Gender affiming therapy - Testosterone

Key points below

With Testosterone

What is testosterone?

Testosterone is a hormone that makes a body look more masculine. Some effects only last while you take the medicine. Some of the effects of this medicine are permanent.  They cannot be undone even if you stop taking it. Testosterone is given with a shot into the fat layer under the skin.  

What are some of the risks and benefits of taking testosterone?

Benefits                                
• Looking more like a man.
• Bigger clitoris.
• Coarser skin.
• Lower voice.
• More body hair.
• More facial hair.
• More muscle mass.
• More strength.
• No more menstrual periods.
• More physical energy.
• More sex drive.
• Protection against bone thinning (osteoporosis).

Risks
• Acne (may permanently scar).
• Blood clots.  This risk is higher if you smoke. 
• Emotional changes, like more aggression.
• Headache.
• High blood pressure (hypertension).
• Increased red blood cell count.
• Infertility.  You may not be able to have biologic children.  
• Interaction with drugs for diabetes and blood thinning, like Coumadin.
• Male pattern baldness.
• More abdominal fat.
• More risk of heart disease.
• Swelling of hands, feet, legs.
• Swollen or larger liver.  
• Weight gain.

What will happen if you stop taking it?

• The acne caused by the testosterone may get better.  Acne scars may not go away.
• You may start having menstrual periods again. This can happen within a few months.
• When you take testosterone, you will notice less fat on your butt, hips, and thighs but more on your abdomen.  If you stop taking testosterone, the fat distribution will change. 
• More muscle mass and strength will go away when you stop taking it.
• Vaginal dryness will decrease.

The effects of testosterone on fertility are not known. 
• You can become pregnant even after testosterone stops menstrual periods.
• You may or may not be able to become pregnant even if testosterone is stopped. 

What are likely permanent changes even if you stop taking it?

• Bigger clitoris, often about half an inch to a little more than an inch.
• Deeper voice.
• Slow growth of moustache and beard.
• Hair loss at the temples and crown of the head.  You could become completely bald.
• More, thicker, and coarser hairs on abdomen, arms, back, chest, and legs.

ALERT

Call your child’s provider if you or your child have any concerns related to using this teaching sheet or if your child has special health care needs not covered by this information.