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asian-hero · 6 years

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I really love your blog!!! And I was kinda wondering if you could do some Headcannons with the paladins and their s/o is FTM? That’s a little bit of me, and I just wanted some loving from my paladins ^///^

I’m not familiar with FTM myself, but I do hope that you’re having a safe and easy transition! Also, I apologize if some of the information is incorrect, feel free to correct me on any mistakes!

Shiro (my main hoe):

I fully believe that this man would love you even if you were part Galra

So when you tell him that you’re transitioning, he supports you no matter what

Will tell off anyone who talks shit about you

Once punched an alien because he made a comment about how you don’t look “masculine” enough

You had to pry him off before he caused too much damage

He’ll help you in anyway that he can

You want/need a binder? He’ll look everywhere online and in stores to find you a comfortable one. Want to get top and/or bottom surgery? He’ll try to pitch in some money along with helping you manage the money that goes into the surgery. Want to get started on testosterone? He’ll be there with you when you go to your doctors.

At the end of the day he just wants you to be happy

If you choose to get testosterone injections, he’ll be with you every step of your journey

He’ll make sure that you never feel uncomfortable or unhappy with yourself

Will constantly remind you of how handsome you are and how he’s the luckiest guy in the world

Totally loves you and will do anything in the world to make you happy

Keith:

This boy is a little confused at first

He’s not well educated when it comes to FTM or MTF transitions

You’ll have to explain to him for a couple of hours

Once he understands, this boy is all for it

Like Shiro, he’ll make sure that you’re as comfortable as possible through your transition

Binder? Check. Top/bottom surgery? If you want to, he’ll absolutely be for it. Thinking about getting hormone injections? He’ll be there every step of the way for therapy.

At the end of the day, he really wants you to be as comfortable as possible

Will 100% beat up anyone who even scoffs at you

You had to hold him back once because someone looked at you and rolled their eyes

He had his knife out he was ready to kill

Constantly reassures you and tells you about how handsome he thinks you are

If you feel a little smothered and uncomfortable though, he’ll tone it down immediately

This angry boy turns into a fluffy boy when he’s with you, and he does anything in his power to make your transition as easy as possible

Pidge:

Out of all the paladins, they’re the least shocked about it

They understand that freaking out or just looking shocked probably doesn’t make you very comfortable

Will tell you that they love you no matter what and that they want you to be happy

Makes sure that your transition is as comfortable as possible

Is the only paladin who actually researched about FTM transitions and about all of the necessities that you would want

Won’t go as far as to beat people up if they talk shit

But you best believe that if they’re electronics will definitely be malfunctioning for the next couple of weeks

One time Lance made some insensitive comment about your transition (he didn’t mean to though, he apologized profusely afterwards) and Pidge was pissed

They made sure that Lance’s door malfunctioned and stole all of Lance’s beauty supplies until you found out

Occasionally gives you comments about how handsome you are and how lucky they are to have you

At the end of the day they just want you to be happy, and if that means getting a binder, getting top/bottom surgery, or getting hormone injections, then they’re all for it

Hunk:

When you first tell him that you’re transitioning, he’s a little confused

Like, transitioning to what? Are you going to do something different? A new job?

Once you tell him that you’re transitioning to a new gender, he’s super supportive

Will constantly shower you in complements about how amazing and handsome you are and how he loves you

100% will get into a fight if anyone even looks at you the wrong way

Once an alien made a remark about how “men don’t look that dainty”

Hunk was immediately at your side and punched the asshole alien square in the face

You had to hold him back because he was so mad

This is one of the only times you’ll ever see Hunk really mad

Is supportive of whatever you want to do (Binder? He’ll find the most comfortable one. Surgery? He’ll look up the best surgeon in your price range. Hormone injections? Will be sure to look up everything before you just take them from a doctor.)

