Its been a year since I started Testosterone Replacement Therapy (TRT) and I’ve seen plenty of changes since then. I can happily say that things have really turned around for the better for me since last summer, when I was truly suffering from those Low Testosterone (Low T) symptoms. In this video, I go over some of the most prominent changes while on T – all from an intersex guy’s perspective.
Click here to catch up or get a re-cap on all my other ‘TRT diaries’ entries!
This transition and quest towards getting TRT (which is independent from my transition) is really my “Rite of Passsage”. I’ve never had one before, and this was my perfect opportunity to have one so I decided to make my own (I’ve been doing this for 2 years now). While I may already be exhibing all the characteristics of a man, I still don’t feel completely like one. I still feel like I’m stuck in childhood. I feel like I’ve “unofficially” or “partially” entered manhood. The problem lies with my body and identity documents (but primarily my body).
Mentally, I feel like a man, since I’m exhibiting all the (psychological/mental) characteristics of one. But physically, I still feel like a boy. My body is pretty androgynous and boyish, not manish. I have a strong male gender identity, so I need my body to conform to that. Its pretty frustrating to have to compare yourself to other 24 year old men and see that they basically have entered manhood (physically, at least), while you’re still stuck in boyhood. Even looking at a teenage boy brings frustration – their bodies are developing into that of a man, and therefore entering manhood. Then you look at your body and realize that you’re 24 and didn’t really have a puberty (talk about arrested development!), therefore you haven’t officially entered manhood. It easy to get jealous of your peers (young men), as well as teen boys (I’m not afraid to admit that I get jealous sometimes). And when you’re Low Testosterone (Low T), its easy to get down and ruminate on this since Low T messes with your brain (I’m very convinced that the worst symptoms of Low T are the neurological ones).
I have low muscle mass (even though I’m fit), building muscle is very hard when you’re Low T. Stamina is down, so I can’t do physically demanding activities for very long. Weight management is difficult, so I’m underweight. Facial and other body hair is scanty, so I can’t grow a noticeable beard and I look too young. My voice still sounds boyish, not manly. Lets not forget about the neurological effects of Low T, it makes you feel like total crap! (Again, these would have to be the worst symptoms of low T.) Overall, low T makes you less of a man. It basically turns you into a “girly man”, or (if you’ve had Low T since puberty) turns you into a “man child”. You really don’t feel like a man at all. Testosterone is everything to us guys. It profoundly affects our brains, and differentiates us from the opposite sex/gender. I think you can all see how important T is for manhood (its basically its foundation, which in return defines it).
Lets not forget that I had a gender misassignment at birth. It can be hard to believe sometimes that one little marker can affect your whole life – how people perceive and treat you. It can either validate or invalidate you. It can make your life great or hell. It’s just really frustrating when you have to deal with situations that require you to show identity docuements, and find out about your illegitimate identity. Its sometimes frustrating to have to tell and correct people about your true identity and how you’re working on fixing your identity documents. It is frustrating to have to deal with places and people who basically treat you like someone you’re not, or see you as someone you’re not. Its just so frustrating when your own government doesn’t recognize who you really are. You feel invalidated. When you identify as a man, your manhood is basically straight-out denied and invalidated.
Let’s face it, if we were still hunter-gatherers, I would be totally screwed. Sure, my intersex and transition would be respected, but my manhood would either be denied, or only partially approved (since manhood is an earned status). My body would not be producing enough T, so I would be unable to do a lot of the manly activities expected of me – I would get tired too quickly, be unable to concentrate, be unable to recover quickly, be anxous and on edge all the time, be tired and fatigued all the time, and basically still be a boy (or at least still be seen as one). Since there’s no advanced medicine in those societies, I would have no way of treating my T deficiency, so I would be doomed to be a “man child” forever and a life of mediocrity, where I don’t get to fulfill my manly responsibilities and my potential. With all of that in mind, I feel very lucky that we don’t live in that type of environment anymore. I feel very lucky to live in a more advanced society, with advances in science, technology, and yes, medicine.
After everything I’ve been through, I’m not taking my manhood for granted. I think that unlike a lot of my peers, I’m taking great advantage of it. I, after all, have more to prove, more to gain, and nothing to lose than most of them. When you’ve lived the first 21 years of your life in the wrong gender role and were forced to be someone you’re not, you obviously have more to prove, more to gain, and nothing to lose. I think that a lot of people these days take things like manhood, identity documents, gender roles, and that sort of stuff, for granted. If you’re trans and/or intersex, then you’ll know what I mean.
