Testosterone! To T or not to T?

The postnatal period is a funny thing. Like I’ve said before, it comes after a period of the biggest change that someone’s life and body can go through.

As a trans person I’m not unfamiliar with my body changing. Heck, over the last 5 years I’ve played the hormone hokey cokey, stopping and restarting testosterone with pregnancies in between. My poor body doesn’t know whether it’s coming or going when it comes to hair growth, fat redistribution and muscle mass, let alone all the other changes big and small that come with hormonal changes.
If you’re an adult reading this then you’re likely to have been through at least one puberty so you’ll have some grasp of the power of hormones, but the topsy turvy-ness of how they can impact you will be much more familiar to anyone who has been pregnant, gone through menopause, taken HRT of any form or even just had periods. Hormones are powerful and given that we are so often at the mercy of them, it’s strange to be in a position to get to actively choose how I’d like mine to look.
Back when I first started testosterone I didn’t have a choice. Honestly, I don’t think I’d be here today if I hadn’t been able to access medical transition in the form of hormone therapy, it was quite literally life saving (despite being wrongly told I was infertile because of it, I could have done without that mind mess!)
But testosterone is powerful stuff and there are a lot of changes that don’t go back (or not without further medical support, e.g. electrolysis for hair removal). Even after only giving birth 3 weeks ago and only being on testosterone for 10 months out of the last 5 years, I have a full beard, chest hair and my voice is still low (not as low as it once was, but nobody else would know that).

Testosterone isn’t the driving force here right now but it has left its mark indelibly on my body. So I’m left wondering, should I restart taking it?

I had my blood test today to measure my base hormone levels. I could restart testosterone right now if I wanted to.
And I know if I do, my body will change. Again. And I’m kind of exhausted with having to learn a new body all over again. New hair, new smell, new texture, new shape. I’m only just getting used to not being pregnant, am I ready to change again?
Even after all I’ve been through, I am still assumed to be a cis man by strangers (which is honestly wild considering what my body has just done) and I’m wondering if I really want to smell like one again. I’m not kidding. You know that teenage boy smell? I’d be signing up for that. Not to mention the back hair and the way that my arm hair joins up all the way round when I’m on T (I don’t know why, but I really don’t like that!)
But I also know that not taking testosterone is still signing up for change. Without testosterone I’m facing the peaks and troughs of oestrogen and progesterone. A monthly merry-go-round that has never done me well. Between physical agony and life disrupting PMS (that’s an understatement honestly, check out PMDD for more info) I’ve always had a rough ride of them.
When I first started testosterone I suddenly had an opportunity to learn who I was without the constant psychological flux from my PMS cycle. I finally found some balance in myself. But I now know what that balance feels like so even when I am affected by hormones I am much better equipped to manage it. (Or so I’m telling myself, if I don’t restart T then ask me again in a couple of months!)

After my first birth I went through a similar experience and I waited around 5 months after giving birth to restart T, which I decided in retrospect was too long as my mental health had been affected. But despite the parallels I don’t feel quite the same this time. I was definitely struggling with PND last time and I was also facing another pregnancy within a few years. This time I’m done and it feels strange to face an indefinite time on a medication when I don’t know if my body is going to feel familiar on it. I know it once did, but that was 5 years and 2 pregnancies ago.
If my beard had gone, this choice would be easy. My beard is one of my biggest sources of gender euphoria and without it I wouldn’t even take the time to write this because I’d be too busy sticking a needle filled with testosterone in myself. But my beard is still here, my voice is still here and my body is in a beautiful in between where I am lucky enough to be comfortably masculine but with a softness that after all this time feels familiar and safe.
Running parallel to my pregnancies and during my hormone hokey cokey I’ve also been exploring my gender in new ways. Despite my comfort in a masculine body, I’m also recognising that I get gender euphoria from softness, from colour and from nurturing. I am nonbinary, but I didn’t realise it for the longest time.
More than that, I get some amount of euphoria from having a nonbinary body that isn’t striving for cis-ness in a way that I once was.
There’s an unsatisfactory conclusion to all of this. I’m at a crossroads and there’s no pause button where I can stay right here. Softer than testosterone would make me but more predictable than when I’m having periods.
I’m going to wait, which means continuing down the oestrogen and progesterone path for a while. That feels right for now. And perhaps next week, next month or next year I’ll consider taking a fork in the road and restart T on my terms. And believe me when I say I know how lucky I am to get to have that choice.

