Taking testosterone is not just for men

“I’ve received a lot of comments asking ‘why am I taking testosterone, even though I’m non-binary - it's just for men.’ That's just not true, it’s about feeling comfortable in your body.”- Gialu

My close friend, model and performer Reenie and I are catching up on the phone one day. Bringing me up to date on her life, she mentions that she’s begun to identify as gender-fluid (keeping she/her pronouns) and is microdosing testosterone. I love this human, whatever form she takes. But I have to admit that, at first, I had a lot of questions. You usually hear about hormone replacement therapy in connection to people transitioning from one gender to the next. Reenie is the first of my friends using it as a means to break away from this binary – and she’s not the only one.

Testosterone replacement therapy was originally developed for cis men with low levels of testosterone experiencing symptoms such as low sex drive, erectile dysfunction and depression. Even now, most resources are written with cis men in mind. Despite this, TRT is also used by post-menopausal women, as well as trans men as part of their transition. The effects of T are different for everyone and can include changes in facial structure, a deeper voice, increased body and facial hair, different weight distribution, quicker muscle gain and halted menstruation. For many trans, non-binary and gender non-conforming people, the changes extend beyond the physical as well. Every person on T that I spoke to described how it has improved their mental health, helping them find “peace” and “finally feel like themselves”.

Over the past few years, awareness around full binary transition has become more mainstream. What is much less talked about, is how TRT can serve people outside of the gender binary, many of whom are microdosing for a more gradual transformation. “There are infinite ways to be trans and non-binary,” says non-binary campaigner, DJ and drag king Tommy. “A default understanding is that you have men and women and all the stuff in between – but it’s actually about being BEYOND those things and a rejection of all of it.” Tommy has been taking T for almost a year now and sees it as a means to establish a new relationship with their body. “I knew I wasn’t a trans man but I also wanted some more masculine elements to my appearance. I wanted to see if T would help with the dysphoria I was feeling.”

This desire to exist beyond the conventional gender binary is something that German non-binary model and musician Gialu also relates to. “I tried so hard to fit into the gender binary and gender roles,” they say. “I had this long hair… and at one point I remember looking in the mirror and feeling like I was wearing a wig because of how much I was hyper-feminising myself in order to fit in.” After nine months of taking T, Gialu says they are the happiest and most at peace they’ve ever been. They are now considering reducing their dose to maintain their “own level of androgyny”.  

It was while working as a go-go dancer that Reenie started to question her gender. “When I perform, it’s hyper, hyper-feminine. And I realised that since I was a teenager, I’ve been performing that femininity,” she says. “When I was on stage, it started to feel like drag.” While she has decided to keep she/her pronouns because they “express my femininity, and that’s still a big part of me”, microdosing has allowed her to have “softer changes” as she starts to develop more masculine qualities to align with how she feels inside.

“Once you really start understanding and navigating the gender soup, you realise none of this makes sense,” says non-binary dancer and model Danni Spooner. “So much of this has been conditioned on us. So why can’t we play with it?” Danni has been microdosing T since last year with the goal of looking “confusing and kind of in-between it all.” For them, the experience of being non-binary is about letting go of society’s expectations and building themselves again – this time starting from moments of joy. Not only does this disruption of gender norms feel liberating, but on a deep psychological level, T has changed their experience of the world, from “constantly dissociating” and feeling like “I wasn’t here”, to finally “feeling like I’m actually alive”.  

Hearing statements like these it’s hard to understand why so many have to jump through hoops to access this medication, while others aren’t able to access it at all. “The reason trans suicide rates are so high is because people are being forced into boxes that they don’t fit in,” Tommy says. “It’s not about ‘Oh isn’t it fun that we get to choose how we look.’ There is joy and play in it, but above all it’s about survival.” Despite living across Germany, the UK and France, each person I spoke to found a serious lack of information, resources and support for trans and gender non-conforming people seeking HRT. The path to accessing hormones can be rocky and stressful, and getting a prescription is often a long and expensive process. Whilst Danni, Gialu and Tommy have managed to get prescriptions, many people have to resort to self-medicating.

Across the world, LGBTQ+ support networks have evolved as a stop-gap for the shortfall of national healthcare systems. Whilst you can order hormones online, many feel safer sourcing their hormones through these networks, from people with prescriptions who have more than they need. Reenie is one of those people who are self-medicating, having struggled with the healthcare system’s limited understanding of gender identities. “When I spoke to my doctors I felt like I had to lie that I wanted to transition into being a man, just so that they would give me access to what I know is right for me,” she says. “[The medical field has] only just accepted the fact that trans men and trans women exist and need help. Many healthcare professionals haven’t considered the fact that there are non-binary people, gender-fluid people and other people that also want to access gender-affirming health care.” 

French non-binary artist and sculptor L. Camus-Govoroff has been on a T prescription for 11 months but sees the community exchange of hormones as a critical act of resistance. “It’s really important to share our knowledge and our hormones with each other if we want to break free from a hegemonic medical system,” they say. Their argument aligns with a wider discussion around body autonomy – our right to choose what we do with our bodies. For L., testosterone has helped them to take back control of their body and identity. The results have been life-changing, they say. By developing more masculine qualities, they have also managed to accept the more fem parts of themself. “I think now I’m truly capable of loving someone because I’ve finally made peace with myself.”

The disadvantage of self-medicating, however, is that it’s not always safe. As Gialu says, “not everyone is aware that you can overdose from testosterone. By not giving proper guidance, the State is actually putting people at risk.” With the help of clinics such as 56 Dean Street, those self-medicating in London can get their blood tested to check their hormone levels are safe. But in many places, this service isn’t readily available, which can lead to potentially dangerous side effects. “It’s super hard to get a prescription if you’re trans, let alone if you’re non-binary.” says Gialu. “So, I understand why people choose to source it illegally. I just hope they are being safe.” But, it’s a risk people are willing to take, because it could save their life.

Tommy says their one regret is not starting the process sooner. “I think if there had been more information available when I was younger it wouldn’t have taken so long for me to figure out who I am.” It’s clear that T is central to many people’s sense of self. And so, until systems improve, people will continue to lean on their communities to source the hormones they need to feel at peace. “In a system that continuously tells you you’re not legitimate, that this isn’t real, what else can you do?” Danni concludes, “You’re reclaiming your body. You’re saying this is something I want and I need. So I’m going to do it no matter what.”

Testosterone is used in gender-affirming healthcare by those seeking to masculinise their physical appearance in line with the gender they identify with. While it is safe and legal to access through prescriptions, delays to this process through long NHS waiting lists and recent rollbacks on gender-affirming healthcare has forced those exploring their gender identity in this way to turn to more illegitimate means of procuring these treatments.

For many, the consequences of illegally sharing hormone replacement therapy within the community are preferable to the alternative of purchasing unregulated treatments on the Internet or the mental health implications of going without gender-affirming healthcare while waiting for the system to catch up. Please consult a medical professional if you are thinking about any of the subjects discussed in this article.

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