If you ever feel self conscious about the way that you look he’ll be there to give you the best hugs and a string of heartfelt compliments

Loves you so much, he just wants you to be happy with yourself

Lance:

Is probably the most confused of the paladins

He just isn’t well educated on this topic

When you explain to him about your transitioning he’s super supportive

He makes sure that you’re comfortable no matter what (sometimes he goes a little overboard)

Isn’t as violent as some of the paladins, but if someone tries to make fun of you, he’ll do his best to defend your honor

One time Keith made some uneducated remark about your transition (again, this boy didn’t mean it and he was extremely sorry afterwards)

Lance was fuming

Not only because Keith opened his mouth, but because Keith opened his mouth about you

Needless to say, you needed to hold him back before he caused some actual damage

Will constantly remind you about how handsome you are and how much he loves you

If you ever express any distaste about yourself, Lance will sit you down and tell you about all the things he loves about you until you’re either crying from happiness or a bright blushing mess

At the end of the day he just wants you to be happy, no matter what

Yo yo, I don’t usually do ending notes, but I want to say to everyone that’s transitioning, whether or not you choose to get surgery or hormone injections, it does not make you any less of man/woman, you are who you identify as, end of story. If someone wants to talk shit about what you identify as, then remember that they’re just closed-minded assholes that are too stuck in their own ways to reeducate themselves. Love who you are and who you’re going to be, because at the end of the day, your opinion is the only opinion that should matter. ❤️🏳️‍🌈

#takashi shirogane #keith kogane #pidge gunderson #lance mcclain #hunk #voltron x reader #voltron headcanons

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answersfromzestual · 5 months

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We hear about the surgeon of the first phalloplasty procedure, but we don't hear about the man under the knife Laurence Michael Dillon, or Michael Dillon (article)

Pink News Article about Michael

Commonly known as Michael Dillion, he was born in 1915 London, but grew up in Iceland.

After graduating university in 1938, he began to transition, and was prescribed hormone tablets (testosterone).

After a horrible experience working (being misgendered and mocked), he found a plastic surgeon who performed his top surgery and allowed legally change his name, with the note of the surgeon.

Some time after his transition, he became a follower of Buddhism and settled in a Buddhist colony without anyone knowing he was transgender.

And that's just a tiny snippet of his amazing, yet tragically short, life.

Be sure to check out the amazing articles I have found on him!

Sources: https://www.thepinknews.com/2023/03/31/laurence-michael-dillon-trans-man/

https://www.st-annes.ox.ac.uk/life-here/library/blog/michael-dillon/

#Michael Dillon #trans pioneer #transgender #trans ftm #first man to get phalloplasty #transman #ftm transition #ask me things #phalloplasty #ftm phalloplasty #phalloplasty blog #lgbtq #phallo education #ftm top surgery educational blog #ftm educational blog #ftm advice blog

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answersfromzestual · 4 months

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15ish Years Post Op - Shadows' chest.

I decided to show you all my chest. It has been about 15ish years since my top surgery.

I lost 1 1/2 of my nipples during the healing process. After three or four years, I had them tattooed back on. My left looks near perfect to me, and that one was just a tiny little spot of nipple left. I know exactly it was 100% my fault. I was told to take the bandages off wet (you want to get into the shower with the bandages on and soak them through. The goal here is to gently part the bandage from your nipple skin without pulling or tearing your nipple skin), but my young self 'knew better' apparently. I also did not realize the 'scab looking' things were my actual nipples.

Before chest surgery I worked out a lot to build my chest up. The spots also have sensation in other ways as well.

Yes, I do feel more sensitive over the spots where my real nipples used to compared to the rest of my chest. I love chest rubs.

Listen to what the professionals have to say.

Some advice I have to help prevent losing your nipples after the flap procedure never take your bandages off dry (soak them as mentioned above), do not touch/pick at them (skin or bandages), not scratching when it itches even over the bandage, just let the soapy water cover your nipples when showering, and do not scrub, and follow surgeon's and nurses' orders of your chest/nipple care when you get home.

Good luck with your journey, everyone!