Eventually I decided to begin my medical transition privately because the mental and physical pain I was going through daily was unbearable and I had come to terms with the idea that I would adopt or foster – something I still wish to do in the future.
Understandably when I found out that I was pregnant at 22-years-old I believed that it was now or never, that this was my only chance of having my own biological baby and some other-worldly force decided that I would get pregnant the week before I started testosterone. I don’t believe in one God but I’m a massive believer in fate and despite knowing now that many trans masculine people have came off testosterone years later and managed to conceive, I still believe that I was intended to have my son. I struggled greatly coming to the decision that I wouldn’t go to that appointment because I was meant to be going into my final year of Acting at university that September and I didn’t have a partner, or my own house, but I knew that if I did struggle to have a biological child in the future then I would always remember what I could have had, had I not gotten a termination.
I spoke to my mum, in her car in our local supermarket carpark, telling her that I was pregnant and that I didn’t know what to do. I know that my mum only believes in abortions for very specific reasons, so perhaps on reflection I had probably made up my mind that I wanted to keep the pregnancy when I asked her for advice, I was more asking for her consent to do so. She was happy with the idea, when I came out as trans she also believed that I wouldn’t be able to have biological children so I think that she felt the same way that I did, and she told me that she would support me in any way that she could.

Throughout the pregnancy I was concerned that my having used testosterone for 10 weeks of his 11 weeks of life would have had negative affects on him, so the NHS gave me extra scans and did my blood work until my testosterone levels were back within a “normal” range for a birthing person. With my first set of bloods, I had a phone call asking me whether I could come in and have them done again, I was concerned about this and agreed that she could come and take them that afternoon, when she was taking them, I asked her what had happened and she told me that they had gotten lost somewhere. At a later appointment a lead came in and told me that what happened with my first bloods should not have happened, she explained that they arrived at the lab for testing and the technicians saw a male name and discarded them believing that they had been sent there incorrectly, she then put down a piece of paper and said that they have updated their guidance for maternity blood testing and showed me that they had changed it to reflect that regardless of what gender sounding name it is they should test them, this I was thrilled about knowing that despite the minor mistake they had actually taken action to prevent it happening again.
Unfortunately the NHS Pennine system won’t allow for a pregnant male to be selected, so my midwives and other health professionals involved worked around it in hopes that something would update or change on their systems before it was too late in my pregnancy. At around thirty weeks one of my midwives sadly informed me that I would have to go on the system now because the risk would be that I could turn up at hospital without a computer record. They put me on as female, apologising profusely. I had someone ring me from higher up apologising and saying that only two people would be involved in doing it and that it wouldn’t affect me being marked as male on other systems. It sucked, but I knew that it was coming because change is something that doesn’t happen fast, but hopefully them working with me will be a part of it changing for the future birthing people.
Mostly the pregnancy went well, aside from the sleepless nights and pain from wearing a binder – Still I was constantly worried that I would lose him, I kept checking how young a baby has been born and still survived, it’s typically considered viable after 24 weeks however some babies have been born before then and still survived, the earliest a baby has been born and survived is 21 weeks and 5 days.

Once that milestone had passed, I was relieved, I think the initial shock of being pregnant had just turned into fear of losing him, but as the weeks passed the more his survival rate went up and I became slightly more hopeful.

