A reader writes: “I’m a trans man who has been on T coming up on two years. I don’t have a sex drive. I got a slight taste of it for two weeks in the beginning, then it went away for a few months, then returned for two weeks again – but then went away again. I can’t understand why I am missing out on this experience!

“This isn’t really the kind of question you expect, but I thought since you no doubt hear from lots of TBoys, maybe you have heard something like this before, and how I might fix it. It’s really, really getting me down.”

Sex drive is an interesting phenomenon, particularly in the trans man community, because you hear so much about it. Both estrogen and testosterone seem to affect it, but there are many other factors, as well.

The problem is that taking testosterone tends to significantly increase sex drive for so many trans guys that those who don’t experience that can feel left out and/or “abnormal.”

The reality is that sex drive varies a great deal in individual people, both men and women, but because it is so highly valued for men in so many cultures, we rarely hear from the men – trans or non-trans – who do not have a strong sex drive. And if we do hear from them, they are often misrepresenting their sex drive in an attempt to fit in, be “manly,” or be “normal,” so we are not aware of their numbers.

In the United States, and in many other countries and cultures as well, a strong sex drive is considered a “masculine” attribute and is prized and rewarded almost everywhere, from college fraternities to Congress. Men with strong sex drives are praised, while, even today, a strong sex drive in women is frequently discouraged.

I don’t know who society thinks these men are supposed to have sex with, because we certainly don’t want them having it with other men, but nevertheless, the paradox continues, the expectations continue, and even men who aren’t all that interested in having sex with anyone are not going to admit it for fear of social repercussions.

Even surveys are misleading. Both men and women have a tendency to over-report or under-report sex drive and sexual activity depending on the purpose of the survey and who’s administering it. Self-reporting can be highly inaccurate. And casual conversation is even more inaccurate, so we often misjudge the “fun” that everyone else is having when compared to our own.

So a low or even nonexistent sex drive is not, in and of itself, a problem. It becomes a problem when it is making you unhappy and when you see it as a problem – and, in this case, you do. So let’s look at a few things that might contribute to a lower-than-you-want sex drive:

> Low testosterone levels. In non-trans men (and women), lower testosterone levels can contribute to a lower sex drive. You might want to check with your doctor and have your levels measured. If you are comfortable talking to your doc about sex drive in particular, ask him or her about this and whether or not you can increase your dose and if that might make a difference.

> Other physical problems. Again, if you’re comfortable talking to your doc about this situation, he or she might be able to look for other possible physical or health problems that could be contributing to a lack of interest in sex.

> Body image. Do you feel sexually attractive? Do you feel okay with your body or are you uncomfortable about it? A discomfort with your body can cause disinterest in sex if you don’t want others to see it or touch it, and if you don’t want to see it or touch it yourself. Working with a therapist might help alleviate this.

> Other psychological issues. Is there anything in your history that might cause you to have a disinterest in sex, such as a bad sexual experience, child sexual abuse, or rape? Sexual desire can be influenced by the mind as much as by the body. We tend to think of sex drive as a biological function that simply occurs naturally in people, but it can be heavily influenced by psychological factors. Again, working with a therapist might help alleviate this.

> Religion or other family or cultural expectations. If you belong to a religion that discourages sexual enjoyment, or if you were raised in a family or in a culture that frowns on sexual enjoyment, that could hamper your interest in sex without you even realizing it. Also, if you were socialized as a female and discouraged from being interested in sex or acting on your sexual desires, that socialization could be affecting your ability to enjoy your sexual feelings now, and therapy might be able to help with this.

If your testosterone levels are fine, your physical health is fine, and you have no other issues that might be preventing you from acknowledging your sexual desire, then you could just be one of those people who does not have a strong sex drive. Being horny all the time isn’t everything it’s cracked up to be, and that initial teenaged horniness that often comes from taking testosterone generally goes away with time, anyway.

You are two years out with your testosterone. Even if your sex drive had gone through the roof when you started, it would have calmed down by now. It might still be at a higher level than you had experienced it as a female, but it would not be at that fever pitch that can accompany a “second puberty.” It can be fun while it lasts, but it can also be uncomfortable and anxiety-producing.

The most important thing is that you enjoy sex, if that is important to you (there are people for whom that is not important, and that’s okay, too). You might not want to have it as frequently as some people do, but when you do have it (alone or with someone else), do you like it? If you don’t like it, but you want to like it, that might be another thing to discuss with your doctor or therapist. If you don’t care, then it doesn’t matter.

The vast majority of people on earth – men and women, trans and non-trans – spend the vast majority of their time not having sex. So don’t let a low sex drive discourage you from enjoying all the other aspects of your life.

And don’t be intimidated by the tales of others. Remember, those who believe that they are experiencing what they “should” be or what is expected of them tend to talk about it more than those who don’t. And those who are not experiencing what they think they “should” might misrepresent their feelings in order to be one of the crowd. This goes for both trans and non-trans people. You are probably not missing out on nearly as much as it seems.

Readers, what do you think? Suggestions?

A reader writes: “I wonder how people feel about going through their second adolescence at a later stage in life than folks do naturally? I remember hearing a guy at an FTM meeting saying he did not wish to go through it in his thirties. I went through it (am still going through it?) in my fifties, and found it quite brilliant.

