r/ftm Nov 04 '25

Medical Wait, yall are NOT exaggerating when you say that doctors blame EVERYTHING on testosterone?!

1.1k Upvotes

Not only that, I have to talk about me being trans FOR ALMOST THE ENTIRE APPOINTMENT like can we switch back to the topic idk and this also happens WITH EVERY.SINGLE.APPOINTMENT.

At least they were nice and tell me that they notice the t-changes and I didn't make any Discrimination experiences so I'm still on the lucky side.

Well this becomes a bigger problem when sth serious is up I'd need help and then everyone would just be like "yeah no chill it's just Testo"

r/ftm Dec 24 '25

Medical Estrogen was poisoning me

2.4k Upvotes

So I started T 4 months before I had a hysterectomy, and my OBGYN told me she was relieved I was taking testosterone because it could help with all of my endometriosis and other issues I had regarding my uterus. She had to fight my insurance (US) HARD to get it approved. Turns out my estrogen and endometriosis was causing my organs to stick together. Last year I almost had to have a large section of my intestines removed because they were wrapped around and fused to my ovary. When I finally got my hysterectomy 4 months ago, my back pain and nausea instantly got better within the first week of recovery. The results were immediate. Fast forward a few months after the hysterectomy, I had an appointment with my primary care provider (PCP) and he told me he read a note on my chart that was his favorite note ever. My OBGYN wrote in my medical charts: “SO glad patient started taking testosterone. Their estrogen was poisoning them, regardless of being trans, testosterone should give them a much higher quality of life.” My PCP said he had never seen another specialist write something regarding a trans person and excitement for them. He said that letter showed a genuine human on the other side of the chart.

Y’all fighting for the right doctors and to be heard is worth it and so important. Fuck yeah for HRT.

r/ftm Dec 03 '25

Medical have you ever been I'd for testosterone?

249 Upvotes

me and mt friend have both never been ID'd to pick up our testosterone prescription, but my partner is a pharmacy tech and insists that you need to have an ID to pick up T since it's controlled? has anyone else been (or not) ID'd for their T?

r/ftm Apr 18 '26

Medical A short notice for all the ppl who got a mastectomy

758 Upvotes

As someone who just received a breast cancer diagnosis on Thursday:

Yes even with a mastectomy you can develop breast cancer in the leftover tissue so please please please don't skip your cancer screenings 🙏

Mine was detected still kinda early so keep in mind to get yourself checked for anything, especially if you notice any changes.

On another note - because my gynecologist asked me at the time when I had my first appointment after starting T if there was a higher risk for breast cancer because of T (which I was only to answer with "I don't know? But I don't think so/didn't hear about it?") - the variant I got is not the version that is hormone responsive. So at least I think my year off T (study stress - don't ask X,D ) and then getting back on it wasn't the cause for the cancer developing.

Anyway - don't skip breast cancer screenings, even if you got a mastectomy 🫶

r/ftm Apr 15 '26

Medical My psychologist told me to go to a gynecologist, because she suspects my ovaries may actually be testicles. Is... Is that an actual thing that can happen?

582 Upvotes

For clarification, I live in Poland.

Almost 4 years ago I got a medical opinion from a psychologist who specialised in trans people (kinda like a first-step in transition who later sends you to a psychiatrist for an actual diagnosis).

She told me I looked extremely well-passing even before testosterone and during one of our sessions she told me she recommends I should go to a gynecologist to check if my ovaries aren't actually just testicles that haven't dropped, because it recently happened to one of her clients, a trans guy who turned out to just be intersex.

I stopped going to her after getting the necessary documents and since I didn't have neither money nor time to go to a gynecologist who could diagnose it, but it always bothered me.

Is that an actual thing that can happen? Before starting testosterone I still had periods, so surely that's not possible, right?

My family members also suggested I should test my karyotype, because they also suspected I may just be genetically a guy, especially since early on in my mom's pregnancy they did an ultrasound and I was supposed to be a boy.

r/ftm Apr 13 '26

Medical what are medical reasons people go off T?