I’m 24. I’m supposed to be out there conquering the world like all my other peers, not at home resting and depending on others for resources (due to illness). My mind is ready (and wants) to conquer the world, but my body isn’t. It just really sucks when you sometimes feel like you’re the only one going through this. I just really, really, REALLY can’t wait to get over this stupid low T. I can’t wait to get my identity documents fixed. I can’t wait to finally and officially enter manhood.
Forget puberty. Forget adolescense. 24 is my REAL coming of age! (Better late than never, right?)
I had my 2nd appointment with my Endocrinologist on Tuesday (June 3rd). This is where I got the results from the blood draw I had back in mid-May. I had quite a bit of work done (I had to get blood drawn to 8 tubes!), and the results show that:
Comprehensive Metabolic Panel:
Glucose: 93 mg/dL
Urea Nitrogen (BUN): 11 mg/dL
Creatinine: 0.58 mg/dL
eGFR Non-Afr. American: 130 mL/min/1.73m2
eGFR African American: 151 mL/min/1.73m2
BUN/Creatinine Ratio: 18.9
Sodium: 141 mmol/L
Potassium: 3.5 mmol/L
Chloride: 104 mmol/L
Carbon Dioxide: 23 mmol/L
Calcium: 9.7 mg/dL
Protein, Total: 8.0 g/dL
Albumin: 4.9 g/dL
Globulin: 3.1 g/dL
Albumin/Globulin Ratio: 1.6
Bilirubin, Total: 0.3 mg/dL
Alkaline Phosphatase: 63 U/L
AST: 14 U/L
ALT: 10 U/L
Hormone Panel:
Estradiol, Ultrasensitive LC/MS/MS: 251 pg/mL
17 Hydrodyprogesterone, LC/MS/MS: 81 ng/dL
Androstenedione, LC/MS/MS: 215 ng/dL
DHEA, LC/MS/MS: 471 ng/dL
Dihydrotestosterone, LC/MS/MS: 18 ng/dL
DHEA Sulfate: 338 mcg/dL
FSH: 4.0 mIU/mL
LH: 22.9 mIU/mL
Prolactin: 15.2 ng/mL
T4, Free: 1.1 ng/dL
TSH: 1.27 mIU/L
Testosterone, Free: 2.6 pg/mL
Testosterone, Total, LC/MS/MS: 29ng/dL
CBC (Includes DIFF/PLT):
White Blood Cell Count: 8.1 Thousand/uL
Red Blood Cell Count: 4.31 Million/uL
Hemoglobin: 12.9 g/dL
Hematocrit: 39.5%
MCV: 91.7 fL
MCH: 29.9 pg
MCHC: 32.6 g/dL
RDW: 13.5%
Platelet Count: 192 Thousand/uL
MPV: 97 fL
Absolute Neutrophils: 5840 cells/uL
Absolute Band Neutrophils: DNR cells/uL
Absolute Metamyelocytes: DNR cells/uL
Absolute Myelocytes: DNR cells/uL
Absolute Promylocytes: DNR cells/uL
Absolute Lymphocytes: 1110 cells/uL
Absolute Monocytes: 494 cells/uL
Absolute Eosinophils: 616 cells/uL
Absolute Basophils: 41 cells/uL
Absolute Blasts: DNR cells/uL
Absolute Nucleated RBC: DNR cells/uL
Neutrophils: 72.1%
Band Neutrophils: DNR%
Metamyelocytes: DNR%
Myelocytes: DNR%
Promyelocytes: DNR%
Lymphocytes: 13.7%
Reactive Lymphocytes: DNR%
Monocytes: 6.1%
Eosinophils: 7.6%
Basophils: 0.5%
Blasts: DNR%
Nucleated RBC: DNR/100 WBC
So as you can all see from that extensive list, I had a lot of work done, but I think it was well worth it (and is required for successful TRT). Now, lets go over some of the numbers on the list. Be warned that this is going to be a pretty lengthy post, since there’s quite a bit to cover, so get ready to devote quite a bit of time to reading this.
If you look at my (Total) Testosterone levels above and if you remember the results from my last blood test, you’ll see that my T levels have actually gotten worse. My T levels from last time was 36. This time around its 29 (ouch!) (I think that a cold/cough that I had during that time might have contributed to my lower T levels this time around). My Free T levels are low too (obviously). My Estradiol (E2) levels have also gotten worse. My levels from the last blood test was 192. This time around its 251 (yikes!).
