T Update: Low Dose Testosterone, and Starting and Stopping

Yes, I made a Video

Please watch the video. My hair isn’t perfect, the lighting leaves something to be desired, and once again the camera was way too close. But I made an effort! And you can see my frog. Say hi to the frog.

Please read the post too. It says pretty much the same thing. But obviously I had it written down already.


I started testosterone about 2 years ago. However, in that time, I’ve started and stopped several times, and have been mostly on a low dose. Because of that, most trans people look and sound very different than I do after 2 years on T.

I have been on T inconsistently and at a low dose primarily because I’m not a man. I’m not a trans guy, I don’t feel like a man and I don’t want to look like a man. I’m non-binary, or what others refer to as genderqueer. Specifically, I identify as neutrois, which can best be described as gender neutral.

In this post I want to address some of the more common questions I’ve gotten about T, namely the effects of being on a low dose, and the effects of starting and stopping.

Low Dose Testosterone

For the better part of two years, I’ve been on a low dose of testosterone. How low? About 1/4 of a “regular” dose, which is 1cc of 200mg/mL, so my dose has been .25cc of 200mg/mL. Needless to say, there is no actual “regular” dose (just a majority average), and dosage varies greatly from person to person. Moreover, the numbers aren’t really comparable when talking about various methods of application, such as injectable vs cream vs gel.

I started on cream. Once I worked up to the maximum dose for cream, the effects plateaued, meaning I wasn’t gaining any new changes, so I switched to bi-weekly injections. There aren’t many differences between the two in terms of effects or how they make me feel (as far as I can tell). The stand out is that I had to put on the cream every single day, whereas when I inject I don’t have to worry about it again for two weeks.

Effects of Low Dose T

The biggest effect of being on low dose is that the changes are really, really slow and gradual. Sometimes too slow, especially those times when I’m really excited about seeing changes! Some changes are gradual enough that I barely notice them until I remember how my body was a few weeks back.

The advantage of this is that it buys me time. Time to think. Time to process. I realized I need a lot of time to take in what is going on with my body, time to adjust and get used to it. I don’t suddenly see a different person in the mirror every day, and that is very comforting. (Not that you would see this on a regular dose, but the time to adjustment is much narrower.)

It also gives me a lot of control. If I start to question my decision to be on T again, I don’t have to stop. I can take my next shot and use those 2 weeks to think and see what happens, knowing that not much more will significantly happen in those two weeks.

Why I’ve been on and off

When I started testosterone, I was unsure of my dosage. It turns out I was on a “regular” dose for the first 3 months. Which means I saw a lot of changes really fast. Too fast. I freaked out and had to stop.

Stopping gave me some time to breathe, to make a plan.

I had to reevaluate my goals, figure out whether I still wanted to be on T, why I wanted to be on it, and establish how far I’d be willing to go in terms of physical changes, where I would need to pause and consider stopping again.

Most of the times I’ve stopped have been for this reason. To pause, and think.

Whenever I start back up, it’s because there’s a remnant, nagging feeling, a subtle need to masculinize just a little bit more. It is still frightening, because I honestly do not know when, if ever, I will stop this cycle.

Effects of Stopping Testosterone

Whenever I’ve gone off T, it took about 6 weeks for my body to get completely rid of it. This is obviously a very subjective feeling (I didn’t have any official blood tests) but every time it has been similar, I still feel the effects of testosterone in my body for about 6 weeks.

Let me preface this by adding that, for the most part, it has been hard for me to accurately track changes of individual factors, given so many extraneous variables that have been at play (like stress, varying eating schedules, erratic fitness routines, weather, and lots of trips).

I’ve outlined in previous articles the permanent and the reversible effects of hormones, so I won’t go into much detail about that. Obviously, the permanent effects do not go away, and my body eventually reverts back to those changes that are not permanent. But to what degree?

Muscle Mass

Since muscle mass is a reversible effect, I very gradually lose some of the strength and muscle I gained. This is invariably the first effect I notice when I start taking testosterone; it becomes easier for me to gain muscle, and I start to feel slightly stronger at a much quicker pace than usual. It is noticeable, but I don’t think it’s too significant on a low dose. I am not a bodybuilder or an athlete, and my workout regimens have been too erratic to accurately measure this, but if I actually committed to a solid exercise routine I think I could maintain the muscle I lose when off T, but I could also gain a lot more muscle when on T.