“Just the other day I was thinking how great it was to be going through adolescence and being able to do all those things that we would not have been allowed to do (legally or by parents) in our original adolescence. And the thought of traveling to an adulthood in our desired form is awesome.”

I also liked my second puberty and adolescence at the age of forty-two. I don’t know if there is a correlation between the age of transition and the enjoyment or non-enjoyment of a revisited (and revised) puberty, but maybe we’ll find out in the Comments section.

It could be that the older we are, the more fun it is to get a “second chance” at youth and do all the things that we wanted to do, but couldn’t, because of the prohibitive gender expectations that we were saddled with.

Because gender roles in general are becoming increasingly fluid, it’s possible that some younger people didn’t feel so confined by expectations, so they don’t feel as strong a need to experience adolescence in their correct gender. Also, maybe they remember their first adolescence better, since they have just recently lived it, and they don’t really want to go through another one so soon.

Of course, not everyone who transitions goes through a second adolescence, but I have heard enough people – both trans men and trans women – talk about it that I think it is a pretty common experience. The introduction of hormones (either testosterone or estrogen) in such major doses basically results in a second puberty for most people, and it can be exciting or aggravating. That, combined with the opportunity to finally live as you were intended to live, can bring on some of the good and bad stuff that adolescence is known for.

It can cause us to act a little goofy sometimes – to say and do some things that society thinks should be reserved for the young, or to wear clothing and hairstyles that some people might think are “too young” for us, or to display youthful attitudes and behaviors that are unexpected for someone our age.

But these were the things that we were supposed to say and do, and the clothing and hairstyles that we were supposed to wear, and the attitudes and behaviors that we were supposed to have when we were going through our first adolescence. It’s just that we never got a chance, because it was the wrong adolescence. When we finally have a shot at the right one, I say we should go for it. It passes soon enough.

And non-trans people go through a second adolescence, too – it’s called a midlife crisis.

A couple of years ago, I wrote the post “Testosterone and Sex Drive: My Second Adolescence.” And when I was forty-three (was I ever really forty-three?), I wrote the following little musing called “Testosterone: the Promise and the Reality”:

I have the appetite of a 14-year-old boy and the metabolism of a 43-year-old man.

I have the libido of a 14-year-old boy and the dance card of a 43-year-old man.

I have the zest for life of a 14-year-old boy and the energy of a 43-year-old man.

I have the curiosity of a 14-year-old boy and the cynicism of a 43-year-old man.

I have the face of a 14-year-old boy and the body of a 43-year-old man.

I have the desire for junk food of a 14-year-old boy and the cholesterol level of a 43-year-old man.

I have the need for cool possessions of a 14-year-old boy and the credit card debt of a 43-year-old man.

I have the desire for freedom of a 14-year-old boy and the responsibilities of a 43-year-old man.

I have a 14-year-old boy’s feeling that my whole life is ahead of me and a 43-year-old man’s knowledge that more than half my life is behind me.

I have the dreams of a 14-year-old boy and the realities of a 43-year-old man.

And, boy, do I LOVE my life, man!

That’s how I felt then, and there are times, even fourteen years later, that I still feel that way.

What do readers say? How did you or do you feel about going through a second puberty and adolescence brought on by hormones and transition? Thumbs up or thumbs down?

A reader writes: “My son is eighteen turning nineteen, and he just started using testosterone. He wants to look like his dad. I don’t approve of it because I’m scared that it may harm him, but his dad said he will be fine. Should I be concerned or am I just being a worried mom?”

First of all, there’s nothing wrong with being a worried mom. The use of hormones carries risks, and being knowledgeable about those risks helps to prevent possible complications. I’m not a doctor, and nothing I say should be taken as medical advice, so I would strongly advise anyone who is using hormones for any reason to be under a doctor’s supervision. They are powerful stuff, and they need to be monitored and regulated, because they can work magic or wreak havoc on the body.

My concern is that I don’t have a lot of information here. I have read your letter (which is printed here in its entirety) several times, and I have not been able to determine if your son is a non-trans young man who is producing sufficient amounts of testosterone on his own, but simply wants more, or if he is a trans young man going through a female-to-male transition. Either way, I would advise medical oversight.

For a non-trans young man who has his own properly functioning testosterone-producing gonads, the introduction of additional testosterone can be problematic. I don’t know if his dad is very muscular or hairy and he thinks that additional testosterone will help him achieve that appearance or what his reasoning might be, but his reasoning could be way off base.

Just like with trans men, he is genetically programmed to be a certain way, and that’s what his testosterone will act on. If he doesn’t have his dad’s genetics, no amount of additional testosterone will make him look like his dad, although it is possible that it could help him increase muscle mass when combined with weight-bearing exercise. But it could also produce side effects that he doesn’t want to have.

Some possible side effects of testosterone therapy in non-trans men include increased acne, enlarged prostate, decreased testicle size, decreased sperm production and possible sterility, breast enlargement, increased red blood cell count, and liver damage. Bodybuilders and other athletes who use steroids are very familiar with these concerns.

When testosterone is introduced from the outside, the testicles might stop producing it on their own, which can then shut down sperm production. Also, too much testosterone in the body can cause the body to convert the excess to estrogen, which can then exacerbate “female” characteristics, such as enlarged breasts. If he is a healthy young man, I’m not aware of a reason for him to take additional testosterone unless his levels are too low – something only a doctor can determine.