Stay Golden Everyone ✌️ 💙 💜

#chest surgery #flap chest surgery #transman #transgender #ftm top surgery educational blog #ftm top surgery image #ftm top surgery #ftm education #ftm advice blog #answersfromtheshadows #trans ftm #ftm transition #ask me things #phalloplasty #ftm phalloplasty #phalloplasty blog #lgbtq #phallo education #tw male chest nudity

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answersfromzestual · 5 months

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I have noticed you all are enjoying the directory I made!

I thought you guys would all enjoy it, I wanted to for awhile but it's so much work to make. I'm glad it was worth it. This was you can find what you need without aimlessly scrolling.

Please enjoy this blog.

Stay Golden Everyone ✌️💙🩷

#phalloplasty blog #phallo education #ftm top surgery educational blog #ftm education blog #i made an index for it #youre welcome!#love you all #wishing you all successful journies

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answersfromzestual · 7 months

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I may be ending this blog, too much work, too many people arguing with not me, but years of research and medical advances in the field. I am also tired of very little reblogs/interactions actually READING the information or articles. Why do all this work for no one to read anything?

I won't be posting for the meantime as well. There is a lot going on in my real life.

I only can vouch for my information, nothing added or reblogged by any other tumblr.

Stay Golden! ✌️ 💙🩷

P.s. I appreciate anyone who found this blog helpful and read the content. Thank you.

#transgender #trans blog #tips and tricks for phallo #trans ftm #transman #ftm transition #ask me things #ftm phalloplasty #phalloplasty blog #phallo education #metoidioplasty education education #ftm top surgery educational blog

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answersfromzestual · 4 months

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I made this to remind us all of our wins, no matter how little they may seem. You should be proud of yourself for being here. For being you. For taking all the crap the world puts you through. Im glad you are here.

Stay Golden Everyone ✌️ 💙 💜

#postivevibes #postive affirmations #postive thoughts #postivethinking #postive mindset #be proud of yourself #it doesnt matter where you are be proud of what you have accomplished #transgender #ftm blog #ftm educational blog #ftm body affirmation surgery #ftm top surgery educational blog #ftm bottom surgery education blog #ftm phalloplasty information blog

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answersfromzestual · 7 months

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To MY followers,

I have not found anything besides hearsay and antitransittion propaganda, that binding PROPERLY can lead to ineligiblity of top surgeries.

I have not found a single reliable source done by medical professionals in the field of gender affirmation.

Please do not listen to the person reblogging my post on binding.

There is no medical evidence to back his facts, I even again spoke with the surgical team at Montreal grs.

I'm sorry but I do a lot of work, and again "I heard it from here, but don't know where or who by". I work hours and hours sometimes on these posts with research always deeply involved and i only use medical sources, otherwise it has been said by many professionals. It's just assenining. You are spreading hate and you don't even know it!

Spreading fear to people who want to flat (bind)and be comfortable before surgery, it can be very dysphoric to not wear a binder, and not leaving someone that option which you say you have is just ignorant and rude.

#transgender #trans ftm #transman #ftm transition #ftm top surgery educational blog #dont listen to hearsay #do your own research #please im stressed out i cant do this anymore

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answersfromzestual · 9 months

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Any requests for a particular topic of transition information?

I know I have covered many things very basically, so I am open to diving deeper into a topic that would be helpful to be either more thorough/ clarified, or a topic I haven't covered at all.

Also still open to asks, as always anonymous, is perfectly fine. Otherwise, unless specifically stated in the ask, I will copy and post the question with my answer, I will not post the ask itself and will not include your username.

Stay Golden Everyone ✌️ 💙 💜

You are all loved

#trans ftm #female to male transition blog #ftm transition blog #ftm transition #transgender #transman #ftm phalloplasty education blog #phalloplasty #ask me things #ftm bottom surgery education blog #ftm top surgery educational blog #ftm hormone replacement therapy educational blog #you are loved

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answersfromzestual · 4 months

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I feel like maybe the post wasn't worth the wait... I apologize, everyone. It was a lot of work, but I understand that sometimes it takes more than one pair of eyes to make something perfect.