Body Fat

My body fat eventually redistributes to pre-T proportions, as this is a non-permanent effect. There’s a bit more fat on my hips. It’s very subtle; it’s one of those things that nobody else would notice except me, because I am so familiar with my body. It’s also been hard to keep track of this, because I’ve been getting fit and losing weight recently.

Facial Hair (and hair in general)

Any facial hair or leg hair I’ve gained doesn’t go away (thankfully I’ve only seen chest fuzz come in, but no hair yet). However, when I am off T, the facial hair will stop coming as fast. For example, I had to shave my face about every 3 days. When I went off T, I only had to shave every 7 days. The facial hair started coming in thinner as well. As soon as I start T again, the facial hair goes back to growing in a little thicker and more frequently. Additionally, being on T means I am sprouting new facial hair.


My voice does not change. It doesn’t go back to a high-pitched voice, and it never will. However much it dropped, it stays at that pitch. However, I do feel that after stopping, it levels out a little. I might lose the slight drop I had gained in the last weeks.

At times, my voices has sounded low enough to me, as low as I would like it to get. However, I still get mostly “ma’am” on the phone, which means it’s probably not at a male range yet. (Also, as a quirky sidenote, since my voice dropped I’ve continually felt that I speak way too loudly (which I sometimes do anyway). My voice just reverberates in my head. Also, I don’t recognize my voice when I hear it outside of me. At all. I’m starting to sound more like my brother!)

Hair loss

Since I’ve been on a low dose for a relatively short time, I haven’t experienced any hair loss (thank goodness) but should you stop T, any hair you lost will not grow back.

Psychological Changes

I don’t feel any effects directly from T (other than the consequences it has on my gender presentation). Many people report increased anxiety while on T, decreased anxiety while on T, a harder time crying, being less emotional, more aggressive, and just a myriad of other mood changes. I don’t think I get any of this, or at least I don’t feel it, so I can’t speak to the effects of that. (It’s possible I might get slight insomnia while on T, but it’s hard to say.)


As far as periods go, I cannot speak to this either, because I had a hysterectomy last January. My guess is that my dose is too low to stop periods, or at the very least it would make them irregular.

Going Back On T After Being Off

It’s really just the same as the first time. Your body picks up where you left off.

When going on testosterone, I always recommend building up to whatever your full dose is going to be (which is very hard to do when on an already low dose, but you can do it).

Stopping Testosterone, Summary

  • Going off T is not the end of the world.
  • Starting and stopping T multiple times is not the end of the world. You should do it if that’s what you need to do.
  • Know that you are in control. As soon as you feel uncomfortable with the changes, you can stop.
  • As long as you still have your ovaries and are producing estrogen, there is nothing else you need to do when you go off T except let your body resume its endogenous hormone production.

Keep in mind that my hormone regimens have been fairly consistent within themselves. I don’t sporadically miss shots or apply whenever I feel like it. When I’m on T, I’m on it for at least 2-3 months or more, same when I’m off. It’s important to give your body time to adjust, and not to jolt it into an unpredictable hormone imbalance.

Hormones control a lot of processes in your body. It is not advisable to oscillate so much. This is why it is in your best interest to find a doctor who can monitor your progress. I just went in for my latest blood tests, and everything’s fine!

38 thoughts on “T Update: Low Dose Testosterone, and Starting and Stopping

  1. Micah, this video is so concise and really speaks to your journey on T. You make it absolutely clear that this is about your process and the control you have over your ultimate goal, to feel who you know yourself to be. I appreciate the latitude of room you give yourself to this very personal experience. It is very easy to box oneself in to expectations and in doing so lose the magic of the journey. This is not the case with you. You live in the magic of the moment. “Micah Magic”. I think I will eat a bag of M&M’s (without nuts) today in honor of you. Thanks for posting.

  2. I read the post first, and then viewed the video. I found the post+video format to be a great combination. While the post is comprehensive and achieves an admirably balanced level of detail (not too much, nor too little), it felt like you covered a few things in the video which weren’t in the post. I couldn’t tell you what exactly, so perhaps it’s just a perception (or a matter of nuance!). The post offered all the benefits of the well-written word, plus the links to relevant content.

    While you’re the expert on your video hair, I didn’t find the camera to be too close, and the lighting was fine.

    Thank you, and Hi to the frog.