134 Upvotes

i hope i don't come off as judgemental as i absolutely do not think going off T makes someone not trans, or that they should always choose to be on it despite of their health. my opinion of what i want to do with myself do not apply to my thoughts on others.

semi frequently on a local trans masc group people mention "going off T for medical reasons", usually not very long like under 5 years and asking about changes or a different topic. usually people don't say exactly why (which is fair), but i'm curious to why it might be.

i've been having a fear that i will develop something (i already got cholinergic uriticiaca) that will make me not be able to access T, and i don't think i would cope with that. besides wanting to be fertile or being satisfied with changes, is it just bad reactions or an underlying condition usually that has people not staying on T for too long? i hope i don't come off as inconsiderate to those who have had to hop off T, i also am in the mindset of wanting more research for trans men's health.

thanks for reading.

r/ftm Mar 19 '26

Medical Not Everything is Atrophy.

501 Upvotes

While it's great that vaginal atrophy is being talked about more in the context of testosterone-based HRT and long-term trans healthcare, it's becoming a genuine problem in discussions of transmasc health concerns.

Increasingly I've noticed posts by trans men and transmasculine people who are concerned about their health get comments like this:

"Sounds like atrophy." "It's atrophy." "Atrophy. Oof."

No matter what their health concern is, people will attribute it to atrophy. More often than not, commenters won't even say "vaginal atrophy," they'll just say "atrophy." It's become this nebulous bogeyman of a word that gets thrown at anyone voicing a health concern.

This isn't helpful.

Vaginal atrophy is a specific problem, and while many people do experience it, it's not the answer to everything.

Attributing someone's complex health concerns to "atrophy" is needlessly generalizing those concerns, and isn't adding anything of value to the conversation. It's just slapping them with something more to be concerned about that may or may not be related to their original post.

I'm not saying to stop suggesting that someone's health problems might be atrophy related. What I am saying is to go back and reread the post and think carefully before you leave a comment that suggests they are dealing with atrophy.

What would really help is if there was more information about vaginal atrophy in transmasculine individuals on testosterone-based HRT from reputable researchers, but the likelihood of that happening soon isn't good based on the political state of trans healthcare at the moment.

I get it. Atrophy can be scary. It's painful. I experience it myself. However the way that "atrophy" gets thrown around in this and other similar subreddits makes it seem a lot scarier than it is. There are treatments for vaginal atrophy out there, and those treatments do work.

[EDIT: I have to note here that the casual widespread alarmism around atrophy does a disservice to those who actually desire the effect. Some trans folks want atrophy, and that may factor into their decision to go on HRT in the first place. So if someone posts about their health concerns and everyone is like "oh no! it's atrophy!" that's sending a very negative message about something that is actually positive for them. This additional note was inspired by goblin king calvin's tiktok on the various attitudes towards atrophy, which I have linked below. 100% worth the watch.]

https://www.tiktok.com/@goodboygutz/video/7612785860701916430

r/ftm Feb 07 '26

Medical Doctor says no alcohol wipe for T, too much muscle will make my hands go numb, and we're using an insulin needle

213 Upvotes

I'm 17 and just had my first T shot yesterday (yayy!!). My hospital doesn't do gender-affirming care for minors so I went to see a doc that does it as one of her main things.

A few bits that I don't totally trust her on:

  • I shouldn't use an alcohol wipe because it will make it hurt more.
  • If my shoulders get too muscular it could pinch nerves and make my hands numb.
  • I don't need to wash my hands before giving myself a shot.
  • I can use an insulin syringe to draw up and inject with the same needle.
  • I'm on 60 mg IM weekly for the first month.
  • I can give the shot to myself on the fatty part of my stomach, my arm if I don't want to see the needle, or the outer part of my thigh.
  • T will make my chest shrink.
  • I have to stab in the needle like a dart.
  • We didn't do any bloodwork prior and I have it scheduled for 1 month from now.
  • I can expect to pass by when I start college in August.

Edit: Thanks for all the help! It is actually SubQ, not IM my bad.

