FTM Transition: My First Year on Testosterone

My transition journey as a middle-aged transgender man

Two years ago, I began my transition journey. It began with my social transition, when I came out to my close friends and family. I also began wearing a binder, got a more masculine haircut, and sought out a therapist. I took the time in therapy that was necessary to make sure that a medical transition was the right course of action for me. Once I was diagnosed with gender dysphoria, I was then referred to an endocrinologist in order to begin my medical transition.

My Medical Transition Journey

It has now been one year since receiving my first injection of testosterone. Before I received that shot, I had done a lot of research to understand what I should expect. My endocrinologist was impressed with how well-informed I was, although he did have to correct a few things based on his experience with his patients.

On a side-note, during my first visit to the endocrinologist, he found a lump on my thyroid. So, while I was going through the beginning of my medical transition, I had the worry I may have thyroid cancer. Thankfully, it turned out to be benign, but I had to go through surgery to find out.

I was on the verge of menopause when I began my transition, so my transition experience has been and will continue to be somewhat different from younger transgender men. This is why I wanted to write this article, so other transgender men in my generation who may be considering a medical transition could have a peer to relate to.

After being on testosterone for a year, I have had some notable changes. Some changes happened faster than I expected, while others are going slower. Regardless, I already feel more comfortable in my own skin that I have since before I hit puberty. It’s great to feel like myself again.

Physical Changes After One Year on Testosterone

These are all the notable changes that testosterone has done in the past year. (Warning, I will mention genitalia and other anatomical changes).

Bottom growth and libido. This is the first change I noticed. Within a week of getting my first injection, my libido began to increase substantially. This was a direct result of changes happening to my clitoris. It began with some increased sensation, but as the appendage began to get bigger, so did the sensitivity. That in turn had an effect on my libido. After one year, I’m now at one-and-a-half inches in length. This is an increase of one inch of growth so far.

Body hair. The next thing that changed fairly quickly was the increase in body hair. The body hair I already had began to grow in darker, thicker, and longer. Over the course of this year, I’ve also started growing hair in places I hadn’t before (thighs, butt, abdomen, chest).

Facial hair. My facial hair first started growing in on my upper lip, then slowly on my cheeks, and finally under my chin. Currently, it’s still very sparse and patchy, so I keep it shaved. I have noticed the hairs slowly getting thicker as they grow in, but it remains sparse.

Cessation of Menstruation. A couple of months after my first injection, I stopped menstruating. My cycles had become very irregular, even before I started testosterone. I had also been having other symptoms of menopause, most notably hot flashes. Those also ceased when I started testosterone.

Voice. My voice took six months before it began to have any noticeable changes. Once it did, I had the experience most teenage boys do. As my voice got deeper, it began to crack and squeak frequently. It’s started to even out recently and it doesn’t crack as much anymore, but it’s still getting deeper.

Fat redistribution. The most recent change that I’ve noticed is that my fat is slowly starting to redistribute, giving me a more male body shape. I still have a long way to go, but my butt and thighs have been getting smaller. That fat has started to settle into my abdomen, which is why I’ve been trying to exercise more. I hope to stave off the potential beer belly I might develop otherwise.

Besides all those changes, I have developed one medical issue that is most likely a direct cause of my transition. Due to the increase of testosterone in my system, I’ve developed fibroids on my uterus, which have been causing me painful cramps, despite not having any more menstrual cycles (I discuss this in more detail in my article about developing uterine fibroids).

One thing that I was told to expect was developing vaginal dryness. Just being on testosterone was supposed to bring that on. I’ve also had both ovaries removed already (for health reasons not related to my transition) and that was also supposed to lead to vaginal dryness.

Instead, I have experienced the opposite, an increase in vaginal moisture. It’s gotten to the point where I’m often changing my underwear at least once each day (and no, wearing panty liners really isn’t an option). It’s not a bad thing, just something I find very curious. My doctors haven’t offered any explanation as to why my body is behaving differently, but in the end I can’t complain. I’ve heard vaginal dryness can be very uncomfortable.

The Future of My Transition

Looking at the next year of my transition, I plan to have two surgeries. First, I will be having a full hysterectomy at the end of this month. This is a surgery I have long wanted for many reasons, and it will solve my fibroid problems once-and-for-all.

Then, the only gender affirmation surgery I plan to have is known as FTM top surgery or male chest reconstruction. This includes the removal of the breasts and a nipple graft. Having a flat, male chest without having to wear a binder will be very liberating. My chest has long been another problematic area for me. I never liked having breasts, and mine have always been painful because they are filled with fibroids and cysts (not caused by my transition).

There are a couple of bottom surgery options, which can include the construction of a penis and scrotum, known as phalloplasty with scrotoplasty. The other option is a metoidioplasty, with an option to include urethral lengthening and a scrotoplasty. This would allow me to pee standing up through my micro-phallus that has grown from my clitoris.

However, I’ve decided not to undergo any of those surgeries. I don’t have dysphoria regarding my genitals, especially now that I’ve experienced bottom growth. I’m very happy with the micro-phallus I’ve grown, and it may continue to grow for another year or two. If I’m lucky, it could exceed two inches in length (maybe three) once it’s done growing.

My one concern I had before I began my transition was the possibility of hair loss. Thankfully, so far that has not happened. Since I am well into middle age, there was a very real possibility my hair would have just started to fall out. It’s determined by genetics, and both of my grandfathers were bald. My father sadly passed when he was only 43, and he still had a full head of hair then. In the end, it’s hit-or-miss, but I’m still eyeing the Rogaine every time I go to the store.

Transgender writer and author. I primarily write on LGBTQ issues, with a focus on the transgender community. http://glbalend.com/

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