    1. Aw shucks, thanks. Frog says hi back. I have a few other frogs (used to have a big collection!).

      I thought about it, I’m not one for making or watching videos seem to like watching me speak, or they hate reading, or they just like to listen. So a bit of both is a good thing. Also I can always update or edit the post later with new information, while it’s hard to do with video. In the future I will try to make more videos.

  3. I’ve been very nervous about starting T in the future, but the video reassured me that it’s going to be okay and I’m probably going on a low dose too and now I just feel so good about myself and my transition plans and ahhh. :–)

  4. Hola, eres la única persona que he visto por aquí que piensa exactamente como yo. Llevo 9 meses de testosterona con dosis baja, he parado, he regresado. No muchas personas lo entienden, muchas me juzgan. No creo ser un hombre, ni tampoco una mujer, podría decir que soy trans* no binario. Me parece fabuloso que publiques este tipo de puntos de vista para que entiendan que no a todxs les apetece el mismo tratamiento. ¿De dónde eres?

    1. me da mucho gusto que me hayas encontrado! en general hay poca información y visibilidad sobre esto, por eso documento el proceso.

      soy originalmente de México. saludos!

  5. Thank you for this! Like you say, not many people talk about this, so I really appreciate the information. When you say “It is not advisable to oscillate so much,” are you saying that your own practices aren’t technically medically the best idea or have you been consciously calibrating your dose in a way that mitigates the effect of the oscillation? What IS the risk of hormonal oscillation on your body? Are you saying that the risk is worth it for you in terms of your gender expression? Thank you.

    1. This is just my un-professional, un-medical opinion. Hormones regulate a lot: sleep, mood, appetite, metabolism, energy, how oily your skin is, even stuff you can’t see like red blood cell count and liver health. Moreover, testosterone and estrogen production interplay with each other. I imagine it’s just not healthy to continually force your body to adjust to random bursts of hormones.

      I’ve previously experienced hormonal inbalances due to mistreated thyroid issues, and I felt like total crap. On the other hand, I’ve felt perfectly fine despite being on-and-off T. But as I said, I don’t take random doses, and I do get frequent blood tests.

      1. I agree, I have felt like crap every time I missed a shot for a week, some people can handle it, but often our bodies get used to hormones and if I shot suddenly it makes me feel tired, lethargic, and gives me major headaches (but I get headaches anytime I have a drastic hormone change). Again, for some people it’s no big deal, but for me I need to make any changes to hormones slowly just like I would with any other medication I am on.

  6. I think you are brave to tell your story publicly. Being non-binary can be hard to express and transition to.

  7. Hey, Micah. I watched this before and just watched it again. You and I talked once about hypertrophic scars (unfortunate for both of us). I went on 1/4 dose on 9/9/2014. I finally gave up trying to make a “decision” on T after 15+ years of consideration. Decided to just go low dose and see how I feel! Thanks for this blog.

  8. Hi, this makes for interesting reading. I’m XXY, or as the medical establishment likes to put it – Klinefelter’s male, so I have low testosterone. When I take T, most of it ends up converted to estrogen and I feel female which is kinda where I want to be. If I don;t take it, I feel nothing at all – had 20 years of that – I don;t like it. Sadly, while I can get T at the drop of a hat, access to E is much much harder.

    1. Hey Chlorine, I have something that might help with access to E! 😀 If you live in the U.S., Plume is HRT for trans and nb people LED by trans and nb people.

      Here’s a link! https://getplume.co/

      It may be expensive and isn’t available in 3 states, but it would hopefully be an ACTUALLY accessible way to get your E! I wish you the best of luck in your hrt journey. I know you’re going to get where you want to be someday. <333

    2. Hiiiii Chlorine, there may be better ways to get E now! :))

      If you live in the US, there are two WONDERFUL trans-led sites, Plume and FOLX, that can help you with HRT!

      Plume (doesn’t explicitly say it has knowledge on intersex people): https://getplume.co/

      FOLX (includes intersex people): https://www.folxhealth.com/

      They might be expensive for low-income people, but they’re supposed to be extremely accessible so you can get the E you deserve! <333

  9. I guess what I am wondering is, is it ok if you wish you could keep your biological female traits like breasts and and below, but wish for a deeper voice and slightly more masculine look? Also is this even possible?

    1. Because I am genderfluid but I am a married woman who doesnt want to deprive my partner of anything we have had thus far.