My FSH levels haven’t changed much from the last time. Although it seems like my FSH has dropped a bit from the last time (from 5.3 to 4.0). This isn’t surprising as my my low T levels and high E2 levels are very likely compromising my fertility (my FSH also seems to be on the low side). Plus, my T levels dropped a bit and my E2 levels went up from the last time, so its only natural that my FSH would drop as result of this. This time around I was able to get my LH levels checked. The result I got was 22.9. This is a high number and is very typical of somebody with 17B-HSD, as well as a male with primary hypogonadism (high LH is an indication of primary hypogonadism). This is something I was expecting – I guessed that it would happen and I was right.
This time around, I also got my Androstenedione (A) checked. The result? 215. This is pretty high and is just above normal (normal is under 151 – although just like every other hormone range, there is no definite range). This, along with low T levels and high E levels, is very typical of somebody with 17B-HSD (characterized by a high A:T ratio, in my case 215:29) – and I’m betting that the number would be higher if I had taken an HCG stimulation test.
I got my Dihydrotestosterone (DHT) checked this time around as well. The result was 18. This is a low number (it needs to be 30-85), but seems normal for someone with my T levels (29). Obviously, the T:DHT ratio (mine is 29:18) isn’t high enough to indicate 5-Alpha Reductase Deficiency. I knew that the result would be something like this, and this indicates that I was right about having 17B-HSD.
My Prolactin fortunately wasn’t ultra high (which I knew), so there’s nothing indicating a possible tumor 😀 (something my Endo was worried about). However, my Prolactin is on the high-normal side, almost above normal – which isn’t surprising considering the fact that I have Gynecomastia. But the good thing is that it’ll be easy to manage and get it to be lower – more towards the middle of the scale.
My white and red blood cell counts are in range, although it looks like my RBC is on the lower end of normal (does not seem uncommon with Low T). My Hemoglobin and Hematocrit seem to be on lower end of normal (which is normal for Low T guys) – . The rest of the numbers from this blood draw are all in range (except for a couple or so, which are slightly above normal, but not a big deal). My Thyroid is all good (which I suspected). Although, my Creatinine is below normal. Additionally, Glucose seems to be on the high end of normal (which I don’t think is surprising for a guy with Low T). My Liver and Kidneys also appear to be working well.
The only results I didn’t get back was from the Sex Chromosome test – this was due to an error. I really have no problem with that. I don’t need a Chromosome test to tell me I’m 46,XY – my physical characteristics tell me that, as well as the results from my bloodwork (but really, why should it matter? Here’s a very insightful article that deals with this). I don’t plan on re-taking that test, simply because of the fact that the evidence that I have already tells me that I’m biologically male. I don’t need this test to ‘validate’ me (I rather take a semen analysis). I know what I am and I know how my body works – it is after all, my body, and nobody knows my body better than me. Intersex people are already medicalized enough and this just contributes to it, in my opinion.
See, the thing that bothers me about this is that they’re (the medical establishment) are trying to mythologize us and basically are trying to tell us that either we don’t exist or that we are ‘hermaphrodites’ (with two sets of working testes and ovaries). I mean, if the testes are palpable down there, despite the fact that the person (in this case, that would be me) has ‘ambiguous’ genitalia, then that should tell you that there are no ovaries – especially if those “lumps” are adult-sized (i.e. adult-sized testes). I mean, what else could they possibly be? Its humanly impossible to have a working set of testes and a working set of ovaries. I think that right there should tell you something. All in all, I don’t care what my chromosomes are because it doesn’t matter (and chromosomes actually don’t matter).
Now at this point, you may be asking yourself why I’m putting a spotlight on the ‘medical’ side of intersex, if I’m against the medicalization of intersex. The answer is because I want people to see that intersex folks have differing hormonal (and other) profiles, even within their own variations (if that makes any sense). This also helps people to see that overall, intersex people tend to be healthy just like everyone else, and that when it comes to health, we basically face the same challenges like everyone else. I’m simply educating people on this stuff in a way everyone can understand (I’m trying to make everyone understand how diverse intersex and everyone else’s bodies really are). The rest of this series will be focusing more on my treatment of and recovery from Low Testosterone – from the perspective of an intersex person :D. Overall, this shows that we’re no more different from non-intersex people, and that’s the message I’m trying to get across here.
