Scenario: I Am Masculinising and My Testosterone Levels are Low but I Am Happy With My Progress

Scenario: I Am Masculinising and My Testosterone Levels are Low but I Am Happy With My Progress

In the scenario where you are assigned female at birth (AFAB), on testosterone therapy for masculinisation and happy with your progress but your testosterone levels are low poses some challenges.

If you are not taking blockers, it will be assumed that your ovaries will produce enough estrogen to supplement your hormones and make sure you have enough, so it is OK to keep your current dose of testosterone the same.

If you are taking GnRHa blockers and aren’t taking enough testosterone, the situation is different, and the recommendation will be to stop the blocker or consider increasing your testosterone.

Why You Might Be Advised to Stop GnRHa Blockers:

  • Hormone Balance: GnRHa blockers work by suppressing the production of your sex hormones. If your testosterone levels are low and your estrogen production is blocked, there will be concern that continued suppression of hormones will leave you with insufficient hormones for maintaining good health..
  • Long-Term Health: Prolonged use of GnRHa blockers without adequate hormones can have potential side effects and long-term health considerations. These may include decreased bone density (risk of osteoporosis), and impacts on your mood.

Why You Might Be Advised to Increase Testosterone:

  • Health and Development: Adequate testosterone levels are essential for maintaining overall health and wellbeing in individuals who are masculinising. Testosterone plays a role in bone health, muscle maintenance, and other physiological functions. You want to ensure that you have enough testosterone to support your health and development.
  • Reaching Optimal Levels: Healthcare providers aim to achieve hormone levels that fall within a healthy and typical range for individuals undergoing masculinisation. This may involve adjusting the dosage to reach a balance that is both satisfactory to you and within a medically recommended range.

It’s crucial to have a comprehensive discussion with your healthcare provider to better understand their reasoning and to express your own goals and comfort levels. You have the right to advocate for the treatment plan that aligns with your wellbeing and gender-affirming goals. Ultimately, the decision should prioritise your physical and emotional health while respecting your individual preferences and goals.

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