I did try my best. I am trying to add things as I think of them, so keep checking back in on the post for the next little while.

My story is long and complicated.

I want to try to have my story out in a week or shortly more. Afterward, I want to work on a medioplasty UL post.

I will let you all know that first of all, I have an autoimmune disease and bladder/ kidney issues, and my SIL kept moving my toilet hand sanitizer, so that was a thing too. So, my story will probably differ from most of what you would experience with this procedure.

We all have different bodies, and they all heal and work (in small ways) differently.

Like I said, I want to be very transparent, and with that said, keep in mind that having an autoimmune disease can really make healing take more time and difficulty, and staying sanitized even more important.

What is an auto immune disease?

When you have an autoimmune disorder, your immune system does not distinguish between healthy tissue and potentially harmful antigens. As a result, your body sets off a reaction that destroys normal tissues. - (medline plus.gov)

If the UL post needs anything, let me know.

Did I miss what you wanted to know? Did you have a hard time understanding my wording? Do you have a question? Want to chat about it? Send me a message in my ask or an email.

#phalloplasty with urethra lengthening #urethra lengthening and phalloplasty #transgender #trans ftm #ftm transition #transman #ask me things #phalloplasty #ftm phalloplasty #phalloplasty blog #lgbtq #phallo education #ftm transition educational blog #ftm trans guy tips #ftm transiting tips #ftm bottom surgery experience #ftm top surgery educational blog #ftm bottom surgery blog

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answersfromzestual · 2 days

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Please Reblog this Post Trans Community and Allies.

I am Zestual (some know me as Shadow), and I run a blog for female to male transition and have for almost four years now.

A little about me I am a retired social worker and addictions counsellor. I have completed all surgeries (last one was just over a decade ago). I've had chest surgery, I've had phalloplasy. I actually enjoy sleuthing the internet for proper information to inform the community that phalloplasty is not bad, and not nearly as risky as many say. As long as you take care of yourself pre and post op you will have a phallis that you've dreamed of.

This includes hormone treatments, top surgeries, metoidioplasty, phalloplasty, and much much more.

If you are looking for a resource that only uses reputable sources and is a source of unbiased information on transition.

Here is the blog directory:

https://www.tumblr.com/answersfromzestual/748974533324800000/improved-blog-directory-find-what-you-need?source=share

Feel free to ask question, send in concerns or questions. I welcome all blog related questions, comments, and concerns.

-Zestual

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answersfromzestual · 3 months

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Penile/ Phalloplasty Erectile Devices

There are two main types of penile implants:

Inflatable Devices

Semi-Rigid Rods Device

We will go over inflatable devices first. There are two mainly used types of inflatable penile implants used in phalloplasty, as well as cis men with health issues.

What are they?

Inflatable devices are the most common type of penile implant used, especially on phalloplasty procedures.

The two types are:

Three- Piece Penile Implant

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Three-piece inflatable implants use a fluid-filled reservoir implanted under the abdominal wall, a pump [in your main hand side] and a release valve placed inside the scrotum [and slightly located above the pumping mechanism], and two inflatable cylinders located on each side of the penis.

To achieve an erection, you pump the fluid, which is salt water (saline fluid), from the reservoir into the cylinders. Afterward, you release the valve inside the scrotum to drain the fluid back into the reservoir. Usually, this is done by holding a small button on the release valve.

In both devices, the reservoir is filled with salt water (saline water) the day of surgery and remains in the device.

This particular system [three-piece] is how I get an erection/ deflate my erection.

Two - Piece Penile Implant

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The two-piece model works similar to the three- piece, but the fluid reservoir is part of the pump implanted in the scrotum. This device is not the most effective at maintaining total flaccidity (it may sometimes look slightly erect). This device has more limitations on types and styles of penetration/sex. Be sure to ask if there are limitations with the device and its particular model that was implanted.