I’ve always struggled with mental health, I was on Sertraline before I found out I was pregnant and came off it cold turkey despite being told not to because I didn’t want to put anything in my body that might affect my baby. For anybody who doesn’t know, Sertraline is an anti-depressant, because of this I was worried that I might not bond with my baby, that I would have post-natal depression or that I wouldn’t be able to look after him and he would be taken away from me because I’m transgender.
All of this changed on the 30th of September 2019, H was born at 37 weeks. I had told my midwives the whole way through I would have him at 37 weeks because I couldn’t stand the idea of having to be pregnant much longer than I needed to and 37 weeks was the earliest you could go into the birthing centre instead of the labour ward. They would just laugh at me and tell me that he would come when he will come.
In the birthing centre at Royal Oldham there were beautiful fully enclosed rooms filled with lots of different options for birthing, a ball, some rope pulley thing, a bed, a couch and most importantly a birthing pool. At 4 o’clock on Sunday the 29th, I started to feel a weird niggle in my back and side, and I wondered to my family whether it might be labour starting – they all didn’t know because it wasn’t painful at all yet and it seemed to happen so randomly. As usual me and my mum went round to my grandparents’ house for tea and after my cousins had left around 8pm it was just me, my mum and my grandparents sitting around the dining table as I secretly had been timing the very mild cramps that had been happening more frequently.
I told them that they’d happened almost on queue every 20 minutes or so and seemed to be getting stronger, my mum and grandma both told me that it could be Braxton Hicks or it could be labour. When we got home I was in pain so I tried going for a bath because I’d heard it can help, I was only in for about half an hour, I’d messaged my best friend A so that she was aware I could be in labour and her and her mum told me I definitely was and A asked whether she should come up, but I told her that it was probably just Braxton Hicks despite being in that much pain that I couldn’t stay in the bath.
My mum had work in the morning so she told me to wake her up if I was in labour as she didn’t want to be tired for work. I have quite a high pain tolerance so I hadn’t shown any external signs of pain whilst in front of anyone, though when I went upstairs to my bedroom I put on Netflix and I couldn’t help but writhe in pain when a contraction happened so when I realised I was missing all of the episode about 15 minutes in, I went downstairs to sit with my dad.
My dad is not the type of person I would tell that I am in pain, not in a bad way but we just don’t have that kind of relationship and that is okay, when he could see me unwillingly tense up in pain he even said “it must be painful because you don’t normally come down to sit with me when your mums in bed”. By midnight, two hours after the bath, my best friend told me she was coming up whether I wanted her there or not and if it was a false alarm it didn’t matter.
A was amazing, she supported me through the pain and timed contractions for me as we had googled and it said you need to have 4 strong contractions within twenty minutes for it to be active labour. A kept telling me that I need to ring the midwife but I declined and said that I didn’t know if I was actually in labour yet, despite having had four in ten minutes multiple times.
Eventually she told me that if I didn’t ring them then she would, so I said I would ring them. Y, a continuity midwife, answered and told me to try breathing through the contractions instead of tensing up – something I wish I’d have known hours beforehand as this made things much easier. She also told me to ring her back when I’m having ones that come about every 5 minutes and last for 60 seconds. Again I didn’t believe that I was in labour so while I had been having them come every 5 minutes almost precisely and lasting for 60 seconds or longer for an hour I still was reluctant to call the midwife before my best friend pushed me again and said that I need to do it otherwise I might end up having the baby at home. My midwife said that she would come and check me out at home first, I assume because I have a high pain threshold I didn’t sound like I was in labour as far as I was – she arrived around 5 in the morning, Y was kind and asked my permission whether it was okay if she felt my cervix to check how dilated I was and told me that I was already 4cm. She cheerily told me that I was in labour and that I would be having him today.
We rushed to get all of my bags and meet her at the birth centre, when we got there she had already checked us into a room, me, my mum and my best friend were there around 6AM and we asked Y when she thinks the baby would be born and she guessed around midday, I laughed and told her there’s no way I can be in this much pain for that long. She gave me gas and air and my mum ushered me into the birthing pool because she could tell that if I didn’t get in now then I wouldn’t be able to use the steps by how much pain I was in. H’s other dad arrived and my grandma did too, Y said that they were okay to come in for now but that they can’t all stay in with me, but throughout my whole pregnancy I’d said I would be happy if I could have my mum, best friend, my grandma and the other dad in for the birth.
Within ten minutes of them all being in the room with me, H was born.

After only about an hour of having been at the hospital I had him, so my best friend was right to get me to call my midwife when I did and for that I am so thankful for her. When he came out Y caught him and passed him to me and all I could feel was this small fragile weight on my chest, so in shock I blurted out “oh, a child” as if I wasn’t expecting a baby to come out at the end of it. I think partly I didn’t, between my worries of losing him I don’t think I allowed myself enough hope to believe that I would have an actual baby in my arms. Everything was perfect, I was in that much of a haze that the midwives asked me whether I wanted an injection to help the placenta to come away or whether I wanted to birth it and before I’d managed to decide what I wanted it had already passed, but they were both extra patient with me and didn’t try to rush me to decide.
They helped me out of the pool and onto a chair, everybody had a cuddle and everyone except me, my newborn and A were left in the room. I decided I wanted to get up to put some clothes on or something along those lines but as soon as I stood up blood started pouring down my legs, it was like something out of a slasher movie, me and A freaked out and hastily pressed the buzzer for help – turns out that is something that tends to happen but they hadn’t expected me to try and get up so they hadn’t warned me and my mum and grandma weren’t there to tell me that it was normal.
Y my continuity midwife clocked off because her shift had ended and believed I was in safe hands. However when she had left a doctor came in and asked where ‘mum’ was which could have been prevented had there been communication or pronoun stickers, or anything to let that doctor know that I am a trans man – luckily I didn’t hear that and it was A that did and said “Dad’s over here”, it was only after that I knew what had happened, which again I couldn’t be more thankful to my best friend for being my strongest ally. I did get somebody refer to me with she/her pronouns and I didn’t have the energy to correct them because I had been up all night, so I just let it go. This again could have been solved had they been more trans inclusive in their training, which is why it’s so important to have birth workers that aren’t only aware of but are active in their support for transgender parents.
H is two on the 30th of September; it has been a wild journey, but I wouldn’t change anything for the world. I’ve now been back on testosterone for a year and 9 months because I chest fed for 3 months before moving onto formula and now cow’s milk.
Since he was born we’ve found an awesome community of Seahorse parents and allies, it’s astonishing that before I had him I thought that I was weird for being a man whilst also wanting a biological child but the community is wide and support is vast, all of us connected because we’ve done something that no cis man ever has and in that way I feel we’re more man than any of them. (trying a bit of irony because most of the hateful comments I get is that I “could never be a real man” because I’ve birthed)

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