      1. Shanah, everything is possible! 😀

        I’m a dydadic (not-intersex) AFAB (categorized as female at birth) non-binary person who is usually read as a sometimes-cis gurrrlllllllll and doesn’t have access to any gender-affirming medical therapies. However, I can queer myself up with clothes to the point where random cis strangers whisper and stare! (And ngl that’s part of the transition goal for me haha)

        I can’t provide advice on medical transition, but I can DEFINITELY help you with what you can do if you don’t want to or aren’t able to medically transition.

        To start, there are a TON of life, makeup and clothing blogs out there made by transmasculine, non-binary, and gender expansive people that can teach you how to present yourself in a way that reflects your gender!

        Some basic tips I use from blogs like those are to go for baggy OR tailored clothes that don’t make your frame look too femme. Also, through experience, I’ve also found that not worrying about how you look and adding some very small femme details can actually help masculinize you. Many young cis guys (even obnoxious straight ones! :O ) will accessorize with pearl necklaces, knitwear, layers, shaved legs, colorful nails, and more small details considered femme! If you have a masc clothing base and you feel comfortable, you can femme up just a little bit to show you’re not insecure about your masculinity. Another way to put it is thinking like a gender-conforming cis guy – as if you’re free to present your masculinity however you like – can actually help you seem more masculine through confidence.

        Also, I know that having a short, masculine haircut can help as well. However, I have back-length, “femme” curly hair and cis strangers are still scared of me, so please don’t chop off any hair you don’t want to! :))

        Body language, like taking up space or slouching can help change people’s perceptions of you as well. Of course don’t be obnoxious, but don’t be afraid to make your presence felt either! (Something that helps me is pretending to be a sexy man CEO character, like you would see on TV.) You would be projecting a masculine body-language role-model onto yourself, and hopefully get to the point where the body language of that character would grow to be YOUR body language!

        Another thing that can help is natural-looking makeup, particularly masculine contouring and anything to make you look “messy.” Essentially, you want to find your bone structure in your face and draw on a more angular/skeleton-like version of it, making modifications if you like! I also suggest VERY light mascara the same color as your natural hair and a little bit of purple, orange, or brown shadow right under your eyes to butch you up. Believe it or not, it works! The most important part of this, however, is your brows. Make them as dark, massive and messy as they can be without looking like you have makeup on. The rest of the makeup tips are irrelevant without thickening your brows. I know sometimes I’ve only needed to do the brows and with (gray) baggy butch clothing, I’ve passed as a gay cis boy! Btw, everything I know about makeup I’ve learned from drag kings and non-binary performers, so I reccomend supporting a few! (Or more than a few! Or ALLLLLLLLLL of them!!!! They all deserve our love! >:DD)

        Finally, a gender-affirming therapy that doesn’t/shouldn’t require a medical transition is voice therapy! A specialist can work with you to determine what you want your voice to sound like and how to get there through vocal exercises. If you’re not able to access a voice therapist, then I have a fantastic youtube channel for you! It’s called Trans Vocal Training, and you learn how to masculinize or feminize your voice. I’ve tried a couple videos, and when I did the exercises they’ve really helped!

        Full disclousure: I don’t do a lot of the tips I’ve given you :)) I usually go out in whatever clothes I like (they usually look “androgynous,” whatever that means in my American Californian culture) with no makeup and my hair in whatever state it’s in at the moment, but because I bind and pack I get clocked as trans a LOT. (I’d like to start doing makeup and combine “masculine” contouring and a fake moustache with really femme colors and shapes, but I don’t have time for that right now.) However, these are all things I’ve learned in my transition from a cis woman to a nonbinary person that may help you out! Ik it was a LOT, but I really hope it helps! I hope your genderfluid dreams come true! <333

  10. Your blog was recently recommended to me since I identify somewhere between genderless and male and wanna retain that *pretty* aspect. You’re very brave, and it’s so good to see someone who not only has been on a lower dose like I was considering, but push through the periods of NOT being on T- I’ve seen a trans friend panic whenever he can’t afford or schedule his T-shot and it made me more nervous about it all.

    I’m definitely going to look around more. I just wanted to thank you. I haven’t found many nonbinary trans resources yet. ❤

  11. I’ve been on a low dose of T for the past two and a half years, around .25 (sometimes a bit higher, sometimes a bit lower) weekly. I have loved the pace of my transition and how I appear physically now. My only concern is that I feel tired often and my friend thinks it might be because of my low dose, I’m not sure if this is from this or something else, have you or anyone else experienced this? I’m checking it out with an Endocrinologist but it is also very useful to know about other people’s experiences when advocating with doctors.

