I recently found out that the medication I use to help me manage my blood sugar has a tendency to lower testosterone levels. For a while, I’d been experiencing low energy, a decrease in my sexual desire, and feeling less focused, but those are all so nebulous that I hadn’t connected them until I participated in a panel discussion on the topic of sex & aging and heard a presentation by a medical doctor who specializes in men’s sexual health issues.
I have to admit that I felt some trepidation about writing or talking about this. The cultural links between testosterone and masculinity are complex, and while many of my female friends who have health issues with their hormone levels have spoken and blogged about that, it felt different for me. Upon reflection, I realized that my hesitation was based on how I thought other people would perceive me if I admitted that my testosterone levels were low, even if it was the result of a medication. Testosterone is linked to our notions of masculinity differently from how estrogen and progesterone are connected to how we think of femininity. Once that became clear, I decided it was important to come out about it. I refuse to let outdated ideas about masculinity whether mine or someone else’s, keep me from speaking my truth. If there’s no shame in having low estrogen or progesterone, whether because of a medication, a health issue, or anything else, then there’s no shame in having low testosterone.
It’s been really interesting to notice how things have changed over the last few weeks, since I started using a gel that delivers testosterone through the skin. I had a bit of a heads up regarding what to expect from some of the transgender men who have shared their stories with me, but there’s a big difference between their experiences and mine. After all, testosterone has been the primary sex hormone in my life and I don’t share their experience of switching from a primarily estrogen/progesterone-based system to a primarily testosterone-based system. For me, it’s been more like coming back to myself, rather than coming into myself (a phrase I’ve heard some trans* guys use when describing testosterone).
The biggest effect that I noticed almost right away was that I started feeling more energetic. I’m waking up more alert, I have more focus, I don’t get tired as easily, and I’m sleeping better. It’s as if the dial had been slowly getting turned down and now it’s back where it belongs. Life seems brighter and I feel a lot happier. I’m a lot more optimistic in the face of challenges and my “can do” attitude has returned. (Good timing, too. September has been an especially busy month.)
At the same time, I’m also a bit more irritable. Little things trigger anger more easily and it’s taking more work to contain and manage it. Most of the people in my life haven’t really noticed it, but my partner certainly has seen me get irritated or cranky more easily. That’s often the case- she saw the effects of my dysregulated blood sugar much sooner than anyone else, too. I’m also more easily distracted when I’m doing something that I’d prefer to skip. I have less patience for the tasks I need to do that I wish I didn’t have to do. And being interrupted when I’m working on something feels much more annoying than it did before.
Both my renewed energy and my increased irritability have been fascinating to observe, in as much as I can from the inside. I remember being a teenager not being able to sit still because I wanted to jump up and do stuff. I also recall how easily I’d freak out about things that seemed hugely important at the time and really were nothing to worry about. Part of what I’ve been sitting with around this is a deeper understanding of how much biology shapes how we interpret the world and how we choose to act in response.
Along those lines, I’ve also noticed that my urge to look at people I find attractive has has increased. Walking down the street or sitting on the train, I have more of an impulse to check folks out. I’m glad that I have more practice at managing my sexual energy than when I was younger. I’m also grateful that I’ve learned some better tools at initiating sex, at flirting, and at recognizing the differences between flirting and harassment. Though I wish it hadn’t been so, when I was younger and less practiced, there were times when my sexual energy came out more strongly than the person I was directing it at wanted. At 42, I have a much easier time keeping things in check than I did at 15, 25, or even 35.
I can say pretty much the same thing about my increased sexual desire. While it has definitely shifted in response to the increased testosterone, I don’t feel like it’s beyond my ability to manage it. But that was certainly not the case 25 years ago, when I sometimes felt like I was being pulled along at the whim of urges beyond my ability to manage.
All of this has given me a lot to think about. Without making excuses for anyone’s behavior in any way, it does seem to me that the ways that some people talk about how men manage ourselves rarely takes the physiological effects of testosterone into account. I suspect that part of the root of that is that most of the people talking about how men behave are women who don’t actually understand what it’s like from the inside. For example, I’ve been told by several women that it’s not hard to not check out somebody’s ass, or that it’s not difficult to keep from staring at someone’s breasts. But frankly, sometimes, it is. When I was younger and I lacked the skills to keep my impulses in check, it really was challenging and I wasn’t always successful at it. Now, I can notice the impulse and not act upon it, but that’s something that only came with age and practice.
Just to be clear- I’m not denying how annoying and oppressive such behavior can be. It’s just that we can’t teach young men (and, for that matter, older men) how to deal with this if we can’t be honest about what’s going on. I don’t want to coddle anyone, and the best way to support positive change is to understand where things start. In my view, gender is the result of a recursive interplay between biology and culture. There’s a lot of discussion about the cultural side, for a number of reasons. I think it’s time we started paying more attention to the biology side so that we can take it into account and develop strategies for working with it.
As an example, if I see someone I find attractive, it can feel like my impulse to look at them is beyond my control. It’s no wonder that so many cultures try to manage men’s sexualities by controlling women’s behavior. After all, if I can’t control myself, then external circumstances need to be controlled so I don’t get set off. The difference, of course, is that it can feel like things are beyond my control without that actually being true. We need to hold onto both of those pieces at the same time if we’re going to make any positive changes. We need to acknowledge how things feel AND the deeper truth that our feelings don’t always reflect what’s happening outside of our heads. When we can do that, we can support learning better tools with which to respond to our feelings.
In some ways, that’s a lot trickier when it comes to cisgender men’s experiences of testosterone. Without the ups and downs of a menstrual cycle, the shifts of testosterone are generally harder to observe. Men also tend to talk about our experiences in these realms less often. Most of the discussion about how these influences play out in the world comes from women, so they rarely reflect (and sometimes demonize) men’s patterns. And our society makes a lot of excuses for how men choose to act, rather than holding us responsible. But even so and without wanting to reinforce pointless gender essentialism, I do think that we need to stop pretending that the differences that roughly correlate with physical sex don’t lead to different perspectives, while also holding onto the goal of supporting behaviors that help people thrive.
Men’s anger is another place where we need to look at this. My increased irritability seems to be leveling out as my body gets used to things and as I become more accustomed to regulating my reactions. It’s become much easier for me to grasp why so many men, especially younger men, lash out or break things in a fit of anger. If they don’t have practical skills for keeping their reactions in check, knowing better or being attacked and shamed doesn’t do much good. Having the tools to notice and manage my reactions, as well as doing the physical and emotional self-care I need to support myself, does. Wouldn’t be lovely if we taught those to young boys instead of either excusing their actions or shaming them for their behavior?
I don’t have any specific answers for any of this. But having the opportunity to rediscover the influence of testosterone after developing some of the skills to manage it has been a really interesting ride. Some of it has been pretty much like I expected, but there have also been some surprises along the way. I’m curious to see where it goes and to discover what else comes up as I move through this. It’s given me more compassion for my younger self, as well as the boys and young men I see around me. And it’s given me a different perspective on why addressing some of men’s actions has been so difficult.
If you’ve ever taken testosterone, whatever your gender or the reason, I’d love to know what that was like for you. What did you notice? How did it change your thoughts and feelings? What effects did it have on your sexual desires or actions? Add a comment below!