I think you can all see from my blood draw results that I’ve got the green light to go on T. Unfortunately, there’s another hurdle I have to get through before I can get T: I need to update my gender with the Social Security Administration (SSA) before I can get T. The reason for this is because my Endo said that because my gender on my insurance (which is connected to my Social Security number/records) is still female, I need to provide proof that I got therapy for Gender Dysphoria (GD) – this will also require changing the diagnosis from Hypogonadism to GD. I need to provide my Endo the notes from that therapy session I had with my then-psychologist, so he can submit them to my insurance company, so they can approve my TRT. If can’t track them down, then I will need to go to therapy for GD all over again, and I will not have that (I mean, why do I need to do this again? I’ve been living as a man for 2 years now with great results). This has already consumed a lot of my time (I’ve started this journey early last year), and I just want to get this over with so I can go back to living my life.
Getting those notes has already proven difficult to do. This is obviously already wasting my time. So as a solution to this problem, I made an appointment to see my Primary Care Physician (PCP) on Monday morning. Hopefully, everything goes well and I get my note to take to my local SSA office later that same week. I personally think everything’s going to go well. My PCP is very understanding and laid-back, so I trust him with this (as he was going to do it the first time around but unfortunately ran out of time). But, I’m still going to be a bit cautious – I don’t want to get my hopes up only to have them crushed. Hopefully with this done, my Endo will be able to keep the Hypogonadism diagnosis (he’ll have to or else the insurance company will think I’m a TransWoman and deny my request to cover my TRT) – since I won’t have to go through that ordeal with my insurance – and make my next appointment to finally get my 1st prescription for T very soon.
I’ll keep everyone posted on this situation. Expect an update on this on or after Monday.
I had my first appointment with the Endocrinologist on Tuesday. I had to wake up pretty early (before 8am – I woke up at 5am). Normally, I’m not a morning person (however, I think this will change soon for various reasons) but this time around, I was willing to wake up very early since I was very excited about my day. I was eager to see how the endo would treat me, not only for my Low Testosterone, but also as an intersex and transgender person.
I left my house at around 7am and pretty much got there in time. Since it was my first visit to this endo, I had to fill out some paperwork, which didn’t take very long to do. Additionally, I also had to show my insurance cards and ID. It didn’t take very long to go in and see him (since I was one of the very first ones to arrive and it was still pretty early). The nurse had me come in and check my weight and vitals and then had me wait in a room for the endo to arrive.
After probably 5-10 minutes, the endo came into the room. We both introduced ourselves, and of course, I told him about my real name and gender, which he took very well. Then came the big question: What can I do for you today? (Or something like that…I can’t really remember right now.) I right away told him that I had Low T and was seeking treatment for it (he seemed a little puzzled about when I told him this). I then explained to him how I am really a biological male who happens to be intersex and was misassigned female at birth and was diagnosed as Low T in October, and that that explained why I was seeking treatment for Low T. He completely understood this and then had me explain a little more about my background (as an intersex person), which I did.
The endo then had me do a physical, which included checking my upper body and groin. I was a bit hesistant at first. I told him I was a bit self-conscious about showing my chest to other people because of my Gynecomastia, but he completly understood this and tried to make me feel more comfortable. So after feeling more comfortable with the procedure, I went ahead and did it. First, he checked my upper body (which included my face – he even asked me if I shaved and I said yes). Then, it was on to the lower part of my body.
I think he noticed my testes down there (it seemed like he wasn’t very direct about it) because he referred to them as “lumps” (which is a commonly used phrase used to describe testes in the presence of ambiguous genitalia). He also didn’t seem to hesistate in ordering a sex chromosome test when ordering my blood work. Let me say right now that they are clearly testes becuase they look, feel, and function the same way testes in typical men do (the only person who really, truly knows my body is me). With this in mind, they can’t possibly be something else – in particular, ovaries (because ovaries don’t hang down there and neither are they about the size of chicken eggs). But even with this in mind, my endo probably just wants to make sure they truly are testes since, lets face it, its not his body so he doesn’t know how its like or how it works – plus, I have ambiguous genitalia and its not always easy to tell what is what. He also very likely wants to make sure that I’m indeed 46,XY and not something else.
Let me be clear right now that there was no pressure on me to do the part of the physical that included checking my upper body and groin. The endo was completely laid back about it and was okay with me not consenting. He did not pressure me into it whatsoever. My guess is that he’s very well aware that a lot of intersex people are uncomfortable with doctor visits due to past bad experiences with doctors and the fact that a lot of doctors are ignorant about intersex, and how to treat us.