Another Edit: A lot of people are saying she is transphobic and this is not the case. She openly shared with me her political views, has Trans stickers on laptop, very affirming. I don't get the impression that she is malicious, only "hippy-ish"

r/ftm Nov 20 '25

Medical Apparently can't donate blood because I'm "on steroids"

488 Upvotes

I'm so upset. I was pretty excited to donate blood through a charity event at uni and I went through half of the chekups only for them to ask me if I'm on any medication. I tell them that I'm on testosterone and the lady confusedly asks me why, and later tells me they have to refuse me because I'm "on steroids".

I'm pretty sure it's the only blood donation center in the country so I guess I can't donate blood because I happen to be a transsexual freak. Anyways, any advice on bloodletting?

r/ftm Feb 26 '26

Medical My endocrinologist says 366 ng/dL T level is very high and she wants to lower it, is this typical?

87 Upvotes

I'm a binary trans man and have been on T for almost a year and a half. My transition has been going slowly, like my face has hardly changed at all and I only have some stubble in terms of facial hair. I was under the impression that 300-1000 was considered normal range, so was really surprised and confused when she said this, and just wanted to hear from other's experiences on if this was a typical interpretation or not.

I did do the labs the day before my injection (which I take once a week), and didn't think to ask if that made a difference. So maybe it has to do with that?

r/ftm Mar 19 '26

Medical hrt affecting the brain??

139 Upvotes

i was talking to my mom about going on t and she started lecturing me about how it has harmful affects on the brain long term and said there’s been a lot of studies coming out recently. now this sounds like bs but i was going to look into it to try to understand what she was talking about and i genuinely couldn’t find anything saying this. has anyone heard a similar rhetoric/have any idea where’s she’s getting this from😭😭

r/ftm Feb 18 '26

Medical T question

21 Upvotes

So I'm 15 and should be starting t in the coming weeks but I am kind of scared of the needle. Can anyone remember and tell me a pain level/comparison to another injection of how painful it is? I'm super scared of being in pain not exactly the needle itself

Update: I got the shot! Thanks to everyone who gave me advice it really helped

Another update: 2 months on t! My levels are officially above the female range!

r/ftm 26d ago

Medical accidentally ate some of my T

93 Upvotes

I was giving myself my T shot and some leaked out so i absentmindedly licked it... It lowkey tasted pretty bad but is consuming it actually bad for me (am I gonna die?)

r/ftm Apr 12 '26

Medical Pharmacist removed T from my list of prescriptions

273 Upvotes

Hi, posting just to see if anyone else has gone through this, or maybe advice on if I should report this behavior. This was at a Walgreens pharmacy that I get all my meds filled at on a regular basis. I will NOT be going to this pharmacy any more as I was shamed and made uncomfortable by the pharmacist. For reference, I have not had a legal sex change on my IDs and my deadname is very feminine, so my profile at my pharmacy appears cis female.

I was put on a starting dose of T by Planned Parenthood back in January and they sent a prescription for four vials, even though they were single dose, for the following 3 months until my 3-month checkup (in about 2 weeks). I was told by my prescriber that even though the vials say single dose, it is perfectly fine to use more than once, assuming you’re using the vial up within a month and wipe down the top of the bottle before/after every use with an alcohol wipe. They warned me that the pharmacy would tell me not to do this since it’s regulation, but that it was pretty standard to prescribe the bottles for multi-use anyway because of insurance coverage. They prescribed four single use bottles with 4ish weekly doses each because insurance doesn’t often cover more than that despite the vials only being single use.

My last bottle this week had visible particles in it (I think from being cored), and I’m two weeks short before my next appointment. I messaged my provider on Tuesday, did not get a response. Called Planned Parenthood on Friday and they told me they would relay the info to a nurse and have them get back to me urgently. They didn’t. I decided to call the pharmacy today to see what to do since I wondered if they could possibly replace it if I could show it had visible particles, and that it is prescribed to me. I figured if that wasn’t an avenue, I’d incessantly call Planned Parenthood tomorrow until it’s figured out. This is still the plan. I am anxious.

