Myth #1: Taking testosterone (“T”) for transition will make trans men uncontrollably angry and volatile, or cause “‘roid rage.”
This is one of the most common myths about FTM transsexuals who take testosterone, but there is no compelling evidence to support such a sweeping generalization. Indeed, while some trans men anecdotally report feeling shorter tempered or irritable for a period after starting T, many others report that they feel calmer and more even-tempered since taking T. Yet time and again, trans men and their loved ones voice fear that taking testosterone will somehow automatically change an FTM transsexual into a terrible, angry, or violent person.
Myth #2: Taking testosterone will give you cancer.
Calling this a “myth” is somewhat of a misnomer, because there is no solid proof one way or another as to the increased risk of cancer in FTM transsexuals taking testosterone for the purpose of transition. The truth is that FTM transsexuals, as a population, have not been studied in a large enough sample size and over enough time to determine the long-term risks of cancer associated with testosterone use for transition and lifetime maintenance of male secondary sex characteristics.
That being said, the two most commonly cited cancer concerns associated with trans men taking T are liver cancer, and cancer of the female reproductive organs (uterus/endometrium, cervix, and/or ovaries).
Myth #3: Taking testosterone will make you grow taller.
Unless you begin testosterone therapy while still in your pubescent years (i.e., in your teens), it will not make you grow significantly taller.
Myth #4: Taking testosterone will make your breasts shrink away completely.
One of the effects of testosterone therapy in many FTM transsexuals is a redistribution of body fat from a “female-like” pattern to a “male-like” pattern. A decrease in fatty tissue around the breast area therefore would not be unusual. However, unless he is very small-chested to begin with, this decrease will not be significant enough to make his chest appear male (without surgical intervention).
Breast tissue is made up of fat, connective tissue, glandular tissue or “lobes,” and a ductal system. This is true of males and females. The glandular and ductal tissue of most females develops quite a bit at puberty due mainly to estrogen, and a lot of fat cell growth in the breasts also occurs at that time.
Testosterone might decrease some of that fatty tissue distribution around the breasts, but probably not all of it, and the glandular and ductal tissues that have already developed will remain as well. So, hopes of having breasts simply “melt away” upon starting testosterone will only be fulfilled for the few who have very little breast development to begin with.
Myth #5: If you stop taking testosterone after chest surgery, your breasts will grow back.
In order to answer this myth, let’s reconsider from Myth #4 exactly what breasts are made of: fatty tissue, connective tissue, and glandular tissue or “lobes,” and a ductal system. Again, the glandular and ductal tissue of most females develops quite a bit at puberty, and there is also a lot of fat cell growth that comes along with it.
Most trans men have chest reconstruction well after pubescent development of the breasts. When a surgeon removes tissue in an FTM chest reconstruction surgery, s/he is removing glandular/fibrous tissue as well as excess fatty tissue. The surgeon (if s/he is doing a good job) removes as much of the glandular/ductal tissue as possible, and quite a bit of the fatty tissue as well. A little fat is usually left behind because without some fat, the wall of the chest would look too flat or even concave compared to the rest of the torso. (For more information on FTM chest reconstruction surgery, click here.) The amount and location of tissue left behind will depend on the skills of the surgeon and the surgical method used to remove the tissue.
Once glandular/ductal tissue has been surgically removed from the body, it is gone. It will not spontaneously grow back. Any very small amount of glandular/ductal tissue that may remain could experience some shrinkage or growth, but this would be minor.
Fatty tissue left behind may go through phases of growth and shrinkage, just like all fat on the body is susceptible to growth and shrinkage. Fat cells can always grow bigger due to influences in food intake, metabolism shifts, or hormone levels. If a trans man discontinues testosterone and still has functioning ovaries, there may be a shift in overall bodyfat distribution to a more “female-like” pattern, which may include a small fat increase in the chest area. But keep in mind that, for the most part, a post-chest surgery trans man has had a very large amount of tissue removed from his chest, such that even some growth in that fat will probably not become so significant as to re-grow “breasts” in the same way he once had them. Also keep in mind that some trans guys have chest surgery pre-testosterone (sometimes years prior to starting testosterone) and some people opt for chest surgery without testosterone, and these people generally do not experience re-growth of breasts post-surgery.
Myth #6: Taking testosterone will make you gay.
Some trans men may find that their sexual feelings and attractions shift after starting testosterone therapy, while others may not. Some trans guys are attracted to women pre-testosterone and remain attracted to women post-testosterone. Some are attracted to men pre-testosterone and remain attracted to men post-testosterone. Some may find their attractions shift from women to men or vice versa pre- and/or post-testosterone. Human sexuality is a complex subject, and FTM transsexuals are no different in this regard. There are straight, gay, bisexual, and asexual trans men, as well as people who don’t really identify with any of those categories.