In both devices, the reservoir is filled with salt water (saline water) the day of surgery and remains in the device.

The last commonly used erectile device is called:

Semi-Rigid Rod Penile Implant

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Semirigid rod devices styles are always firm. The penis can be bent away from the body for sexual activity and toward the body for concealment. There is no inflating or deflating.

A "positionable penile implant" is a semirigid device with a central series of segments that are held together with a spring on each end. It can maintain upward and downward positions better than other semirigid rods can.

What is best for you? Comparison Images:

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Most clinics have their own style of procedure that involves a certain type of erectile device. You may or may not have a choice with certain clinics, so make sure you research clinics and make sure they fit with your chosen device and procedure.

This article was written about just implantation of these devices in general, the different devices, and their functions. If you are interested in sexual intercourse, especially penetration, consider where you want to penetrate.

For example, some men are not able to perform anal sex with the two-piece option, while some men are able. Always ask your doctor before leaving the clinic about the sexual acts you can/ cannot perform. You can seriously injure yourself if you try something your device is not capable of.

I hope you enjoyed the article and know a little bit more about the selection of erectile devices for phalloplasty. I hope this helps you make an informed decision.

Stay Golden Everyone ✌️ 💙 💜

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#transgender #trans ftm #ftm transition #transman #phalloplasty #ftm phalloplasty #phalloplasty blog #lgbtq #phallo education #transman phalloplasty #ftm phalloplasty education blog #female to male affirmation surgery blog #female to male transition information #ftm bottom surgery education blog #ftm top surgery education blog #ask me things #erectile devices #educational post #types of erectile devices used in phalloplasty

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answersfromzestual · 9 months

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Information on Testosterone Hormone Therapy:

As you prepare to begin treatment, now is a great time to think through what your goals are, as the approach to hormone therapy is definitely not one-size-fits-all.

Do you want to get started right away on a path to the maximum safe effects? Or, do you want to begin at a lower dose and allow things to progress more slowly? Perhaps your long term goal is to seek less-than-maximal effects and you would like to remain on a low dose for the long term. Thinking about your goals will help you communicate more effectively with your medical provider (an endocrinologist is the best way) as you work together to map out your care plan.

Many people are eager for hormonal changes to take place rapidly- understandably so. But it's very important to remember that the extent of, and rate at which your changes take place, depend on many factors. These factors include your genetics, the age at which you start taking hormones, and your overall state of health.

Consider the effects of hormone therapy as a second puberty, and puberty normally takes years for the full effects to be seen. Taking higher doses of hormones will not necessarily bring about faster changes, but it could endanger your health. And because everyone is different, your medicines or dosages may vary widely from those of your friends, or what you may have read in books or in online forums. Use caution when reading about hormone regimens that promise specific, rapid, or drastic effects. While it is possible to make adjustments in medications and dosing to achieve certain specific goals, in large part the way your body changes in response to hormones is more dependent on genetics and the age at which you start, rather than the specific dose, route, frequency, or types of medications you are taking.

While I will speak about the approach to hormone therapy in transgender men, my comments are also applicable to non-binary people who were assigned female at birth and are seeking masculinizing hormone therapy.

There are four areas where you can expect changes to occur as your hormone therapy progresses: Physical, emotional, sexual, and reproductive.

Physical

The first physical changes you will probably notice are that your skin will become a bit thicker and more oily. Your pores will become larger and there will be more oil production. You’ll also notice that the odors of your sweat and urine will change and that you may sweat more overall. You may develop acne, which in some cases can be bothersome or severe, but usually can be managed with good skin care practices and common acne treatments. Some people may require prescription medications to manage acne, please discuss this with your provider. Generally, acne severity peaks during the first year of treatment, and then gradually improves. Acne may be minimized by using an appropriate dosing of testosterone that avoids excessively high levels.