He has not prescribed me Testosterone yet, but he’s clearly very much willing to (with my abysmal T levels, there really isn’t any other choice). Additionally, he also seems willing to prescribe me any type of T (I’m hoping to be on Androgel – hopefully my insurance is willing to cover it). Not only that but, he seems willing to prescribe me Anastroozle (Arimidex) or another Aromatase Inhibitor to bring down my Estrogen levels (again, there’s really no other choice). I asked him the hard questions so this is how I know that he’s very open to doing so. He wants me to re-check my T, E2, and FSH levels, as well as several other markers before prescribing me T. In addition, he also wants to rule out the possiblity of a tumor (which I highly doubt is present) from having high Prolactin levels and such. If there’s anything that indicates the possibility of a tumor (which again, I highly doubt), I will have to get an ultrasound of the testes and possibly get my pitituary checked.
I will be getting my blood drawn on Friday morning. Here are all the markers that I will be getting checked:
Androstenedione
17-Hydroxyprogesterone (LC/MS/MS)
DHEA (LC/MS/MS & Sulfate)
DHT
Estradiol (E2) (Ultrasensitive)
FSH
LH
Prolactin
Testosterone (Free & Total)
T4 (Thyroxine), Free (FT4)
TSH
Sex Chromosome Analysis
I’m aware about some of the horror stories of people dealing with endo’s, but my experience so far has been great! He even knew what intersex is! Not only that but, he completely respected my background and referred to me by the right name and pronouns (although there was a slip up at one time, but that’s natural). Overall, he really seems to know what he’s doing and is great to work with. My next appointment with him is on June 3rd and I can’t wait for that day to arrive! I’m very eager about what my blood test results will be and hopefully everything will clear out fine (meaning: no possibility of cancer, thyroid issues, or oher serious complications that might further delay treatment ) and will get my first prescription for T!
So all in all, my first visit with the endocrinologist was great!
P.S. I’m very happy with my new insurance so far. This one’s way better than my old one (which was pretty limited). I’ve had nothing but positive experiences so far. Not only did they approve my referral to see an Endocrinologist (unlike my old one), but they also chose a competent one for me, and I was able to keep my PCP too. I’m very sure they’ll cover my prescriptions as well. I definitely feel like I made the right decision when choosing my new health insurance.
Hormone Levels (as of October 2013):
Testosterone (T; Total T): 36 ng/dL (Total Joke!)
Estradiol (E2): 192 pg/mL (Ugh! Don’t even get me started on this one!)
FSH: 5.3 mIU/mL (I’m fertile, yay!…Well, sort of.)
So as you can see, low T levels and high E2 levels are normal for someone who has 17b-HSD [type 3] (17 beta-Hydroxysteroid Dehydrogenase Deficiency [Type 3]). I wouldn’t be surprised if my LH levels were high (but actually doesn’t need to be) and if my Androstenedione levels were also high (again, doesn’t actually need to be – especially since I’m experiencing the other signs of 17b-HSD). I’m considering getting my LH and Androstenedione levels checked out during my next blood draw (as well as other important things for TRT like red blood cell count). If my A:T ratio is high (that is, if I have high Andro levels and low T levels), then I definitely have 17b-HSD. But then again, I probably don’t need to do this as all the signs point toward 17b-HSD. But even with that in mind, I do plan on getting genetic testing a bit later in the future to confirm this and to see what type of mutation I have on that gene (out of mere curiosity). Its also possible that I could have low LH levels because it turns out that excess E production in males shuts down LH production which in return shuts down T production (and so you end up with T levels normal for women and castrated males).
As for the FSH levels: these are typically high in 17b-HSD (as well as in 5-ARD [5-alpha Reductase Deficiency] – which is basically 17b-HSD’s sibling since they’re so similar to each other), mostly because of undescended testes. However, they can be normal (and even low), as in my case. This seems to mostly come from people with descended testes (as in my case). Even with normal FSH levels, its very likely that my fertility is compromosied because of low T levels and high E levels. It also seems like its on the lower side of the normal range, and combined with all these other numbers, its pretty clear fertility is compromised.
One more thing about T and E levels in 17b-HSD: T levels don’t need to be low and E levels don’t need to be high. They can actually be normal (for both T and E) or low (in the case of E), while T levels can be high (less common but possible). All this depends on your genetics. All this is why genetic testing is far more reliable than endocrine testing.