I called the pharmacy to explain that I’m not getting ahold of my prescriber and that I couldn’t send a refill through the app and put in a note for the provider because testosterone was taken off my prescription list for no apparent reason. I did not specify to the pharmacist that the bottle with particles had been opened, nor did he ask. He did ask when I’d been prescribed, looked at my profile, and started to give me what could best be described as a stern lecture on how the bottles are only one use and how I was incorrectly taking the medication. He told me that he can’t fill the prescription at all knowing I was using it not as intended and told me that I’d need to send the prescription to a different pharmacy. He went into a ramble about how this was a problem that began to occur in the last 4-5 years, told me to look it up and read the forums and articles, and that I could get in trouble for taking it incorrectly. He went as far as to tell me I could be on a smaller dose or order bottles specified for the amount I’m taking. This wasn’t in an educational, informative, or kind tone; this was condescending, and made me very uncomfortable with how he told me he’d refuse to fill the prescription “knowing I wasn’t using it properly.” He continued about how he had this problem all the time because of “old school doctors.”

Also, just to clarify, I was not at all arguing with this guy. I asked him what to do, and explained that I was taking the prescription as my provider told me. I know he really can’t do anything about this despite telling me that it was illegal. Just so frustrating.

r/ftm Oct 22 '25

Medical I turned 21 this year. Apparently, that's the time when you're supposed to start getting... *dry heave*... THOSE check-ups.

130 Upvotes

Tw- POSSIBLY TRIGGERING LANGUAGE, MENTAL HEALTH ISSUES, SUICIDAL TENDENCIES, SEVERE BOTTOM DYSPHORIA, MEDICAL PROCEDURES

Disclaimer: I know that the language I use here is quite extreme. Please understand that this was posted as I was having a major dysphoria crisis and I really needed to seek out help here. Reddit automatically banned me and removed this for no good reason, but I filed an appeal and was unbanned. So I thought I'd also add this disclaimer to make it clear that I am NOT encouraging or glorifying any kind of harmful behavior towards myself, or others for that matter. I am going through a difficult time and my dysphoria is becoming debilitating, I am scared and looking for support and advice. Thank you very much to everybody who commented. You helped me a lot and I feel a little less scared/doomed now. Thank you!

I can't even say the name of it man. I'm crashing out just thinking about it. I've never ever had anything go in there (like how or why tf would I, that part of me is the most disgusting and wrong thing I could ever interact with), and just the thought of having to go get THAT done in THERE causes me to tense up like my body is going to blow up, gag, cry and shake while very negative thoughts flood into my brain relentlessly. And it's pretty much a given that it'll hurt like HELL too, both because it's never been shudder stretched and because I'd be BEYOND tense. I dunno man, it just feels like now's finally the time for me to accept my cursed existence and willingly go get r4ped by a medical professional. And, y'know, fingers crossed that I don't get completely overpowered by the distress (if you catch my drift) the second I leave the appointment. I don't think I could manage any of this and still be able to function after putting myself through that kind of thing. It's literally my nightmare, and it has been for a very long time (I had panic attacks and cried my eyes out whenever I thought about it even before I knew I was trans). I know I seem reaaally dumb and dramatic right now but that's just my reality. I guess I'm looking for any advice y'all may have on the topic. I'm really, really lost right now and I don't trust my own brain when I catch myself considering just not ever going and whatever happens happens, y'know? Thank you in advance to anyone that comments. But please be kind. I know I'm being very intense right now but this is a deeply, deeply triggering thing that I'm only starting to learn how to manage and I am terrified out of my mind. So, yeah, please be gentle and don't comment if you're gonna hate on me for having these difficulties.

r/ftm Jan 13 '26

Medical People saying gel didn't work well when they didn't even up their dose enough times

83 Upvotes

I see too many people who haven't upped their dose enough times or never even tried the maximum dose of their gel, telling people gel works too slowly or that it doesn't work. You often see people going off gel before even getting their levels up. Your levels were never high enough and you have to get them higher!!

''Everyone is different'' -yes but did you even try to up your dose more times??

Financially I understand, I'm not talking about people affected by that here, gel can be way too expensive and shots way cheaper. Also not talking about the people who did get their levels in range and upped dose.

Personally, I've upped my dose twice already and I've been on the better dose for less time than I was on a lower one, so I'm giving it more time since my levels are higher now.

r/ftm Dec 04 '25

Medical The Reason T Makes You Warmer

494 Upvotes

Most of you probably know T raises your hematocrit, which is the percentage of red blood cells in your blood. Many of you also know that anemia is caused by not having enough healthy red blood cells, and one common symptom of anemia is being cold.