So, there is no specific correlation between taking testosterone and suddenly becoming gay.
Myth #7: If someone takes huge doses of testosterone, he will transition faster than at an “average” dose.
During the first months of T therapy, many trans men feel impatient waiting for masculinizing changes to happen. Some may consider doubling or tripling their dose, thinking that the more they put in, the faster the changes will come. However, as was mentioned in the “FTM Testosterone Therapy Basics” section, dramatically increasing your T dose might have the effect of slowing your changes. This is because excess testosterone in your body can be converted into estrogen by an enzyme called “aromatase.” This conversion is part of the body’s natural feedback system— if there is an abundance of testosterone in the body, it is converted (“aromatized”) to estrogen in order to maintain a “normal” hormonal balance. Therefore, taking very large doses of testosterone might not be a great idea.
Changes from taking testosterone are cumulative, meaning that they build steadily over time. While some of the earliest changes (typically in voice, oiliness of the skin, and libido) may happen in the early weeks and months, most other changes (such as body hair and beard growth) take many months and even years to complete. One trans guy might see quick changes in one area and slower changes in other areas, while another person might see just the opposite. The results and overall timeline of changes on testosterone therapy are impossible to know ahead of time. Patience is key (though it may be hard to muster for some trans guys who want changes to happen right away).
If you feel your transition isn’t happening at a reasonable pace, speak openly to your doctor, have your T levels checked periodically (especially during the first year of treatment), take note of your changes and the feelings in your body, and adjust your dosage within reasonable limits if necessary. You might even find that a slightly lower dose could work better for you.
Myth #8: Taking testosterone will make you fat.
Varying levels of testosterone— like many other hormones— can effect a person’s metabolism, as well as other processes and systems in the body. (The word “metabolism” here refers to processes occurring in the body that turn the food you eat into energy that sustains you.) But just because a hormone can affect metabolism doesn’t mean it will make you fat or skinny; usually, there are a combination of factors that go into weight loss or gain, and not all of those factors are fully understood. In order to explore this myth, we need to consider some of the effects of testosterone administration, including metabolic changes, the idea of insulin resistance, and bodyfat redistribution/abdominal fat.
Regarding metabolic rate, testosterone administration in non-transgender men has been shown to increase metabolism, loosely meaning that it increases the rate at which one is able to burn food energy. In other words, administering testosterone may actually help a man in maintaining a healthy body weight.
Myth #9: FTM transsexuals are just lesbians who couldn’t cope with their homosexual feelings.
Until quite recently, in order to be considered a “true transsexual” by the medical establishment (and thus be granted access to hormonal and surgical treatment), one had to declare sexual attraction exclusively to members of one’s birth sex. So, for example, a “true” female-to-male transsexual was thought to necessarily be attracted to women. Indeed, if he declared he was attracted to men, a trans man might not have been considered a “good candidate” for medical transition or for a “successful life” as a man. This notion was probably due in part to the overwhelming assumptions of a heterosexual norm in our culture, as well as to “homosexual/gender invert” theories that were introduced by some doctors and psychiatrists around the early 1900s (see more about this in Myth #10).
Clinicians who treat transsexual populations have in general moved away from such thinking, recognizing that a number of the transsexual people they treat are indeed attracted to people opposite of their birth sex, and identify as gay post-transition. There has been increasing recognition that gender identity and sexual orientation are separate aspects of an individual identity, and one is not necessarily predictive of the other.
The very existence of transsexual people who identify as gay post-transition pokes a giant hole in the theory that all transsexuals are just gay people who cannot accept their own homosexuality, and supports the notion that sex, gender identity, and sexual orientation may all be separate parts of a person’s identity.
Another blow to the theory that FTM transsexuals are simply unhappy or unaware lesbians is the fact that a significant portion of trans men (but certainly not all) have lived “successfully” as lesbians, or in queer women’s communities, for some fraction of their lives. Many of those who have lived in LBG communities transition not out of homophobia, but simply out of the recognition that the identity of woman just did not fit them.
Myth #10: All trans men come from the lesbian community, or originally lived as lesbians.
While a certain portion of trans men have lived as lesbians in the past, many others have never lived as lesbians, and many are attracted to men pre- and post-transition. So to declare that “all trans men” come from the same sexual experience or background is decidedly false.
