THE SPACE BETWEEN MY HEAD AND MY HEART.
“Was there something off with your shot day and bloodwork this time around?” MY DOCTOR asks, staring quizzically at the computer screen.
My jaw clenches.
“Your numbers are quite high, when did you do your shot?” he asks again.
I start to sink into my chair, my legs feeling like lead. My shoulders curl in, I’m subconsciously attempting to get smaller. I suspected this; at our last appointment he was also concerned. We lowered my dose a little bit, I promised to eat more, gain some weight.
I knew this was coming, deep down.
My shot and blood work were perfectly timed 5 days apart so I could know beyond a shadow of a doubt that my numbers were accurate.
Part of being a healthy responsible trans person who has decided to access Hormone Replacement Therapy (something that not all folks need or want), which in my case means Testosterone, is having your bloodwork done regularly to make sure things are going as they should. Folks on Testosterone have to monitor their hemoglobin levels, and keep an eye on liver function. It’s a pain in the ass but it’s important.
My numbers are high, just because they are high. My body isn’t requiring as much testosterone as it did almost 3 years ago. (So many reasons for this I’m sure, one of which is that I’ve had a hysterectomy and top surgery so I’m no longer fighting my natural hormone supply.)
Somehow this feels like failure. The panic and shame set in, my face flushing, my chest feels like it’s caving in on itself. I want to cry but the (apparently overabundance of) testosterone makes it so I can’t.
“Alright, so let’s drop your dose down to .3ml,” he throws out nonchalantly
I however am as chalant as fuck. “If I’m being honest, I’m freaking out about this right now. I know rationally that my numbers are too high and so you’re lowering my dose to make them the same as they were before but I’m freaking out that I’m going to go backwards. Or that I’ll somehow be less ‘manly.’ I know intellectually that’s not true but I can’t make the panic go away.”
He smiles and takes a breath. I take one too.
“Listen, Nick. I promise that’s not going to happen. I won’t let it. But let me tell you about how this works so you can trust me. Testosterone is no joke. And once it gets rolling and you’ve experienced that changes you want it takes very little to maintain. I have many patients who choose to medically transition aggressively and then we put them on the tiniest drip to maintain because they don’t want the intensity of that much testosterone all the time. And clinically they hold the line perfectly. I’ve got you Nick, it’s okay.”
“Okay.” I smile back.
I don’t believe him. He knows it. But he believes him. I can see it in his eyes. I can hear it in his voice. I can feel it in his heart. And since I won’t believe him anyway I’ll have to trust his believing. I’ll have to hear his words over and over again in my head as I panic each week that I’m growing less scruff and loosing my muscle mass, and getting hips again-- all of which will be in my head. And if they aren’t in my head, if those unlikely things do in fact happen, then I do believe that he’s got me that he will help me figure this out.
Or maybe he won’t. And somehow that would have to be okay too. Because although my own deep rooted feelings about myself are there screaming loud, I know that the testosterone I pump into my muscle week after week doesn’t make me a man. I know that I make me a man. That with or without the testosterone, with or without my jawline, with or without my sharp edges and deep voice, that I’m the same man. I found him afraid and shamed deep within me, and with the help of my love Katherine, and with the support of friends and family, I have brought him out into the light.
Testosterone didn’t make me a man, it just helped me find the man I always was.
And when I can’t remember, or feel it deep in my bones, I guess I’ll just come back here and remember that I knew it once, today, for a minute.
The trick is holding on to it.
Here I am, holding on.
Why am I telling you, the internet you ask?
Because aren’t we all fighting with these feelings inside vs the intellectual knowledge we hold in our brains? I’m sure many of you, like my wife Katherine, have noticed the fact that I need LESS testosterone might, depending on how you look at it, be telling me that my body is cooperating MORE not less.
And because maybe this story of mine, might help you feel less alone with the conflict between your head and your heart too.
Hugs and high fives friends,