Your chest will not change much in response to testosterone therapy. That said, surgeons often recommend waiting at least 6-12 months after the start of testosterone therapy before having masculinizing chest surgery, otherwise known as top surgery, in order to first allow the contours of the muscles and soft tissues of your chest wall to settle in to their new pattern.

Your body will begin to redistribute your weight. Fat will diminish somewhat around your hips and thighs. Your arms and legs will develop more muscle definition, with more prominent veins and a slightly rougher appearance, as the fat just beneath the skin becomes a bit thinner. You may also gain fat around your abdomen.

Your eyes and face will begin to develop a more angular, male appearance as facial fat decreases and shifts. Please note that it’s not likely your bone structure will change, though some people in their late teens or early twenties may see some subtle bone changes. It may take 2 or more years to see the final result of the facial changes.

Your muscle mass will increase, as will your strength, although this will depend on a variety of factors including diet and exercise. Overall, you may gain or lose weight once you begin hormone therapy, depending on your diet, lifestyle, genetics and muscle mass.

Testosterone will cause a thickening of the vocal chords, which will result in a more male-sounding voice. Not all trans men will experience a full deepening of the pitch of their voice with testosterone, however. Some may find that practicing various vocal techniques or working with a speech therapist may help them develop a voice that feels more comfortable and fitting. Voice changes may begin within just a few weeks of beginning testosterone, first with a scratchy sensation in the throat or feeling like you are hoarse. Next your voice may break a bit as it finds its new tone and quality.

The hair on your body, including your chest, back and arms will increase in thickness, become darker and will grow at a faster rate. You may expect to develop a pattern of body hair similar to other men in your family—just remember, though, that everyone is different and it can take 5 or more years to see the final results.

Regarding the hair on your head: most trans men notice some degree of frontal scalp hair thinning, especially in the area of your temples. Depending on your age and family history, you may develop thinning hair, male pattern baldness or even complete hair loss. Approaches to managing hair loss in trans men is the same as with cisgender men; treatments can include the partial testosterone blocker finasteride, minoxidil, which is also known as Rogaine, applied to the scalp, and hair transplantation. As with cis men, unfortunately there is no way to completely prevent male pattern baldness in those predisposed to develop this condition. Ask your provider for more information on strategies for managing hair loss.

Regarding facial hair, beards vary from person to person. Some people develop a thick beard quite rapidly, others take several years, while some never develop a full, thick beard. Just as with cisgender men, trans men may have varying degrees of facial hair thickness and develop it at varying ages. Those who start testosterone later in life may experience less overall facial hair development than those who start at younger ages.

Lastly, you may notice changes in your perception of the senses. For example, when you touch things, they may “feel different” and you may perceive pain and temperature differently. Your tastes in foods or scents may change.

Emotional state changes

The second area of impact of hormone therapy is on your emotional state.

Puberty is a roller coaster of emotions and the second puberty that you will experience during your transition is no exception. You may find that you have access to a narrower range of emotions or feelings, or have different interests, tastes or pastimes, or behave differently in relationships with other people. For most people, things usually settle down after a period time. Some people experience little or no change in their emotional state. I encourage you to take the time to learn new things about yourself, and sit with new or unfamiliar feelings and emotions while you explore and familiarize yourself with them. While psychotherapy is not for everyone, many people find that working with a therapist while in transition can help you to explore these new thoughts and feelings, get to know your new body and self, and help you with things like coming out to family, friends, or coworkers, and developing a greater level of self-love and acceptance.

Sexual changes

The third area of impact of hormone therapy is on your sexuality

Soon after beginning hormone treatment, you will likely notice a change in your libido. Quite rapidly, your genitals, especially your clitoris, will begin to grow and become even larger when you are aroused. You may find that different sex acts or different parts of your body bring you erotic pleasure. Your orgasms will feel different, with perhaps more peak intensity and a greater focus on your genitals rather than a whole body experience. Some people find that their sexual interests, attractions, or orientation may change when taking testosterone; it is best to explore these new feelings rather than keep them bottled up.