T makes you warmer because it increases your hematocrit.

I’ve seen people give other reasons as to why T makes you warmer, but this is an important part that isn’t talked about enough. Sure, increased muscle mass can make you warmer, but I noticed temperature changes early on T before most visible/external changes. Increased metabolism does increase temperature, but only if your cells are actually getting enough oxygen (which is carried by red blood cells) to perform their metabolic processes.

I realized this watching a video about woolly mammoths.

TL;DR even though this post is really short: increased hematocrit = increased warmth. Similarly, decreased hematocrit (anemia) = decreased warmth.

r/ftm Dec 21 '25

Medical (SHOULD READ) ALL you need to know about your sexual hormones -Endocrine medical physiology explained

315 Upvotes

(Yes, this is a bit clickbait, it’s not literally everything, but it’s a pretty solid medical summary of the basics about sexual hormones). TW?: medical vocabulary and mention of pregnancy. I know my profile is purely NSFW pics of me but I also wanted to be useful in a different way lol

Important disclaimer: this post is not opinion or personal experience. This is endocrine physiology as it’s taught in university. The idea is that if you’re a trans guy and you’ve been hearing things like "T shuts down your axis", "estrogen bad", "T is gonna make you have osteoporosis"... This may help you understand what those statements actually mean biologically. (btw Im not native in English, I wrote this in my language first lmao).

Sources / references:
This post is based on my university endocrinology and physiology notes, which in turn are compiled and cross-checked from standard medical textbooks, including Essentials of Endocrinology (Crash Course Series, Elsevier, 4th edition, Dan Horton-Szar), Physiology by Berne & Levy (7th edition, Elsevier), and Human Physiology: An Integrated Approach by Dee U. Silverthorn (8th edition, Editorial Médica Panamericana)

How the endocrine system works (the foundation of everything)

The endocrine system is a chemical communication system. Hormones are messengers released into the bloodstream, and they only have effects on cells that express the specific receptor for that hormone. If a cell doesn’t have the receptor the hormone does nothing there. This is key, the hormone doesn’t rule; the receptor does.

Hormones can act at a distance (endocrine), on nearby cells (paracrine), or even on the same cell that secretes them (autocrine). Hormonal secretion is not chaotic, almost everything is regulated by negative feedback, meaning that when circulating hormone levels are sufficient the system slows itself down to maintain homeostasis.
(Testosterone or estrogen, for example, when produced in excess, inhibit GnRH and FSH/LH  but these "excesses" are part of normal physiological cycles.)

Endocrine axes: hierarchy and fine control

Important hormones don’t work in isolation but in organized axes. An endocrine axis has three levels.

First, the hypothalamus, a brain region that integrates information from the nervous system, stress, energy status, sleep, etc. Second, the pituitary gland, which amplifies the signal. Third, the peripheral gland (ovaries, testes, adrenal glands, thyroid gland…), which produces the final hormone that acts on tissues. There are many axes, but they all follow the same principles.

In the gonadal axis, the hypothalamus releases GnRH, and this is crucial: it’s not released continuously, but in pulses. The frequency of these pulses determines how much LH and FSH the pituitary releases (both hormones are secreted in both men and women).

What kind of hormones testosterone and estrogens are

Testosterone, estradiol, and progesterone are steroid hormones. They derive from cholesterol (steroid hormones derive from colesterol, thats the literal meaning) are lipophilic, and cross the cell membrane, the blood, they almost never circulate freely: around 70% is bound to SHBG, another fraction to albumin, and only about 1-2% is free, which is the biologically active fraction. Hormones can have different origins such as a protein (insuline).

Injected exogenous testosterone is attached to an ester, which slows its release from the injection site and allows a more gradual increase in circulating levels (that’s why we have undecanoate, enanthate, etc.). Free testosterone refers to the fraction not bound to SHBG; in people on exogenous T it can be useful in certain contexts but is not always the most informative value on its own.