If, in fact, your son is a trans man transitioning from female to male, testosterone therapy is part of that transition for many men, and it is natural for your son to want to take it. It will cause the masculinization that he desires. Yes, it does have side effects, most of which depend on his genetics.

Possible side effects include increased acne, male pattern baldness, increased sex drive, increased cholesterol count, high blood pressure, and increased red blood cell count, which can lead to increased risk for heart attack and stroke. Because testosterone is processed in the liver, liver damage can also result.

However, under a doctor’s supervision, all possible health concerns are monitored. Cholesterol, blood pressure, red blood cell count, and liver function are tested as frequently as the doctor feels is necessary. Most trans people who use hormones in their transition feel that the necessity of taking hormones outweighs the possible risks.

If your son is transitioning, I would recommend reading my FAQ on testosterone, as well as the information about testosterone on Hudson’s FTM Resource Guide. But whether he is transitioning or not, I would recommend consulting a doctor.

The possible risks that I have listed above are just that – risks. They do not happen to everyone, and when they do happen, they can manifest in various combinations and at various levels of concern. Whether or not your son will have problems from the use of testosterone, and what those problems might be, is something only a medical professional can tell you. Good luck!

Readers – thoughts?

A reader writes: “A few weeks ago I was at a trans advocacy meeting, and the guy who was currently moderating mentioned that he’d not really had trans identity on his radar until three years ago. That short amount of time struck me for some reason.

“I’ve been out for eight years, and aware that I was trans for at least fourteen years. It’s a long time for me, being in my early 20s, and it’s going to continue to be a long time as I age and reach the point of being post-transition longer than I was pre-transition.

“Also for me as a young adult, I find that this older narrative of ‘always knowing’ or having a difficult and long transition is fading away among my peers. Every stage of transition was so emotional for me, whereas more and more, some of my friends have been pretty casual about the huge steps they’re taking. I also frequently meet people who realize they are trans and transition quickly, within a year or a two.

“Sometimes it’s hard to relate to other activists, and sometimes I even feel like I’ve been in the work longer and should have some sort of respect for that that I don’t often get as I move out of leadership in college activism and into the ‘real world.’

“So my question is, how does one address for him/herself having a more normative transition experience and/or being post-transition for a long time when working in trans advocacy or just relating to other trans folks? How does one address it given the direction that trans advocacy is turning with these newer narratives?”

This is a question that I get frequently in different forms, and it seems to be an ongoing issue in various trans communities. I see the experience that you write about as a form of the “old and new gender police” dichotomy, and it tends to happen when those of “traditional,” “normative,” or “textbook” trans experience and those of “non-traditional” experience work together (and often butt heads) in activism.

I would like to say a few things about this experience (are you surprised?) before I answer your question, because I see this “old school/new school” dichotomy causing hurt feelings, mistrust, and divisiveness across activist communities. What follows are some of my observations about this phenomenon:

> Age figures into it, but I don’t think age is the primary factor. The generation gap will probably always divide activists in every movement, with older activists feeling unappreciated for the risks they took and the inroads they made that provided the young with the freedom to vocally criticize them, and younger activists feeling dismissed as they struggle to change a world in which they, but not the elders, will have to live. As the younger activists age, the cycle starts again.

> While age plays its part, I think that the driving force behind this phenomenon in the trans community is the “trans experience” itself, as your letter demonstrates. There is no generation gap between you and the other activists you speak of, but there is an “experience” gap, in that you had what could be considered a “normative” – or what I call a “textbook” – trans experience, while others didn’t.

You knew from a very young age that your gender identity and physical body did not align. This probably caused extreme discomfort, possibly body dysphoria, and a range of emotional issues that you have struggled with all your life. This is the experience that is discussed in clinical and diagnostic manuals and textbooks, and this is the experience that has historically resulted in the need for medical transition.

While it might seem as if you are alone with this situation and that “modern times” has altered or even eliminated this scenario, it still exists. It will always exist. It’s just that those who are struggling with this situation are not entering the activist community in great numbers.

They are not out. Their goal is to transition and assimilate, so you don’t see them as frequently in activist work, but they are there. Those who have had a more “non-traditional” experience sometimes (but not always) tend to be more fluid in their thoughts about gender and gender expression, more open and out about their experience, and more drawn to public activism.

These two groups (and there are more than these two, but these two come to mind) tend to clash sometimes, and what happens is a scenario very similar to the generation gap, where we see the more traditional trans people who have taken risks and carved inroads feeling unappreciated and disregarded, and the more non-traditional trans people feeling that they are not taken seriously or are dismissed by the “elders,” who are elders not in age, but in experience.

> The Internet, I believe, has had a huge influence on this situation, because it has made information so readily available. When I was struggling with gender stuff in late childhood (and here is a plug for Teeny Weenies, where you can read all about it), we didn’t have the Internet. We didn’t have LGBT centers or groups at school. We had the school library and the Dewey Decimal System (try to find anything that way). The Internet has allowed those of “traditional” trans experience to get the information they need to identify their “problem” and to find solutions.

The Internet has also allowed a variety of communities to form, communicate, and maintain themselves. Those of “non-traditional” experience have been able to connect and establish themselves in the trans-activist movement. The Internet has broken down some barriers, because in the past, those of “non-traditional” experience would not have been able to find each other or identify their situation, and they would certainly not have been able to meet the stringent early requirements for transition, which might have given them a community, even if they had wanted to do so.

