
Changing gender usually starts with hormone therapy. In the case of FTM transition, testosterone therapy is used to cause masculinization. Once you start testosterone, it will cause dramatic changes in your body and mind. It will even change your face, as you can see in these photos, and in the videos further down in the post.

An important caveat is that many of these changes are irreversible – if you stop taking testosterone, some of the physical changes will not go away. And if you are one of the tiny minority that changes their mind about transitioning, you may not be happy with these changes in the long term.
I do know someone who did this. She got halfway through a transition when she was 21, and for the 33 years since then, she has had to live as a woman who has a very deep voice and no breasts. She has never had children, so it is possible that the testosterone permanently destroyed her fertility as well. To be fair, she was never the most stable person. Mistakes of this kind are very uncommon.
But clearly, you need to be 100% sure that you want to transition before you start hormone therapy. That’s why I personally believe it’s not a bad thing that all jurisdictions require some professional counseling before giving the go-ahead for people – even sane, mature, intelligent adults – to transition gender.
The joy of Starting Testosterone for FTM Transition
I still remember vividly the day I got my first prescription for testosterone – it was like I had been given the key to start my incredible journey to maleness. It was magical. It is like this for many of us.
Within days of my first testosterone shot I started to change.
My voice cracked and broke within a month. People kept asking me if I had a cold! Now of course everyone is used to my voice, and my wife laughs out loud when we see a video of me pre-T, with my old, girlish voice! This video shows the change in the voice really well. It starts a little slow, but hang in there, because it’s really a great video, and quite heart-warming too. This video is by Ryan Jacobs Flores, and you find his great YouTube channel here.
After my very first shot, I never had another period again, ever (joy!). This is unusual – most people still have one or two periods before they finally go away. It may be that mine stopped sooner because I was already in my forties. The happy side effect of all this was that I completed avoided menopause (something that makes my wife very jealous, as her menopause dragged on for the best part of a decade).
This is an interesting video about the effects of testosterone over a year:
The video above is from another great YouTube channel, this one called BLAKeVOLUTION.
The physical changes to my appearance (facial features, fat distribution, muscle distribution) were much, much slower – in fact, they kind of snuck up on me. However, there is no doubt that the first shot of testosterone into my thigh muscle was the first step on my journey to becoming the man I was always meant to be. It was the beginning of a long, arduous journey to make the outside me match the inside me.
I have now gone far enough on that journey that I feel comfortable in my skin and in the world – for the first time in my life. And much of it is thanks to the magic of testosterone!
What Testosterone Does for FTM Transition: Physical and Emotional Changes
This graphic from http://ftmmagazine.tumblr.com highlights some of the changes that you will experience on testosterone.

Testosterone causes some permanent, irreversible changes, and some changes that will disappear if you stop using testosterone. These are the reversible changes:
- Muscle and strength development
- Increased energy in some people
- Greatly increased libido
- Redistribution of body fat from female pattern to male pattern (that is,
- Cessation of ovulation and menstruation
- Increased sweat
- Changes in body odor
- Veins become more prominent
- Coarsening of skin
- Acne and oily skin in some
- Elevated blood lipids (cholesterol and triglycerides)
- Increased red blood cell count
These are the irreversible changes:
- Deepening of the voice
- Enlargement of the clitoris
- Developing male pattern baldness
Increase in facial and body hair is said to be irreversible, but when I stopped taking testosterone the hair on my stomach disappeared after a few months, and my facial hair also stopped growing eventually. My legs stayed very hairy, though. When I went back on testosterone, all of my body and facial hair very quickly grew back.
Testosterone will Increase Your Upper Body Strength Dramatically
This deserves its own section because it is so dramatic. Before T, I spent years working out in gyms, lifting weights, hiring personal trainers. Still I could not do one decent push-up. Within a year of starting testosterone, I could do 20 push-ups with ease. At the moment, I have not set foot in a gym for a year – yet I can drop and give you 15 push-ups without breaking a sweat. And they feel light and easy! In short, my upper body strength has increased dramatically since starting testosterone.
Negative Effects of Testosterone in FTM Transition
Testosterone is something of a miracle drug for those of us who want to appear more masculine. But it also has side-effects for some people that are not desirable, such as increased cholesterol. And your red blood cell count may increase so much that it becomes a health risk (to prevent that, it is useful to donate blood as often as you can). And of course, like all medications, testosterone takes a toll on the liver and kidneys. That’s why it’s essential to be under the supervision of a medical doctor, preferably an endocrinologist, from the moment you start testosterone.
Bottom line though: starting on testosterone is a wonderful, giant first step for most FTMs on our transition journey.
The above post is excerpted from my book, How I Changed my Gender from Female to Male. You can look inside this book and see the table of contents by clicking on the Amazon link below.
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Hi!
Can you recommend me some best testosterone supplements and products which are side effects free. I am very much afraid of testosterone side effect. I have already gathered some information but i need to cross check.
There are differing medical opinions as to the benefits and drawbacks to hormone replacement therapies– be sure to speak to your doctor if you are considering stopping testosterone therapy for any reason.
Hi. I’m just starting to look into surgery, and I’m not a fan of bottom surgery. Can I still be on testosterone if I only get top surgery?
Millions of FTM folk are on T but do not do bottom surgery 🙂 Perhaps the majority only do top surgery. Some don’t even do that … Good luck!
Hey, I live in Atlanta, Georgia and I’m trying to start the process ASAP. Kindly can you connect me to good doctor’s in Atlanta ?
Sorry, I have never been to Atlanta, and have no knowledge about doctors there.
Hello,
I am terrified of shots? Is Testosterone all shot based?
No, you can use an ointment that you rub onto your stomach every day. Easy peasy!
«[…](to prevent that, it is useful to donate blood as often as you can).»
In my country (Germany), people who are gay or trans, aren’t allowed to donate blood.
The DRK (Deutsches Rotes Kreuz) sees them as…ehm…”individuals who sleep around with many different people (for money) and therefore have all the kinds of STDs”.
Sorry to hear that. It is common in other countries too, including USA and Canada.