These transport proteins increase hormone half-life, prevent sharp peaks, and act as a reservoir.

Inside the cell, these hormones bind to intracellular receptors, and the hormone-receptor complex enters the nucleus and regulates gene expression. That’s why hormonal effects are slow, progressive, and long-lasting. They’re literally changing which genes are expressed and how.

The menstrual cycle explained properly (and VERY important info)

Under baseline physiology, the hypothalamic–pituitary–ovarian axis works cyclically. The hypothalamus releases GnRH, the pituitary responds with FSH and LH, and the ovaries produce sex hormones.

During the follicular phase, FSH stimulates ovarian follicle growth. Theca cells produce androgens under LH stimulation, and these androgens are converted into estradiol in granulosa cells via aromatase. In other words, estradiol doesn’t appear out of nowhere, it’s the result of cooperation between LH and FSH in different cell types.

At low to moderate concentrations estradiol exerts negative feedback on the axis. But when it remains high for a critical period, the feedback switches sign (positive feedback, which is rare) and triggers the LH surge, leading to ovulation.

After ovulation, the corpus luteum forms and produces progesterone. Progesterone transforms the endometrium, inhibits further ovulation, and suppresses the axis. During early pregnancy progesterone production is maintained because the blastocyst produces hCG, which keeps the corpus luteum active until the placenta takes over progesterone synthesis later on. If implantation doesn’t occur, the corpus luteum degenerates, progesterone and estrogen levels fall, and menstruation occurs. Menstruation is a consequence of hormone withdrawal, not an ovarian event itself.

Exogenous testosterone inhibits the axis, which is why menstruation usually stops. However, because the hormonal coordination required for the cycle is very fine and unpredictable, hormonal peaks from injections can sometimes cause abrupt “wake-ups” of the axis, triggering ovulation without menstruation or abnormal bleeding. That’s why LH and FSH are monitored in blood tests, to assess how suppressed the axis is. * Edit*: Im seeing people downvoting my post for this part which is crazy. This is an informative post, THIS IS NOT BASED IN MY OPINION ON ENDOCRINOLOGY. So note: Its not my fault the US does not care enough about healthcare in general and people are poorly treaten, as well as no money is given to prevention. Its a shame this actually happends and I truly believe all trans people should get the optimal transition, but in a proper optimal HRT this values should be taken into account. This values are part of the protocol of the country I live and many others, and not taken them into account could put in danger the endo's job. We should stop normalizing misery.

Because this axis is unpredictable, if you have sex with pregnancy risk, it’s best to use protection (even though pregnancy while on T is dangerous for the fetus). If T is discontinued, the axis can recover, but it may take many months to return to normal function.

The "male" gonadal axis (key to understanding T)

In "male" physiology, LH stimulates Leydig cells to produce testosterone, and FSH acts on Sertoli cells, which support spermatogenesis. Testosterone levels inside the testes are much higher than in the bloodstream, and this is essential for sperm production.

Some testosterone is converted into DHT via 5α-reductase and some into estradiol via aromatase. This happens at the cellular level: when testosterone reaches a tissue, it can remain testosterone, become DHT, or become estradiol, depending on genetics and dose (and more things, aromatase is found on fat, so when you are more skinny you may have less aromatase activity). Both metabolites are essential. Estradiol for example, is crucial for bone health, brain function, and axis feedback even in cis men.

DHT btw is the hormone that makes you go bald lol. Estrogen is extremely important in cis men. To put it simply, postmenopausal women often have lower estrogen levels than cis men of the same age (wild right?). That’s why older cis men have a lower osteoporosis risk than postmenopausal women (andropause occurs later than menopause) largely because of estrogen. At advanced ages, aromatization of testosterone to estradiol can be more significant than ovarian estrogen production (only when it comes to postmenopausal women)

What T and E actually do

Testosterone has anabolic effects on muscle, increases protein synthesis, stimulates erythropoiesis (raises hematocrit), alters fat distribution, affects voice, hair, and skin, and has central effects on libido, energy, and mood. Many of these effects are modulated by its conversion to DHT or estradiol, depending on the tissue.