Voice: My voice is kinda low (but not deep yet) – its about the equivalent of a Transsexual male 2 months on T. I sound like a teenage boy who’s just starting puberty (because that’s pretty much where I still am right now, lol). Its been this way since my voice first cracked on New Year’s Day 2002 (I was 11 and a few months away from turning 12).
Facial/body hair: I actually have hair in my upper lip, chin, sides, chest, and abdomen (I already have hair in my legs and arms). However, the hairs are so light and thin (or in other words, scanty) that you can only see them with a magnifying glass (that is, if you have bad eyesight) and in a well-lit room – or outside during the day, if the weather permits (I can actually see my hairs with just a mirror).
Body build: I currently weigh anywhere from 88-91ibs. As you can see, I’m pretty underweight for a 5’4″, 23 year old man, who should be weighing anywhere from 108-140ibs. I’ve been struggling with my weight since I was a teen. I didn’t know why back then but now I do – it turns out low T makes weight management difficult. Additionally, my chest size is 31-31 1/2 inches, bicep size is 8 inches, neck size is 12 1/2-13 1/2 inches, and I have body fat percentage of anywhere from 11-14% (my six pack almost shows!) and a body mass index of 14-16 inches. All of this makes me look and feel like a kid (or even wrose, a girl), and I’m not very happy about it. I’m fit, but my muscles aren’t huge yet (I want to achieve that ripped look).
Physical performance: Yeah, that has gone down drastically. My recovery is a total joke (I take a very long time to recover) and my stamina has declined. My muscles are still pretty fatigued from my previous workout (which was a very long time ago). I have had to really cut down on working out/exercising because of that (plus, I don’t really have the energy to do that stuff anyways). I really miss working out. I really can’t wait to get over this stupid low T and go back to doing that. Before my regular workouts were interrupted, I could do 50-100 pushups, 36-40 pullups and chinups, 45-75 second planks, and 50-100 squats – all in 1 cycle, as well as and 8-15 sec sprints in a few minutes (I’m following the Primal Blueprint Fitness regime). I could also lift up to 50 ibs (I do compounded workouts).
Energy: Don’t even get me started on this one. My energy levels are a joke. I’m constantly fatigued. I can barely get through a whole day. I even have had to reduce the hours I work, and take more days off as a result, since I don’t have much energy to do stuff. Its affecting other parts of my daily life too – I probably don’t need to say anymore, as I’ve pretty much already said it all. Basically, survival is my only goal. Everything else is a chore. I just wish I didn’t have to feel this way. But you know who I really feel bad for? The people around me. I feel like I’m neglecting them.
Mood: I have a case of “Dr. Jekyll/Mr. Hyde Syndrome”. My moods fluctuate pretty often. I get irritable pretty easily. I have no patience for people who get on my nerves. I feel like like a walking zombie (which is a common statement made by men with low T). Additonally, I don’t seem to be really “grasping” life – I feel like like its just going by…I literally just “exist”, I’m not really “living” life (this is also a common statement made by men with low T). Additonally, my anxiety levels seem to have gone up (which has always been this way), but there’s nothing that’s really incapacitating (in other words, I don’t have an anxiety disorder). Apparently, this is common with men who have not just low T but also high E – there’s evidence that high E levels cause anxiety in men.
Cognition: I feel like low T is affecting my cognition quite a bit, especially my concentration and verbal performance (which has always been a weak spot for me because I’m a visual-spatial thinker/learner). I actually seem to have this thing called “anomic aphasia” (or “word selection anomia”, or “dysnomia”), which is apparently a side effect of low T (but particularly very low T levels, such as mine). From what I’ve read, I should see improvement on that in about 2-3 months after starting T, and that includes my overall cognitive dysfunction. My performance at work has taken a huge hit – I can barely concentrate on my work and it takes a long time to get me into the “flow” of things. All this stuff isn’t good, as my career is intellectually demanding – so I gotta have a sharp mind and low T isn’t giving me that. Additionally, my memory is lagging a bit as well. Overall, this stuff is a huge pain in the ass.