  12. Can I still get away with looking a bit feminine on low T? The reason I ask is because sometimes I am masculine and other times I am more feminine, I want to know if I can still get away with wearing a dress if I want to or will it just look like I’m in drag?

  13. Hi micah,

    I was wondering about something more practical. Are all vials one use or do you get multiuse vials? Also the syringes or(whatever is on the other end of the big needles) do the come in a microlitre reading? If one vial has 10ml of 200mg/ml and you wanted 50mg only youd need 0.25ml right?

    1. Great questions.

      Vials come in 1mL, or 10mL. If you take a standard dose, the small vial is good for one or two times. On the low dose 50mg (0.25mL – which is what I take) the large vial last me over 6 months. I try to replace it after that. With a $10 copay, that’s a bargain! Even if you pay full price at Stoheckers ($50-$100) it’s still cheap.

      The syringes can be are fairly large. So I ask for the 1mL ones, the small ones diabetics use (that’s how the pharmacist understood.)

      Also, the needles come in different sizes. Testosterone is thick, so you need a larger needle to pass it through (try 22 guage). Now, I’m a wimp, so if you get the screw top syringes, you can draw the T with one, then screw on a smaller needle (25 guage) for injection. This is something doctors don’t care or notice; before knowing this I was using up to an 18 gauge – which is huge!

      One more bump. If you have a small dose like 50mg, a 1mL vial is technically 4 doses, or two months. One time my insurance refused to cover it because they only covered one month at a time. Ridiculous, because they don’t make smaller vials.

  14. I just want to personally thank you for being willing to share your journey and putting this out there. I am a genderqueer person and have questioned for months whether I want to go on T, and this article and video have given me the starting information I needed to process so I can confidently look into it. I didn’t really even know if low dose T was an option and the thought of HRT has really freaked me out in the past, but this video just took a ten pound weight of anxiety off my back! Seriously, man – thank you from the bottom of my heart!

  15. Thank you so much for sharing all this info!! I’m nonbinary and have been thinking about low dose testosterone mainly for a voice change and this really really helped me!!

  16. Has the low dose helped with your energy levels?
    I’m a butch (male presenting) lesbian. I hate my voice (have heard it when paging stat cleans and it makes me cringe as I sound like a total girl). And my energy levels are horribly low. I’ve considered going on t, a majorly low dose of it, as I would like to get rid of the girl voice, build up some muscle, and gain some energy. The biggest thing stopping me from discussing it with my Dr is I don’t want to gain facial hair. I already get some facial hair and it drives me crazy. Yes I want to man up a bit, but I don’t wanna be scruffy.

    1. Some people do report more energy on T. Personally I don’t feel as fatigued as I used to, but I’m not sure if it was T that gave me energy, or just stabilizing my thyroid levels.

      Facial hair was something I struggled with a lot. Now that I have it I’m not bothered by it (but I did transition towards a more masculine appearance). If you already have facial hair, it will likely increase even on low dose. Then again, T would likely change your voice as well.

      What low dose would give you is time and control, in case you see changes you don’t like and decide to stop. There are a lot of elements to balance and think about, be patient with yourself as you figure it out…

      1. First off, thank you for responding
        I’ve been getting chin hairs for years and have a bit of a stash that’s just getting darker over the years (I’m 35),you’d think I’d be use to it, but I want it gone lol. But u also just have issues with upper body hair too being with (unshaved legs don’t bother me but everything else does). In no way am I against looking more manly as I’m already looking into reducing the size of my chest. I’ve hated my chest for years, but my wife prefers that I keep at least a little something, otherwise I’d take them completely off. I also hate when I’m called ma’am, young lady, our really anything girly. Besides the body parts there’s really no girl here at all.

  17. While it’s your body and you can do what you like, I don’t think it’s a good idea to be giving anything like advise out. You can say what you’ve done, but that’s it. Anyone coming here and expecting a good idea of what low dose T is like should so so knowing that they should go to a doctor. Hormones aren’t candy. They don’t just affect sex characteristics, they affect your entire body and I don’t know what effect going on and off would have. I’d imagine it would throw certain bodily processes off. In other words, always ask a doctor!

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