So while the Internet has been a true boon to our community, it has also allowed factions to establish themselves, which has resulted in some alienation and bad feelings between certain groups.

Now that I am (finally) finished with my introductory material, let’s get to your question:

How does one address for him/herself having a more normative transition experience and/or being post-transition for a long time when working in trans advocacy or just relating to other trans folks? How does one address it, given the direction that trans advocacy is turning with these newer narratives?

I think it’s easy to get discouraged, and when that happens, it’s easy to walk away, when what is really needed is a dialogue. The community is so large and so diverse that we will never have one representative or spokesperson, one agenda, or one activist methodology that everyone will get behind and support.

But I think that there are certain common goals that most of us would like to see achieved – freedom from discrimination in employment, housing, public accommodations, and all other areas; appropriate and necessary medical treatment recognized by providers and insurers; and safety, particularly an end to the violence that is perpetrated overwhelmingly on trans women, and specifically trans women of color. I’m sure there are other goals as well.

There are a lot of things that intersect with these goals, such as race, class, sex, and gender, so these goals cannot be achieved for “trans people” in a vacuum, without consideration of other variables. But if we can identify what is most pressing for the gender-diverse community as a whole, then we can see the value of the experience that each person brings to the table, and we can leverage that experience where it is most needed.

There will always be people of “normative” trans experience. They are being born as we speak. So there will always be a need for others of similar experience to be visible in the activist community. The “new narratives” will continue, but they will not be representative of everyone, because no narrative is representative of everyone. We need all the voices that we have, and having them but not utilizing them is a waste that we simply can’t afford.

If we as a community are unable to value the experience that each person brings to the table, then each person must value his or her own experience. If we are unable to leverage that experience where it is most needed, then each person must find for him- or herself where that experience is needed and move into that realm. If we are not wanted in one place, we will be welcomed in another. If one group can’t relate to our experience, another group will.

So I think the most important thing to do is to identify for yourself the value of your own experience and your own narrative. Realize and acknowledge what you have to offer, then find the activist niche that suits you best. If you change things for one person, you have changed the future, had an impact, made a difference.

Don’t let any narrative, old or new, discourage you from recognizing what you have to offer and running with it, in whatever direction it takes you. You will end up where you belong.

Readers?

A reader writes: “I have three questions: How much did chest surgery help with dysphoria (if you had any)? How did you pay for it? Who was your surgeon?”

This is short and sweet, but it lends itself to a lot of reader input. I think it would be valuable for readers to find out who people have used as surgeons, not just for FTM chest surgery, but for other types of procedures as well, for both FTM and MTF transition. So I would invite those of you reading this to share information about your surgeon(s), if you so desire, and about how surgery relieved any dysphoria, or what effects it had for you.

My chest surgeon was Dr. Michael Brownstein in San Francisco. At the time (this was in 1998), I believe I paid about $6,000 total for surgery, hospital, anesthesia, and so on, and I was very lucky and very privileged to have a credit card company that advanced me the money at a low interest rate for “medical procedures.”

Most surgeons do not take credit cards, that I am aware of, and getting the money together is difficult for many guys. It would actually be far more difficult for me to get access to that kind of money today than it was fourteen years ago. If I had to pay for it today, I don’t know how I would.

I can’t say that having chest surgery helped with dysphoria, but that’s because I don’t know that I had extreme body dysphoria to begin with. My gender stuff manifested differently from a lot of people’s. What chest surgery did for me is to reinforce a perception that I had of myself as a guy; allow others to perceive me as a guy (because, at that time, people were looking at my chest to try to determine my sex), which then further reinforced my own perception of myself; and provide the feeling of finalization, even though I didn’t know at the time whether or not I would have more surgery.

If I had to put an “end” on my transition (because many people think that there is some “done” point, like barbecuing a chicken), it would be my chest surgery. I could wear a T-shirt by itself instead of layering some other shirt over it, I could take off my shirt if I wanted to (I didn’t want to, but I could), and I didn’t have to worry about binding or wearing a tight sports bra, which was not only uncomfortable, but which made me have to think about what was really there.

So for me, it was a form of physical validation for what I felt inside, and it was a type of “end point” to a transitional stage in my life that, at the time, I just wanted to get through. It was like nearing the end of a marathon – I don’t care if I win, I just want to finish. And I did. That’s what chest surgery was for me.

I think that if you are experiencing body dysphoria, chest surgery would certainly help with that. As I mentioned in a recent post, your perception of yourself could interfere with accepting the reality of what other people see – it’s quite possible that you could look in the mirror and see “female,” even though no one else does. But the good thing is that you won’t look in the mirror and see “breasts.”

However, if you are having serious reservations about having chest surgery, you might want to wait. There is no hurry, and you are not on anyone else’s timeline. If you have no reservations, but simply can’t afford chest surgery right now, you will have to accept the fact that this is the body you have for the time being. You don’t have to like it. You just have to acknowledge that that’s the way it is and find other ways to deal with the situation until it can be resolved.

If you have no real reservations and you have the money, I would say that you would likely find chest surgery a help for the dysphoria that can accompany gender issues. There are no guarantees, but I have never regretted it, and I found it extremely beneficial for body/identity integration. However, I can’t say for sure what will be helpful or work for you.