Don’t be afraid to explore and experiment with your new sexuality through masturbation and with sex toys. If you have a sex partner or partners, involve them in your explorations..

Reproductive system changes

The fourth area of impact of hormone therapy is on the reproductive system.

You may notice at first that your periods become lighter, arrive later, or are shorter in duration, though some may notice heavier or longer lasting periods for a few cycles before they stop altogether.

Testosterone may reduce your ability to become pregnant but it does not completely eliminate the risk of pregnancy. Transgender men can become pregnant while on testosterone, so if you remain sexually active with someone who is capable of producing sperm, you should always use a method of birth control to prevent unwanted pregnancy. Transgender men may use any form of contraception, including the numerous options available that do not contain estrogen, and some that contain no hormones at all. There are many contraception options that are long acting and do not require taking a daily pill. Transgender men may also use emergency contraception, also known as the “morning after pill”. Ask your medical provider for more information on the contraceptive and family planning options available to you.

If you suspect you may have become pregnant or have a positive pregnancy test while taking testosterone, speak with you provider as soon as possible, as testosterone can endanger the fetus.

If you do want to have a pregnancy, you’ll have to stop testosterone treatment and wait until your provider tells you that it’s okay to begin trying to conceive.

It’s also important to know that, depending on how long you’ve been on testosterone therapy, it may become difficult for your ovaries to release eggs, and you may need to consult with a fertility specialist and use special medications or techniques, such as in vitro fertilization, to become pregnant. These treatments are not always covered by insurance, and can be expensive. Uncommonly, testosterone therapy may cause you to completely lose the ability to create fertile eggs or become pregnant.

Risks

While cisgender men do have higher rates of cholesterol related disorders and heart disease than cisgender women, the available research on transgender men taking testosterone has generally not found these differences. Most of the research on risk of heart disease and strokes in transgender men suggests that risk does not increase once testosterone is begun. However, longer term, definitive studies are lacking. It has been suggested that the risk of other conditions such as diabetes or being overweight is increased by masculinizing testosterone therapy, however actual research supporting these claims are limited.

One known risk is that testosterone can make your blood become too thick, otherwise known as a high hematocrit count, which can cause a stroke, heart attack or other conditions. This can be a particular problem if you are taking a dose that is too high for your body’s metabolism. This can be prevented by maintaining an appropriate dose and through blood tests to monitor blood and hormone levels.

While available data are limited, it does not appear that testosterone increases the risk of cancer to the uterus, ovaries, or breasts. Because not all breast tissue is removed during masculinizing chest surgery, otherwise known as top surgery, there is a theoretical risk that breast cancer could develop in the remaining tissue. However, it can be difficult to screen for breast cancer in this tissue, and there are risks of a false positive test result. Your provider can give you more information about breast cancer screening after top surgery.

Cervical cancer is caused by an infection with the human papillomavirus, or HPV. HPV is transmitted sexually, more commonly by having sexual contact with someone who has a penis. However, people who have never had sexual contact with a penis may still contract an HPV infection. The HPV vaccine can greatly reduce your risk of cervical cancer, and you may want to discuss this with your provider. Pap smears are used to detect cervical cancer or precancer conditions, as well as an HPV infection. Your provider will make a recommendation as to how often you should have a pap smear. It is unclear if testosterone therapy plays any role in HPV infection or cervical cancer.

If your periods have stopped because of testosterone treatment, be sure to report any return of bleeding or spotting to your provider, who may request an ultrasound or other tests to be certain the bleeding isn’t a symptom of an imbalance of the lining of the uterus. Sometimes such an imbalance could lead to a precancerous condition, although this is rare in transgender men. Missing a dose or changing your dose can sometimes result in return of bleeding or spotting. Some men may experience a return of spotting or heavier bleeding after months or even years of testosterone treatment. In most cases this represents changes in the body’s metabolism over time. To be safe, always discuss any new or changes to bleeding patterns with your doctor.