Libido/Potency: My libido is inconsistent (or in other words, its a mess). I only think about sex occassionally (its not as frequent as it should be), and I have pretty long refractory periods – during these times, I have a hard time getting an erection (which I heard is common during these periods…more on that here). My morning/nocturnal erections are infrequent as well. Same goes for spontaneous erections. Not only that but, they don’t seem as firm as they should be. In addition, my semen volume is very low and at times I have a sort of watery semen – at least at times (these two things are very common with 17b-HSD and 5-ARD – and of course, Low T).
Appetite: I don’t think my appetite is as big as it should be. This is probably because of my lack of energy, which also means that I’m not moving around very often. All this translates into reduced need for caloric energy, resulting in a lowered appetite. I’ve done research on this, and I’ve also seen it in myself – whenever I more around more, I get more hungry and so forth. Low T seems to be messing up my metabolism (which isn’t surprising). The good news is that I will get higher energy levels, and as a result, a bigger appetite when I go on HRT.
Other: Some other stuff I think I should mention is that my bone structure is that of a male – which means that I have wide shoulders and narrow hips, my fat distribution is that of a male (I have no fat around my hips, buttocks, and tights), and I get hot flushes (common with very low T and high E levels) – which seem to be more noticeable in warmer weather. Not only that, but I also have a severe case of Gynecomastia (which is typical for people with 17b-HSD to have). Additonally, I seem to have a bit of imnsonia, which I’ve been dealing with for a long time.
As you can see, low T is making me pretty miserable. This is not a great way to live life and I definitely do not want to live like this anymore – I’m so freaking tired of it. I shouldn’t have to go through this, especially since I’m in my 20s. I just hope I’m on T soon (and I’ll be taking an Aromatase Inhibitor as well, so I hope to be on that soon too). I’m going to got visit the Endocrinologist for the very first time (I got a new insurance provider) on Tuesday (5/13) and hopefully I walk out of that endo’s office with a prescription in my hand by the end of the visit on that morning. I just want to get this over with so I can go back to living my life. Being sick sucks and you’re just not really alive if you’re low T. I want this out of my life now!
I am starting a new series of blog posts called, “The TRT Diaries”. This is where I’ll post updates about my Testosterone Replacement Therapy (TRT), which I’ll be starting soon. I feel that this is a unique series because I am an Intersex person who will be undergoing Hormone Replacement Therapy (HRT), and I haven’t really seen any people document their HRT progress while also being intersex (regardless of their background). It would be pretty nice if more intersex folks who chose to undergo HRT (for whatever reason – whether that is hypogonadism or personal preference) documented their progress (but I know why a lot of them don’t and completely understand). It would let all of us know how its like to undergo HRT while being intersex – which is something that most people don’t experience. Plus (and this is I think the most important part), this information would be of great value to any intersex people thinking about going on HRT/TRT, as there are a lot of intersex variations out there so the effects of HRT/TRT are going to vary by variation (and overall, the genes one has inherited).
So this is just me doing my part and trying to create more visibility for intersex folks…and this is also me trying to fill a niche. This should be pretty interesting, so I can’t wait to start this journey!
BTW, since I’m dealing with hypogonadism (low testosterone, in my case), I’m sure this will be helpful to “average” (i.e. non-intersex and non-trans) men out there who are also hypogonadal and are thinking about going on TRT.
P.S. My intersex variation is 17 beta-Hydroxysteroid Dehydrogenase Deficiency [Type 3] (or 17b-HSD, for short).
I’m going to be completely honest with you and tell you this right now: Trying to rest while you recover from illness or injury is hard, especially if you’re like me and are highly competitive, passionate, and driven. It isn’t very easy. If you’re into sports, then you’ve probably heard stories (from features, interviews, articles, etc.) about high performing (read: highly competitive, passionate, and driven) athletes struggling with this same issue. They’re injured or sick and want to get out there and play/race as soon as possible. They know that while their competitors are getting ahead, they’re getting left behind. Not only that, but they’re also very passionate about what they do. They’re also restless – they need to be doing something at all times or they’ll get bored (they have a very hard time shutting their brains off). There are even times where they’re also struggling with depression.
