My first blog post on my very first personal website and I decide that it’s time to talk about hormones. This is par for the course when coming to this blog I think so steer clear if this isn’t what you were looking for!

I started taking testosterone intramuscular injections (aka hormone therapy aka HRT) in September 2016. For the first three months, I diligently documented the changes both physically and mentally in a draft email to myself. Looking back on that email, the changes hit pretty quickly and I was on an emotional roller coaster of which I did not realize I was on. Excitement that I was finally starting to see progress in my transition, but also lows when the changes weren’t happening fast enough (at that point in time anyway). The unrealistic expectations I had built in my head despite knowing that T wasn’t a magical drug were at times all consuming and dysphoria was rearing its ugly head. Universally though, things were going great so I ignored the fact that the emotional roller coaster was also most likely due to the 14 day shot cycle.

When you do HRT, you have to see your doctor every few months (every four months in my case) to get another script for the next vial of medicine. You must go the day of your next shot and do the shot at the doctor’s office after they’ve taken a sample of your blood to send to a lab to test your hormone levels. Every doctor’s appointment, my doctor would ask, “Have you noticed any drastic mood swings or emotional changes?” And you know how Captain Oblivious would answer? “Toward the end of the cycle, I’ve noticed I get more irritable but I can manage it.”

By the way, I haven’t been diagnosed as clinically depressed because the whole gender dysphoria thing kind of eclipsed that. And really, now that I’ve been on T and gotten top surgery as well, the dysphoria is way down. But also, being on T for a little over two years now, I honestly can’t tell if my mood swings are hormonal or mental health related. I can’t tell if I’m depressed because I’m witnessing my best friend going through the worst time in her life and I feel stagnate in my job. Or if I’m depressed because it’s the beginning of my shot cycle. What makes things even more complicated is that during my last shot cycle, I sat at the top of the emotional roller coaster and was only anxious about the inevitable drop that was supposed to happen around the 13th day. You know when it finally happened? The 15th – the day after my shot.

I need to see my doctor and finally be honest with her, start taking my shots every 10 days or every 7 possibly. But that would mean more scar tissue (since the injections are intramuscular) and even though I alternate between legs every shot, my doctor has been pushing me to alternate with my hips as well which can really only be done by another person. I prefer complete independence so that doesn’t feel like an option. And more importantly, that could possibly mean more doctors appointments which means paying $300 out of pocket each time.

Okay, so what if I work something out with a different doctor, Planned Parenthood? I’m most likely going to pursue this option but I’m worried about the costs with those options too. My insurance doesn’t cover anything transgender related. What if I have to pay more than $300?

Maybe you’re thinking, “James, you should really go see your therapist.” Great idea! That’s $90 each 50 minute session.

I want to keep blaming the hormonal roller coaster I’m riding because that seems more manageable. If I can get on a shorter cycle or a different dosage depending on my levels, maybe things will get better. That seems easier to deal with than the possibility that my mental health is in the dumps and I will need to return to more frequent therapy. Don’t get me wrong, therapy isn’t a bad thing and I should go more frequently anyway. But the money anxious person inside of me is shaking with fear. What if I have to start taking other medicine on top of hormones? What if I have to pay for multiple sessions on top of doctor’s visits? I can barely afford to live now, what will I do then?

All this to say that, yes, HRT has literally been one of the best things I’ve ever done in my life and I would not be alive right now without it. But a part of me is also bitter at not only the fact that I have to take testosterone for the rest of my life just to feel and look like me, but I also have to pay out the nose for it and deal with the negative aspects of hormones, doctors, and the healthcare system. Will the roller coaster ever come to a stop?

Also, fun fact: I started listening to Michael Kiwanuka’s Love & Hate album, specifically the song “Cold Little Heart”, every time I do a shot. His voice comforts me while I stab myself in the leg!