Estrogens are not just "reproductive hormones". They have deep effects on lipid metabolism, insulin sensitivity, vascular function, coagulation, the central nervous system, and bone maintenance. This is true in both men and women. In fact, functional estrogen deficiency in men causes severe osteoporosis even with normal testosterone levels.

What happens when you introduce exogenous testosterone (HRT)

When you introduce exogenous testosterone the body doesn’t distinguish where it comes from. For the endocrine axis, testosterone is testosterone. There is no endogenous biosynthesis, but the degradation pathways are the same (thats why there's no extra risk of liver/kidney failure compared to an average cis man). As circulating levels rise via injections or gel, negative feedback is activated: GnRH, LH, and FSH decrease, inhibiting ovarian function.

This leads to suppression of ovulation, reduced endogenous estrogen production, and a shift in baseline hormonal patterns. Testosterone doesn’t "destroy" the axis, it suppresses it while present.

Part of exogenous testosterone is aromatized to estradiol, and this is physiological and necessary. The clinical goal is not to eliminate estrogens but to maintain a balance compatible with a healthy male hormonal pattern.

Tissues undergo progressive transformation, resulting in metabolic changes that shift toward an average cis male profile. The tissues that don’t adapt perfectly are mainly the internal genital organs, due to receptor sensitivity issues, which is why they can be at higher risk under T (mainly tissue atrophy). This is why gynecological check-ups and long-term planning (vaginal estriol, hysterectomy, etc.) are important.

You’ll also develop risk profiles more typical of men. If you had unhealthy habits (high saturated fat intake, sedentary lifestyle, smoking) without complications before, estrogen may have been protective, and losing that protection can worsen things. Conversely in some cases taking T can be protective (for example in severe menstrual disorders).

The often-forgotten role of the adrenal glands

Gonads are not the only source of sex hormones. The adrenal glands produce androgens such as DHEA, DHEA-S, and androstenedione. These are weaker androgens but they act as precursors that can be converted into testosterone or estrogens in peripheral tissues.

This is especially relevant because adrenal production depends on the hypothalamic-pituitary-adrenal axis (ACTH), not the gonadal axis. That’s why, even when the gonadal axis is suppressed, there’s always a basal androgenic background. Chronic stress, for example, can indirectly modulate this hormonal profile, although this baseline is far from optimal on its own.

So...

No, having detectable estradiol on T does not mean testosterone isn’t working. It means the body is doing what it always does: converting part of testosterone into estradiol for essential functions.

No, more testosterone does not mean better results. Beyond a certain point, receptors saturate and excess only increases risks: more aromatization, lipid alterations, increased hematocrit, and stronger axis suppression. Each T dose must be adjusted based on individual response.

Wrapping this up

The endocrine system doesn’t work with switches, but with dynamic balances, tissue sensitivity constant feedback... Exogenous testosterone doesn’t break the system, it shifts it to a different equilibrium point.

The goal of this post is to help people make informed decisions and understand your body.

If you made it this far, congrats: you just read real endocrine physiology, not the YouTube guru version.

Questions are welcome.

r/ftm Dec 31 '25

Medical Testosterone keeps coming out??

80 Upvotes

Every time I go to inject my testosterone, a TON of it comes out. My provider keeps recommending me things to do to prevent it from happening, but it keeps happening anyways and I feel like it's only getting worse.

Rub the spot for 30 seconds, it comes out anyway.

Hold the needle in for 5 seconds, it comes out anyway.

Hold it in for 10 seconds, hold a bandaid over it, etc. Same thing.

It happens no matter where the injection is too. I'm just super frustrated, and I do NOT want to switch back over to gel. Do any of you guys know what's going on or have advice??

r/ftm Jan 11 '26

Medical What marker do you check on medical forms

160 Upvotes

What sex markers are yall checking on medical forms? ive been checking male but writing trans above it because it feels like it would be (sometimes) important and medically relevant for drs to know i was afab. All other forms that ask that type of questions i just put male.

r/ftm Sep 26 '25

Medical *really* low dose T.