Fortunately, since you do not have a prostate, you have no risk of prostate cancer and there is no need to screen for this condition.

If you have had your ovaries removed, it is important to remain on at least a low dose of hormones post-op until at minimum age 50. This will help prevent a weakening of the bones, otherwise known as osteoporosis, , which can result in serious and disabling bone fractures.

Most people using masculinizing testosterone therapy will experience at least a small amount of acne. Some may experience more advanced acne. Often this acne responds to typical over-the-counter treatments, but in some cases prescription medication may be required. Acne usually peaks within the first year of treatment and then begins to improve.

While gender affirming hormone therapy usually results in an improvement in mood, some people may experience mood swings or a worsening of anxiety, depression, or other mental health conditions as a result of the shifts associated with starting a second puberty. If you have any mental health conditions it is recommended you remain in discussion with a mental health providers as you begin hormone therapy.

Other medical conditions may be impacted by gender affirming hormone therapy, though research is lacking. These include autoimmune conditions, which can sometimes improve or worsen with hormone shifts, and migraines, which often have a hormonal component. Ask your medical provider if you have further questions about the risks, health monitoring needs, and other long term considerations when taking hormone therapy.

Some of the effects of hormone therapy are reversible, if you stop taking them. The degree to which they can be reversed depends on how long you have been taking testosterone. Clitoral growth, facial hair growth, voice changes and male-pattern baldness are not reversible.

Testosterone treatment approaches

Testosterone comes in several forms. Injections are usually best given weekly to maintain even levels of testosterone in the blood. Studies have shown that using a smaller needle and injection by the subcutaneous, or under the skin, approach, is just as effective as the intramuscular approach, which involves a larger needle injecting deeper into the muscle. In addition to injections, there are gel and patches that can be applied to the skin daily. The gel is applied to skin and once dry, you can swim, shower, and have contact with others. The patch also allows swimming, showering, exercise, and contact with others. All of these forms work equally well when the dosing is adjusted to achieve the desired hormone levels, and the decision about which form to use should be based mostly on your preference.

Another option for testosterone is the use of pellets under the skin. These are inserted every few months via a minor in-office procedure. Ask your medical provider for more information about this approach.

Recently, an oral form of testosterone, taken as a pill twice daily, has been approved for use. There are potential risks of high blood pressure when taking this medication, so extra steps need to be taken to monitor your health if you choose to use this form of your testosterone. Ask your medical provider for more information about this approach.

Regardless of the type of testosterone you are taking, it’s important to know that taking more testosterone will not make your changes progress more quickly, but could cause serious side effects or complications. Excess testosterone can result in mood symptoms or irritability, bloating, pelvic cramping, or even a return of menstruation. High levels of testosterone also result in increased estrogen levels, as a percentage of all testosterone in the body is converted to estrogen. In general estrogen blocking medicines are not used as a part of masculinizing hormone therapy.

Other medications that may be used include progestagens, which are hormones similar to or identical to those made by the body to maintain a balance in the lining of the uterus. These hormones can be used in cases where periods continue after testosterone levels have been optimized. These hormones can cause mood swings, bloating, and other side effects, so it is recommended that you discuss these medications further with you provider if they are to be used.

Final thoughts

And finally, please remember that all of the changes associated with the puberty you’re about to experience can take years to develop. Starting hormone therapy in your 40s, 50s, or beyond may bring less drastic changes than one might see when beginning transition at a younger age, due to the accumulated lifetime exposure to estrogen, and declining responsiveness to hormone effects as one approaches the age of menopause. Once you have achieved male-range testosterone levels, taking higher doses won’t result in faster or more dramatic changes, however they can result in more side effects or complications.

Now that you have learned about the effects of masculinizing hormone therapy, as well as risks and specific medication options, the next step will be to speak with your provider about what approach is best for you.

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