Readers? What has been your experience?

A reader writes: “I’m an author who wishes to include a trans person in her fictional writings. I fear I know little to nothing about trans people as a whole, however.

“And while I believe trans people should be treated as people, I also don’t want to write a woman as cis and then claim later that she was actually trans.  I’d like to portray this character and what she might be going through in a way that doesn’t insult or demean her as a trans woman.

“When mentioning her and her struggles, is a brief mention of her being born male but saying that she is in fact female enough? Do I need to elaborate or is that enough to make it clear she’s trans? Should I actually have her claim to be trans or is it all right for her to say she is simply a woman?

“People are different, even when they share things in common.  So while I think either approach would be fine, I want to make sure that I’m not portraying trans women in a negative light or reinforcing stereotypes. Any information you can give me would be wonderful. Any books or Internet sources you can offer would be appreciated as well.”

As a writer, I find this a very interesting topic, because there are really a couple of “sides” to this issue. One “side” is that there are not enough authentic trans characters portrayed in fiction – books, movies, plays, and so on – and when trans characters do appear, they are usually there to induce pity or for shock value, titillation, or comic relief. Therefore, any time that a trans character is presented realistically and honestly in fiction, it will likely be to our benefit.

The other “side” is whether or not a non-trans person should be writing about trans experiences at all, even in fiction. The “write what you know” ethos has been around for a long time in author circles, and it is there for a reason. If we get too far out of our element, we can write ourselves into trouble. However, if everyone stuck to the “write what you know” philosophy, we would have no science fiction, no experimental fiction, no horror genre, no historical fiction, and the majority of romance novels (and erotica) would never materialize.

There are people who will say that a non-trans person should absolutely not be writing trans characters, but I believe it can be done – in fact, I know it can be done, because one of my all-time favorite authors, Suzan-Lori Parks, wrote a trans-masculine character in her book Getting Mother’s Body. It was fantastic to be reading that book and discover this trans character who I didn’t know was in there when I bought the book. The character was very well written and necessary to the story, and there was no hint of sensationalism or exploitation. But then, Parks won the Pulitzer (for Topdog/Underdog) for a reason.

I also liked the Anna Madrigal character in Armistad Maupin‘s Tales of the City series, but I am not a trans woman, so I don’t know how trans women perceived that character. I was also just beginning my transition when I read that series, and I haven’t read it since, so I don’t know how I would feel about the character now.

I have mixed feelings about whether or not you should have a trans character in your fiction, particularly because you say that you don’t know anything about trans people. But that’s not the question you asked, so I’m going to answer the question you asked, but I’m first going to ask you an important question that I want you to consider: Why do you want a trans character in your fiction?

I don’t mean this in a snotty way at all. It’s a serious question, and the reason that I want you to consider it is because you need to know your motivation for adding this character. There are some right reasons and some wrong reasons for a non-trans writer to write specifically trans characters.

Right reasons might include a desire to have diverse characters in your story that reflect the real world; to counter the stereotypes of trans people that exist in most other venues; and, first and foremost, because your storyline requires a character to be trans.

Wrong reasons might include the notion that trans people are the hot new item and having a trans character will make the book more marketable; that a trans character will induce pity or provide shock value, titillation, or comic relief; and because the storyline isn’t strong enough to work without a “gimmick.”

So really consider that question before you move forward with any suggestions that I am about to give in response to the question you asked, which is how to portray this trans character. The answer to your question depends on what you want from this character.

You mentioned her “struggles,” but I don’t know if her struggles are related to being trans or not. If her struggles are related to being trans, then her transness is a very important part of her character, and as you write about her struggles, the fact that she is trans will be apparent. If her struggles are not related to her transness, then why mention that she is trans at all? But if you don’t, of course, then you don’t have a trans character.

You asked whether or not she should claim to be trans, but that depends on who she is as a character. There are many women who have transitioned or had corrective procedures at some time in their life who do not identify as trans. There are many others who do. So whether she does or not is entirely dependent on her – who she is, what she wants, and what her role is in the story. Is she the type of person who would say she was trans? Only you know that, because you are creating the character.

And this brings us back to why she is there in the first place. That’s what you have to figure out. And if you already know that, then what I would suggest to you is that you do not do research on how to write her. What I would suggest is that you find out about trans women, and trans people, in general, because it worries me that you say that you don’t know anything about us.

If that’s the case, you are at high risk of misrepresenting a trans woman’s possible experience, and you are at high risk of insulting or demeaning your character and, by default, your trans readers, and this is what you say that you do not want to do.

I would suggest that you read as many memoirs as you can get your hands on – and any other books you can find – that were written by trans women. You can probably find many of them on amazon.com just by doing a search for “transgender” and “transsexual” in the Books category. I would also recommend reading books and blogs written by various trans people about trans issues in general.

Then I would suggest that you contact a local gender center or LGBT center and ask if there are any trans groups that are open to non-trans people. Then go to the meeting, let them know why you are there (you don’t have to, but I think it’s the ethical thing to do), and ask if there are any trans women who would be willing to meet with you and talk to you about their experiences. Maybe there are some women readers of this blog who would be willing to communicate with you. If so, they can let you know in the comments section.