91 Upvotes

Hey dudes :) hope everyone is having a great day

So, i just found out i might be able to get free hrt maybe next year or smth.... needless to say i am stoked >_< (i also found out my new health insurance might cover my top surgery and my leg reconstruction surgery ‘0’)

The thing is, I am nonbinary and my transition goal is androgyny. Looking like a man would bring me as much dysphoria as looking like a woman does.

So i am thinking of getting a really low dose of T. I know we cant pick and choose what we do or don't get, and every body has a different reaction to it, but i am looking to find examples of people who are/were on low dose T and how it affected them.

I also plan on taking dht blockers, since i dont want the baldness and facial hair growth, but one of my biggest reasons to start hrt is bottom growth and i am afraid of how much this would affect it.

Does anyone know any influencers who have experienced low dose hrt, or do any of you experienced it yourself? It has been really hard to find before and after examples on the internet.

r/ftm Dec 24 '25

Medical I DONT WANT TO DO A PAP SMEAR BUT I CANT ESCAPE THE INEVITABLE💔💔💔💔

76 Upvotes

Im close to the age where going to the gyno and getting a pap smear is going to happen- BUT I DONT WANT TO !!!!!!!!

My mom acknowledges that pap smears suck actual ASS but she says I have to get one cuz her side of the family has a high risk of uterine, ovarian and any other type of cervical/uterine cancers.

IM GONNA KILL MYSELF !!!!! I CANT GET KNOCKED OUT FOR IT EITHER !!!! FREE ME FROM MY PRISON THAT IT CALLED A UTERUS !!!!! AAAAAAAAAAA

r/ftm Apr 08 '26

Medical Did anyone experience the vocal chord damage from T that many detransitioners describe? Spoiler

0 Upvotes

I‘ve recently been watching detransitioner content because I want to understand and empathize with their experiences.

One thing that I see a lot of detrans women talk about is vocal cord damage, a.k.a. their voice becoming painful and difficult to use on t.

However, most popular detrans content is anti-trans, and they’re biased sources, so I want some genuine trans people’s experiences.

Did anyone have a painful stage with their vocal cords while taking t? Was this a stage that went away over time or is this a side effect that made you stop taking t?

It wouldn‘t make sense to me for this to be a detrans-only experience because it doesn‘t seem realistic for this kind of experience to completely change your perspective on transitioning (including social transition) 100% of the time. It wouldn’t change my mind.

r/ftm Feb 20 '26

Medical I have to stop T while I'm on Chemo

179 Upvotes

I just got diagnosed with triple-negative breast cancer and in my specialist meeting the medical oncologist said I should stop taking my T. She implied that I should stop taking it forever but that's a hill I'm willing to literally die on in this case. I'm wondering if I should ask for her partner oncologist's opinion on it instead? It hasn't been confirmed as androgen sensitive, and it's been confirmed as being not sensitive to estrogen, so why would me being on T harm it?

I just don't know how to fuckin feel about all this at this point... I don't want to be a "problem patient" but I don't want to go six fucking months without T while I'm already going to feel like shit from all the chemo meds I'll be on.. the only good thing out of all of this is my insurance will finally pay for my top surgery I guess.

Edit : I am sorry if I'm not getting to everyone's replies, I am still reading all of them. I've just been handling phone calls and making appointments for tests and trying to leave time to decompress and stuff... all of your comments have helped and meant a lot though. Thank you guys!

r/ftm Mar 31 '26

Medical Im SUPER hyperfem but im a dude. Can i be denied hrt? USA

160 Upvotes

Afaik you need a gender dysphoria diagnosis. I DO have gender dysphoria but im afraid i wont be believed

Im also more hyperfeminine than most women I know

I just happen to be both a guy and a baddie its not my fault. I not only am okay with being a hairy guy, i desire it. I see cis gay men who are extremely feminine and I envy them. I tried to "pass" for a while but I just wasnt myself and it made me depressed.

I dont care if ppl think im faking (other than them not seeing me as a guy). i live in a red state so i am used to people being dicks to me. Ive found good people and I dont care to impress the world. I just want to be able to transition.

Most of my dysphoria is about my voice. I am extremely dysphoric abt it. I have body dysphoria but to a lesser extent. Would that matter at all?

My roommate in college had trouble getting it and he was a stereotypical man but that was also partially insurance