I’m this same way. I know how these athletes feel because this is the same thing I’m dealing with (only the professions are different). If you’ve been following this blog for some time, you’ll know that I’m dealing with a nasty case of Hypogonadism (or Low Testosterone/Low T). It is so bad that it is impairing my ability to work. I can barely get through a whole day. I’ve been dealing with this since I was 11 or 12. Reason being because I was born with a mutation in a gene that is responsible for making Testosterone (T). What this means is – not just that I was born intersex but, – that my body has an extremely hard time making optimal levels of T to keep me healthy, well, and fully functional (heck, I haven’t even finished puberty – and I’m 23!). My body has a very severe T deficit (and even worse, a severe Estrogen surplus – because of my body’s excess excretion of Androstenedione, which is how our bodies make T). What all this means is that I have to go on Testosterone Replacement Therapy (TRT). I will have to take it for the rest of my life, I can never go off it or else I’ll be back to where I am now – struggling in life, barely able to make it through a whole day and overall, just trying to survive and feeling crappy.
I’m supposed to be resting right now. I know this, but sometimes it seems like my brain hasn’t gotten the word. A lot of the time, I feel like working. A lot of the time, my brain tells me to do stuff even though my body is telling me to rest. While its true that my profession is in the arts (music and design), I need my brain to be clear. I need to be able to focus and think straight. What I do is very intellectually-demanding (just like computer programming, engineering, and other intellectually-demanding professions), so I have to have a sharp mind and of course, I have to be healthy. This is a highly competitive field (which is a reason why I’m so attracted to it – I thrive on these kinds of things), so I need to be in good shape and have lots of energy. And lets not forget about touring and playing live – it is physically demanding, so that’s another reason why I have to be healthy and well. In addition, I have lots of great ideas, but I can’t really work on them because my cognition is too dysfunctional and because I’m too fatigued.
Low T is not letting me do my best. It is hindering my success. This is something that I struggle with everyday. The more my medical condition goes untreated, the more restless I get, the more I hate downtime, and the more determined I get to recover from this thing (among other things). Its hard to not do anything. Its hard to wait. I want to feel well again and do the stuff I love to do. I no longer want to deal with this. Fortunately, its almost time for me to get on the road to recovery. I went to the doctor just this past Tuesday and got a new referral to see an Endocrinologist (with my new insurance). I should be receiving a notice about it in 5 business days. I hope everything goes well because, like I said, I no longer want to deal with this. I just want to feel better and get back to living life.
2013 was a huge year for me. The majority of events that happened last year revolved around gender. 2013 was the year that I began my journey to get Hormone Replacement Therapy for my Hypogonadism (Low Testoserone, in my case). This was also the year that I continued my journey to legally transition from female to male.
2014 will be the year that I really (read: actually) begin my legal transition. Last year, California introduced and passed a new law – also known as the “Transgender Identity Law” – which allows Trans folks to have a more streamlined and inexpensive way to change their names. Part 1 (the first half) of the law went into effect on January 1st. Trans folks no longer have to go to court to change (more like “fix”) their gender marker on their birth certificates. All we have to do now is get a note from a doctor citing that we’ve undergone ‘appropriate’ treatment for a gender transition (it can be anything, and it doesn’t have to be specified). Then afterwards, we can go directly to the Office of Vital Records and change/fix the gender marker on our birth certificates that way. Part 2 (the second half) of the law will go into effect July 1st. This is when we will be able to change our names without having to put a notice up in the newspaper to do it (I heard you won’t even have to show up at the hearing).
I am very excited about the new changes. This is something that I’ve been wanting since I first started this journey in 2012. I actually never thought this day would come, and neither did I think it would come this soon. This provides us with an easier and more inexpensive way to fix our legal documents (name and gender, in this case). Not only that, but it also gives us more privacy, as we’re no longer going to be required to publish a notice up in a newspaper. That right there, is something that I’ve been intimidated of, as this is something that should be dealt in private. Not only that but I’ll be able to save a lot of money, as I’ll only have to file a fee waiver to have my filing/court fees waived, and I’ll only have to pay for a new birth certificate and ID (if I get the fee waiver granted, which I’m sure I will).
2014 will also be the year I overcome Low Testosterone (Hypogonadism). I really can’t wait to finally get this over with. It’s had such a negative impact in my life. I’m so sick and tired of feeling tired and fatigued all the time, as well as not being able to work out as often as I would like and not being able to put on muscle easily. Additionally, I’m so sick and tired of looking and sounding like a young boy (I’m 23, for goodness sake and shouldn’t have to go through this), and even worse, risking being mistaken for a masculine girl/woman. If you’ve ever suffered from, or are currently suffering from low t then you’ll know how this all feels (and how I’m feeling). I should be getting my prescription for T (and Arimidex or Tamixofen) during the first half of this year (anywhere from February through April, or during Winter or Spring) – at least I’m hoping so.
Elipalooza 