll be asking my doctor about at my next appointment: Longer-lasting implants and injections, which need to be done at a doctor’s office.  I don’t know if either would be covered by my insurance, but it’s worth finding out. Even though I’m already middle-aged, right now I can’t imagine having to keep doing biweekly injections for the rest of my life. I’m growing increasingly resentful that I wasn’t born with the correct hormone profile in the first place.*

Stopping hormones altogether isn’t an option. For one thing, my body hasn’t sufficiently “masculinized” yet; I’ve been on T less than three years. But even more importantly, I’m pre-menopausal, and having my periods return is completely unacceptable. Yes, I still might have my uterus and ovaries removed, but surgery is a risky proposition, no matter how “routine” that procedure is considered. And I would still need to continue hormone therapy anyway, as my body would then be producing no sex hormones at all.

These thoughts are something that I would have shared in a “friends-only” entry before I launched this blog, but all of my blog writing is public now. I feel it’s important for transmasculine people—regardless of whether we are men or non-binary—to know that it’s OK to be vulnerable and ask for help. It’s also important for us to be able to share knowledge, as the field of FTM medicine is still in its infancy, and most doctors are ignorant about our needs. I can only imagine that 50 years from now, trans guys will read about what we went through during this time, and shake their heads or laugh.

For those wanting a more private discussion forum, I’ve found the FTM community on LiveJournal to be helpful, even though it’s not highly active. Hudson’s FTM Resource Guide is very useful as well. Both have advice applicable to non-binary female-assigned people like myself as well as trans men.

I am grateful I have access to the medical help I need to live a more authentic life. I hope that the world comes to accept that gender dysphoria is a legitimate condition that needs to be taken seriously.

* It’s important to note that the “born in the wrong body” trope is not accurate for many trans people. What matters is our self-identification, regardless of our “biology“.