Then go to some events, do some volunteer work, hang around and get to know some trans people – both men and women. Find out their hobbies and interests, let them know yours, and make some new friends. Spend some time in the community and find out about the various struggles and triumphs – both those that are related to being trans and those that are not – as well as the everyday, boring experiences.

Once you feel as if you have the information you need to portray your character authentically, you still need a “reader” – at least one person who is willing to read your book or short story when it’s finished, and even during various drafts, to give you feedback on your character.

Only when you do all this will you be ready to write this character and present her to the world. If you do not do this, you will wind up doing exactly what you don’t want to do, which is to present trans women in a negative light and reinforce stereotypes. I wish you the best of luck.

Readers, you’re on.

A reader writes: “I’m twenty-seven, but only a couple of years ago realized that I have to do something about my gender dysphoria, otherwise I’ll get too depressed and only feel more and more like I’m a guest in this body of mine. The problem is that I’m a perfectionist – too much a perfectionist.

“All my life I’ve gone to bed at night wishing and praying I could wake up and my body would be that of a boy/man, but I’ve nevertheless been reluctant to start transitioning because I’m afraid it’s not going to be ‘good enough.’ I basically want to look like a cis man, not like a trans man. I don’t want people to ever take me for a woman, I don’t want people commenting on that I have a rather feminine body for a man or anything like that.

“The worst part is that in its essence, my body is very feminine. I’ve done all I can to make it less so, but my bone structure is just so feminine – wide hips, narrow shoulders, narrow wrists, small hands, and all that stuff.

“Do you think that testosterone could ever make a person like me truly look like a man? I know that nothing conclusive can be said about the effect of testosterone, and that everybody’s different and reacts differently, but in you personal opinion, do you think it’s realistic? How much can testosterone do? How much can it alter a body? Does it have any effect on permanent things like bone structure? Will it alter my face?”

First of all, you’re absolutely right that testosterone affects everyone differently, so there’s no telling what it will do for you, how long it will take, and so on. However, in my fifteen years in this community, I have met hundreds, probably thousands, of guys, and I have not met anyone who has been on testosterone for more than two years and does not look “fully male,” as our culture perceives this concept. Usually, it takes much less time than that.

Genetics will obviously make a difference with regard to how much facial and body hair you can grow. It also makes a difference with regard to how much hair you will lose (on your head), but balding is a very “masculine” thing, so if it happens, it will certainly mark you as male.

The absence of breasts is also an important marker of “male” in our culture, and if people are uncertain as to your sex, they will often check out your chest and make their determination from what they see or don’t see there – at least that’s what happened to me in the beginning of my transition, when service staff didn’t know whether to use “ma’am” or “sir.” Testosterone will not make your breasts go away – you will need surgery for that. In the meantime, you can bind.

Your face will masculinize. Your skin thickens, and you lose that softness and roundness that is characteristic of women’s faces. I have seen some guys’ faces become more angular or wider, but regardless, the face takes on a more masculine appearance.

So in answer to your question, yes, I think testosterone can and will make you truly look like a man. However, you will look like a man with wide hips, narrow shoulders, narrow wrists, small hands, and all that stuff. Testosterone will not change your bone structure. But there are things that you can do to mitigate that, and there are things that will happen as a result of testosterone that will mitigate that.

First of all, you will always have a wide pelvic structure. That won’t change. But testosterone redistributes muscle and body fat, so you will have some body fat “shift” to your stomach area, which can give you a “beer gut” if you’re not careful, and can also increase your risk of heart disease. So although the “beer gut” is “masculine,” it’s not healthy. You want to try to keep that in check.

Testosterone will, in most cases, increase muscle mass in your upper body, but if you want a muscular physique, you will need to help it along by working out with weights. You can take advantage of that increase in muscle mass by doing shoulder and chest exercises to enlarge and shape these muscles (deltoids and pectorals), which will then lessen the appearance of wide hips. The bigger your upper body looks, the smaller your lower body will look.

Bones fuse in adolescence, although some guys swear that they grow taller or that their hands and feet grow bigger. The likelihood of this happening is slim, although it’s possible that increased muscle mass or some growth of connective tissue can make hands and feet appear slightly larger or wider. If you are short to begin with, you will remain short. If you are a small or petite person, you will remain so.

However, there are many small non-trans men as well. I am 5’7″ tall, and I am actually taller than many (probably most) of my non-trans male friends. I was taller than my former husband and a few of my former boyfriends. I also know a bunch of non-trans guys with big butts and wide hips. I know some with small hands. I know some who can’t grow a decent beard to save their life. I have mistaken trans guys for non-trans guys and vice versa.

The bottom line is that testosterone is so strong that, unless you have some biological reason why it will not interact properly with your physiology, you will look like a guy and you will never be mistaken for a woman – it will just be a matter of time.

One thing that we do have going for us is our invisibility as a group. This “invisibility effect” is lessening as more trans men become visible in the media, but it is still there to a large extent. The “invisibility effect” is basically that people don’t know about us. They don’t think about us. When they hear the word “transsexual,” or even “transgender,” they think about trans women.

Your average member of the public does not look at a guy with wide hips or small hands and think, “Hmmm. I wonder if he’s trans.” It just doesn’t occur to people, because we don’t occur to people. For assimilation purposes, this is a positive thing. For medical care, services, equal rights, and other considerations, it can be negative.

