Some people talk about testosterone poisoning as if just having testosterone in one's system is enough to make you stupid, angry, violent -- in short, a MAN. But surprise: Everyone has testosterone in his or her system. Testosterone is largely responsible for libido (sex drive) whether you are male or female. In the last decade physicians have begun to prescribe low doses of testosterone for post-menopausal women to prevent them from losing interest in sex.

Testosterone helps elevate mood and increases appetite, so it's given to people who are HIV-positive to help increase their overall health. Bodybuilders and other athletes have long known about testosterone's effect on energy and muscle mass and density. But just as with insulin, everyone needs to be sure all their hormones are maintained at the proper levels. Too much testosterone doesn't make a person "more male." Any excess actually seroconverts into estrogen, the so-called "female" hormone. Men who take too much testosterone can expect to grow breasts and stop producing viable sperm -- how "male" is that?

Many FTM guys I've known have talked about their anger and violent behavior. What may surprise some readers is that most of these transmen experienced this anger and violence BEFORE they started transition to male physiology. Most of them found that testosterone made them LESS angry and violent than they were before taking it; in some cases inappropriate anger completely disappeared from these men's lives. One man I know had recurring fantasies of violence, particularly toward men, that stopped within weeks of his first injection.

Personally, I have a better handle on my anger now, since I feel more in touch with myself. I am quicker to express my discomfort with any bad situation, but I don't think that is just due to the testosterone itself; more likely it is because I am more sure of myself and less likely to acquiesce just to accommodate others. I'm less inclined to take physical risks now, too, because I value my body and my life in a way that I didn't before.

What to expect:

So what does testosterone do for an FTM? Testosterone acts on receptors in the body, receptors that are genetically coded to predispose the body toward certain characteristics ? and not every body responds in the same way. Testosterone acts as a catalyst to actuate physical capacity that is already genetically present in the body. Without the receptors, it would pass through the system with no effect.

In general, the effects that testosterone has on a female body are increased libido, increased muscle mass and density, fat redistribution (from hips and thighs to a spare tire), an increase in body and facial hair, thickening of the vocal cords, clitoral growth, changes in skin texture and body odor, and (in some people) male-pattern baldness. Usually menstrual bleeding stops within a few weeks of initiating treatment. Some people will have vocal changes that are noticeable in a few weeks; others will need many months of treatment before any audible change occurs. Many people get acne, which goes away in one to three years.

Hormone treatment puts you through puberty all over again. You have many of the same feelings and social responses as you did when you were a teenager, except this time you have more perspective, and thus a little more control over your feelings. On the other hand, society is set up to expect teenagers to behave in certain ways and adults to behave differently. It isn't always easy to be re-experiencing puberty while people are expecting you to (for example) hold down a professional job, manage other people, or possibly be the parent of a teenager yourself.

Safety

Many people think transsexual people are doing something dangerous by taking hormones. The most extensive long-range study done to monitor transsexual hormone usage (Van Kesteren P, Megens JAJ, Asscheman H, Gooren LJG, "Side effects of cross-sex hormone administration in transsexuals," published in Clinical Endocrinology, 1997, 47: 337-342) documented a total exposure of 10,152 patient years using hormones, and concluded that cross-sex hormone administration provided by a knowledgeable medical expert is an acceptably safe practice. Risks that FTMs need to be aware of are increased serum cholesterol levels, the potential for stress on the liver, and aggravation of any abnormality in the uterus and ovaries, such as fibroids or polycystic ovaries. But generally exercise, avoidance of drugs and alcohol, and a hysterectomy will keep these conditions under control, though some people may struggle with obesity no matter what they do.

Dykes who want to take testosterone to "butch up" need to be aware that the effects of testosterone don't entirely go away when you stop, especially if you take them for more than a couple of years. Also, testosterone won't make you into a man. That's another head space that hormones don't control. If they did, there wouldn't be transsexuals!