How Microdosing Testosterone Changed My Life
I knew I was non-binary, but I was afraid to tell my doctor I didn't want to fully transition from female to male. I thought finding an in-between wasn't allowed.
Photo by Sarah Luby Burke.
The last time I took testosterone was about a year ago. My dosage was 20 mg every two weeks—far lower than the typical dosage for someone looking to fully transition from female to male, which is anywhere from 50 mg–100 mg every week. I’m non-binary, and I’m not interested in presenting to the world as a “man” based on whatever antiquated physical criteria that might invite that assumption. When I took the small amount of T that I did, the resulting physical changes were subtle. Over the course of months, my body fat redistributed, my shoulders broadened, and my face changed from soft to harder as my jawline squared off. The starkest change was feeling much more at home within my body.
I refer to my treatment plan as “microdosing hormones.” I don’t know what other people call it, because there are relatively few public accounts of other non-binary folx who have used hormones in this way—I’ve only seen similar accounts discussed on Instagram, obscure blogs, and the occasional Reddit r/NonBinary thread. The dearth of information around microdosing is one of the many reasons I struggled to find exactly what I needed.
Long before I had the language for “non-binary,” let alone microdosing, I was instinctively trying to figure out what felt most “me.” My first experience with gender-nonconformity happened at the beach when I was four years old or so. My dad said I could choose my own swimsuit, so I picked a pair of fire-engine red board shorts. I was assigned female at birth, but my dad didn’t care about whether my clothes were in line with what girls were supposed to wear—he could tell the shorts made me happy (although he didn’t know it was because another kid had called me a boy one of the first times I wore them). With the water smacking against my chest, I felt free. I had no sense that my swimsuit might be considered abnormal until my mom taught me otherwise. To her, the shorts made me look like a “niño ,” or a boy, and she didn’t want the abuelas shooting looks at the young boy with his ears pierced. Until then, I had been unaware of my gender, or what it meant to other people.
My understanding of being a mixture of boy and girl only grew from there. In middle school, I made up a masculine middle name—my original was Marie, but I said it was Michael—and when I introduced myself to other students, I always made sure to include it. Usually, my classmates were confused, which I secretly loved. When my Spanish teacher assigned nicknames, I asked for one without an “a” or an “o” at the end.
After years of these kinds of tweaks to my presentation and self-representation, I came out to my mom as trans when I was a junior in high school. This was the second time I had come out, the first being when I told my mom I was gay after she caught me cuddling my first girlfriend on my bed. I felt the same pang of anxiety as I did that first time—I had the overwhelming urge to skip the conversation altogether. Instead, I blurted out the words “I’m trans,” and my mother’s face was overcome with shock as I sobbed. I tried to explain how, when I imagined my ideal self, I was masculine and handsome. What I had seen of transness at that time was still based on being either boy or girl, and embracing that felt like the only way to become legible to those around me, although I felt subconsciously that neither was right.
My mom and I went to therapy together to unpack my desire to be a boy. I was terrified of a full medical transition. Looking at images of trans men was both comforting and not—a haze of uncertainty. I spent my therapy sessions describing this haze while maintaining a cool exterior to show that I wasn’t upset by questions that locked me into “male” and “female.”
“Do you want to be a husband someday, versus a wife?” my therapist asked.
“I just wish there were other words for that role.” It was the only answer I had.
I didn’t find a more fitting one until four years later, when I was 21. I spent the first three months of 2014 feverishly reading a blog by someone named Micah who called themself “non-binary.” It was the first time I’d heard that word. The author detailed their transition, which involved microdosing hormones. Reading about this ebb and flow of low-dosage testosterone over the course of years led me to discover what I’d known all along: I was gender non-conforming—something I was only able to see when I learned testosterone could be a tool for embodying that.
I took a group photo with my supportive roommates the morning of my first doctor’s appointment, having told only them about my plan to undergo this newfound transition. I was too afraid to tell my parents, because I knew the word “testosterone” would come with a flurry of questions drawing trace outlines of a new masculine figure that I did not intend to become. I made my way to my appointment, excited, but unsure of what to expect. After I thought “non-binary” had settled into my self-understanding—I assumed that forging my own gender experiment was somehow not allowed, so I kept it quiet. As I spoke to my doctor, I was surprised at how quickly my tongue formed the word “man” and sputtered out lies about wanting to become one.
At the end of the appointment, another surprise: I’d be able to go right downstairs, pick up testosterone, and learn how to inject it that day. While I expected this to give me joy, it stripped me of it: I was assigned a dosage according to my lie. I made the excuse that I would need a friend to inject me and left the clinic without testosterone, feeling defeated and doubtful.
My experience is not as uncommon as I thought at the time. A 2014 study by the LGBT Health Education Center found that more than 40 percent of the medical health professionals surveyed were unfamiliar with how to discuss and treat issues of gender identity. However, that’s not always the case. I spoke to Zil Goldstein, the Associate Director of Medicine at Callen-Lorde, a New York clinic that offers care for LGBTQIA+ individuals, who told me:
[Prescribing low doses of testosterone has] been talked about for a lot longer than people realize. This is the way I see all transgender care for people who have non-binary and binary gender identity: The person getting the care is the captain of the ship. I’m the navigator. That’s how we take care of everybody.
Though gender identity-focused clinics like Callen-Lorde may have a longer history of this treatment for non-binary people, Goldstein has a point: Prescribing lower dosages of testosterone is not unheard of in the wider medical field. According to the World Professional Association for Transgender Health’s Standards of Care Guide:
Some people seek maximum feminization/masculinization, while others experience relief with an androgynous presentation resulting from hormonal minimization of existing secondary sex characteristics...Hormone therapy must be individualized based on a patient’s goals, the risk/benefit ratio of medications, the presence of other medical conditions, and consideration of social and economic issues.
Most portrayals of transness, though, are based in the binary—like Laverne Cox on the cover of TIME or Laith Ashley being a pit member on RuPaul’s Drag Race. The acceptance these platforms offer is grounded in a simplified, cisheteronormative understanding of transness. For non-binary people, that can serve as reinforcement that popular narratives about transness, in otherwise cis contexts, are premised on how far along an individual is in their “complete” medical transition. Microdosing rejects that notion because it is a process that is without a hard and fast “end.”
My uneasiness and fear about telling a doctor how I really felt lessened when I returned to Micah’s blog and decided I wanted to try again, this time with more candor. When I returned to Callen-Lorde and successfully acquired a script that met my needs, I was forthright about what I wanted. I explained to my primary care doctor that I was non-binary and I wanted the changes to be slow—even glacial, if I had the choice. We had an open conversation that left me with a warm feeling in my stomach. I hadn’t kept a secret.
In a world where non-binary people feel like they’re not only reflected, but have access to stories of others who have found their own ways to transition, I don’t think microdosing would be as uncommon. I’m most excited for the future that I see in the images I scroll past on my feed late at night, when I need affirmation most. The people in them—my peers, and people with more visibility, like Alok, Aaron Philip, Shamir, and Chella Man— are, like me, forging new paths. They have bodies I see my own in: non-white, soft around the edges, sprouting facial hair, both pretty, handsome, and more. They show me that being non-binary is amorphous. It comes without a prescribed way of being, free of expectations. I use testosterone to access this freedom, slowly inching my way to a soft, forgiving space where I can be gentle, hard, bold, and understated. Myself.