The other thing that you have to think about is confidence in yourself, your appearance, and your manhood. The (almost always groundless) fear of being perceived as female can cause you to act differently, to shy away from public situations, and to avoid interaction with other people.

Some non-trans men are shy and reclusive. Many lack confidence. But quite a few learn to fake it, because this is what is expected of men in our culture – assertiveness, forwardness, eye contact, firm voice, firm handshake, and so on. You can learn to fake it as well if you don’t feel it.

Very few people will base their perception of you on your body, but they will base it on your body language – the way you carry yourself, your attitude, the confidence you exude, and the “masculinity” you exude.

You do not have to be “traditionally masculine” if this is not you, but you do have to be comfortable with who you are. Your comfort level with yourself, more than anything else, will be the thing that people will notice about you, and any discomfort with yourself will not cause them to think, “That guy must be trans,” but it will cause them to think, “I wonder what’s wrong with that guy,” and that’s when they might start to look deeper – if they even care.

The reality is that most people don’t care, and most people will not take the time to examine you closely, if at all. Their first impression of you will be as male, and that is the impression that they will keep. As trans people, we might be extra aware of people’s appearance and presentation as it relates to sex and gender. Most non-trans people are not. They unconsciously categorize you into one of two sexes and genders, and that’s what they go with.

I know a guy who has been transitioned for more than a decade, and there is no way that anyone sees him as trans or as female, but he believes that people do. This is a self-perception only. It’s possible that when you look in the mirror, you will see your female past and that this will be difficult to shake. You have to realize that you are the only one seeing it. It’s hard to convince yourself of this, but it truly is the case. You might never look like a non-trans man to yourself – but that’s all.

Obviously, I can’t make any guarantees. But I would be very surprised if, two years down the road (and probably sooner), anyone mistakes you for female or sees you as trans. Readers might have different thoughts, so I hope that we hear them.

Readers, you have the floor.

If you’re worried that you’re transphobic, the bad news is that you very well might be. The good news is that self-awareness is more important than a minor case of transphobia, because if you are aware of it, then you can prevent yourself from acting on it – and in addition to some self-regulation, your awareness can help you attempt to make changes.

There are plenty of phobias and isms out there, and most people probably harbor one or more of them. I would guess that almost all of us can take some category of people, stick “phobic” or “ist” after that category name, and claim that label in one way or another. The problem is not so much being able to do that – the problem is not being able to do that.

If we are unaware of our own internalized biases, then there is nothing to prevent us from acting on them. There is no inner control mechanism that stops us before we say or do something offensive, damaging, or dangerous, because we are not aware that we might. There is nothing that prevents us from allowing these biases to continue, within ourselves and within our society.

If you are worried that you are transphobic, then you have already established trans people as a group that is “different from” yourself in a way that is at least a little negative, which is where the “phobia” part comes in. But you have also established trans people as a group that you have the potential to harm by your words or behaviors, and that is where the benefit of self-awareness comes in – because now that you realize it, you are capable of stopping it.

Being worried about the possibility that you are transphobic puts you one step ahead of those who know that they are transphobic and aren’t worried about it one bit, and those who aren’t worried about being transphobic because they don’t know that they are. If you’re worried about it, you are in a prime position to look inward and make some adjustments.

This does not mean that we should simply accept our phobias and isms. No one can sit back and say, “Well, at least I’m aware of it, so that makes it okay.” Self-awareness is only the first step in a long journey of work to be done. But if you can’t take that first step, you can forget about the rest of the trip.

So instead of being worried about the possibility that you are transphobic or that you might say or do something that will mark you as transphobic, harness the energy from that worry and use it to do some self-examination and self-reflection. If you discover any anti-trans feelings, try to identify where those are coming from and what you might be able to do to alter them.

Denial of our biases is actually far more destructive than acknowledging them, because if we deny them, we never do the work to eliminate them. It’s better to face even minor biases head on and say, “I have this, but I don’t want it. Where did it originate, what can I do to change it, and how can I make sure that it doesn’t negatively influence my behaviors or harm others?”

The Implicit Association Tests (IAT) through Project Implicit are a great way to ferret out hidden biases. Although none of these demo tests deals with trans people, there are a variety of tests designed to help you discover unconscious biases. While some people have questioned the reliability of these tests, they have been used for years by researchers and individuals to examine possible biases. They are easy and actually fun to take, and since they have one for sexual orientation, I hope that trans will not be far behind.

Just remember – whether or not you like the results of your IATs or what you discover from your internal soul-searching, being aware of a bias is the first step in working to change it and making sure that your words and behaviors are not injurious. Being worried about it is a good sign – as long as you are willing to move beyond that and into positive action.

Readers, what do you think?

A reader writes: “What do you think the pros and cons are on removal of ovaries and uterus? I had issues with cysts on my ovaries prior to T two years ago. Last Friday, it felt like I had a cyst rupture. So off to the doc for a PAP and an ultrasound to have a look. My uterus and ovaries are very atrophied, so I am no longer producing estrogen.

“I am waiting on the results of the ultrasound and PAP on Monday. If everything comes back negative, what are the pros and cons of removing them? My doc isn’t the most knowledgeable in the transgender department, so I am looking to see what I should be asking the doc.”

Hysterectomy (removal of the uterus) and oophorectomy (removal of the ovaries) is a surgery that many trans men pursue during transition, for a variety of reasons. The uterus can be removed without removing the ovaries, but for most trans guys who are having this done, the whole shebang is preferable, if they can afford it or if insurance will pay for it.

There are several different ways that this surgery can be done, some more invasive than others. How it is done will depend upon your particular condition (if there is a medical condition associated with the surgery, such as fibroids or cysts), your physical health, and other factors that your surgeon will discuss with you. There is some good information about the various ways that this surgery can be done on Hudson’s FTM Resource Guide.

I started transition in 1997, and I have yet to have this procedure done, primarily due to cost. A few years into my transition, my doctor at the time found what he thought was a cyst on one of my ovaries. I had an ultrasound, and it came back negative. He said, “Good news! You don’t have a cyst!” I thought, “Bad news. I was hoping my insurance would pay for a hysto.”

I know quite a few guys who have had a hysto/oopho, and so far, I have not heard any complaints. However, there are things to consider, so, keeping in mind that I am not a doctor and nothing I say should be construed as medical advice or taken as a substitute for medical advice, here are what I consider to be the pros and cons of this procedure. Medical professionals and guys who have actually had this done can probably weigh in with more details.

Pros

> For most guys, having this procedure is important from a psychological standpoint. A uterus and ovaries, although not visible, represent femaleness, and just knowing that they are there can cause some emotional distress. In addition, as long as they are there, gynecological exams are necessary to maintain good health.

This can be a painful reminder of a person’s history before transition, plus it’s just not a fun exam. I don’t know any woman who enjoys feet-in-the-stirrups action, let alone any man. Plus there’s that whole sitting-in-the-gynecologist’s-waiting-room thing. You can only pretend for so long to be waiting for your wife to come out before they finally call your name.

> Although there are no real statistics on this, some in the medical field believe that testosterone can put a person at higher risk for various types of cancer, including uterine and ovarian cancer. Most trans people are familiar with Robert Eads, the subject of the documentary Southern Comfort, who died of ovarian cancer after more than twenty doctors refused to treat him. It’s possible that he would have gotten ovarian cancer had he not transitioned. There’s no way to know. But many guys want this procedure as a preventative measure, and that is not a bad reason.

> For younger guys who are starting testosterone and whose ovaries are still producing a lot of estrogen, the procedure can eliminate that estrogen and possibly create a T-friendlier environment. When I started T, my period stopped with the first shot and I haven’t had one since, and testosterone basically overpowers estrogen almost immediately. However, for the first couple of years, I had high levels of both. My ovaries were not going to go quietly. In addition, as Hudson’s FTM Resource Guide says, you might be able to lower your level of T when there is no estrogen present to do battle with.

Cons

> Hysto/oopho is a major surgery. There are some methods that are not as invasive, but not everyone can utilize these methods. It simply depends on your situation. For the most invasive methods, recovery time can be substantial and there will likely be visible scarring. And, as with any surgery, there are risks – bleeding, infections, reactions to anesthesia, and so on. If you don’t do well with surgery, or if you would rather not take these risks, then the negatives can outweigh the positives.

> This type of surgery can run $6,000 and up. Insurance will sometimes cover these costs if there is documented evidence of a problem, such as fibroids, cysts, abnormal bleeding, or debilitating cramping, but most insurance policies won’t cover it for transition only. So the money can be an issue, and even if you have it, you have to decide whether or not it’s worth the cost.

> Although “transitioning back” is very rare, if you would ever decide to do that, you would have no natural hormone-producing mechanism, which can lead to health problems such as osteoporosis. However, non-trans women who have had this procedure have the same issue, and there are ways to deal with it. In addition, even having ovaries is no guarantee that they would kick back in and produce the estrogen you would need.

> Again, a very rare situation, but something young trans men might want to consider – we know that there are a few guys out there who are giving birth. If this is even a fleeting thought, a hysto/oopho would obviously negate that possibility, although there would be no guarantee that a pregnancy could occur after long-term testosterone use anyway.

> There is anecdotal (and possibly research-based) evidence of the loss of sex drive in women after hysto/oopho. However, these are non-trans women who are not using testosterone. Hudson’s FTM Resource Guide reports other possible problems, including “irritable bowel syndrome, incontinence, damage to the urethra or bowel, prolapse of the vagina, back pain, or loss of sexual feeling or function.” It’s likely that these possible complications are rare, but there are never any guarantees.

Again, I can’t advise you medically. I can tell you that, if I was having problems with cysts and there was a possibility that my insurance would cover the procedure (although I no longer have insurance, but this is hypothetical anyway), I would probably do it. The reason I would do it at this point in my life is more preventative than anything else. It would be just one less body part I would have to worry about in my golden years. But it would also depend on what my doctor said about the risks versus the benefits.

Another consideration is whether or not you are planning to have genital surgery at some point in the future. If so, you will have to have this done for any major genital surgery, so if you can get it out of the way now, so much the better.

I would recommend that you talk to your doc about what surgery, if any, would be the most appropriate for you. Find out about cost, recovery time, possible risks, and so on, and then weigh all that with what’s going on in your life right now, how having these organs is affecting you physically and psychologically, and what you might want in the future.

As I said before, no one I know who has had this surgery has regretted it, but I’m sure that there are guys out there who do or who have had a bad experience, so I hope we hear more pros, cons, and thoughts from readers.

Take it away!