This misconception is common because many people erroneously think of transsexual and transgender people as being “just another kind of gay person.” This is probably due to early theories of sexologists and psychiatrists (from the late 19th and early 20th centuries)— as well as persistent cultural stereotypes— that describe homosexuals as being “gender inverts” (i.e., where gay men are thought to be necessarily very feminine and lesbians are thought to be necessarily very masculine). Of course, many gay men are not terribly feminine and many lesbians are not terribly masculine in comparison to their heterosexual counterparts, but the association of gayness with gender bending continues to be popular to this day.
Of course, the reality of gender presentation and identity in both LBG and heterosexual persons is far more complex. There are very “butch” straight women as well as very feminine lesbians, there are “metrosexual” straight males and masculine gay men, with all shades in between.
The LBG community does has a proud history of celebrating gender bending traditions and lifestyles (consider the examples of drag shows, camp, and butch/femme culture), but those traditions and identities are not the same as the experiences and identities of most transsexual people. Indeed, while the LBG community has celebrated certain aspects of transgender/gender-bending traditions, they often have been lukewarm or outright negative in their reactions to transsexuals. Gay and lesbian people often dislike associations of gayness with transsexuality, because most gay and lesbian people are quite happy with their bodies and do not wish to be anything other than the sex/gender they were born into. The compounded “LBGT” acronym (lesbian, bisexual, gay, transgender) can further confuse the issue for those who cannot or will not differentiate between sexual orientation and gender identity.
However, those who have studied transsexual and transgender phenomena and people in earnest have come to realize that a person’s gender identity (the gender/sex they believe themselves to be) is not correlated in a predictable way to that person’s sexual orientation. This idea is borne out in the observation of the diversity among trans men. As was noted in Myth #8, there is a portion of trans men who are attracted to men pre- and post-transition, and who have had little or no contact with lesbian communities (but may certainly be in contact with gay men and gay male communities). There is also a portion of trans guys who are attracted to women pre- and post-transition, who exclusively date women who identify as heterosexual, and who have never lived their lives in contact with lesbians or LBG subcultures. A portion of trans men are attracted to men and women, and may or may not spend time within LBG circles. And there are trans guys who lived some of their lives in lesbian relationships and communities prior to transition. Some retain ties with LBG communities post-transition, while some sever those ties (or are ostracized) from those communities. In short, trans men have a variety of sexual histories and identities, much like all other people.
Myth #11: It is always easy to tell who is an FTM transsexual.
Some people feel they can always tell who is a transsexual just by looking at them. Perhaps some of those people have spotted a transsexual successfully at one time or another, or perhaps they have erroneous assumptions that all transsexuals will always show tell-tale signs of their birth sex (i.e., they think wide hips, a high voice, or an androgynous appearance will always “give away” an FTM transsexual).
However, this kind of thinking fails to account for major flaws in observer bias. That is, if you don’t recognize someone as being transsexual who is sitting right in front of you in the elevator or bus or grocery store, then you go right on thinking that you didn’t see any transsexuals that day! Many observers do not notice transsexuals who look “normal” to them.
Asking someone to pick the transsexuals out of a crowd is like asking someone to tell you who in a room is wearing blue underwear. If the observer declares that two people are wearing blue underwear because he can see two pairs of blue shorts poking out in the crowd, he might have missed five others whose underwear simply doesn’t happen to be visible.
Additionally, there is a chance of misreading a non-trans person as trans due to rigid stereotyping about the sexes. For example, just because a man happens to be very short, or happens to have narrow shoulders, doesn’t mean he is trans.
Simply put, lots of trans men— especially after years or hormone therapy— blend right in with most men, and look quite unremarkable. Many of them can walk naked through a men’s locker room easily without anyone knowing they are trans. Couple this with the fact that there are different sizes, shapes, and kinds of men in the world, and the ability to differentiate trans and non-trans men tends to go right out the window.
Myth #12: It is known with certainty that transsexuality is caused by any of the following:
- congenital defect or heredity
- a hormone imbalance in the womb
- chemical exposure
- atypical psychological development
- physical or sexual abuse, an overbearing mother, an absent father, or other environmental factors
- an inability to cope with homosexual feelings
If anyone, including a trans person, tries to tell you that they know with certainty the cause of transsexuality or transgender phenomena, they are not being entirely honest with you. The truth is that we simply do not know for certain why some people are transgender or transsexual. Numerous theories exist (including all of the ones listed above and probably more)—and perhaps one or more of those theories may turn out to be true—but as yet none has come close to being proven.
While there is no known “cause” for transgender and transsexual phenomena, we do know a few things for certain. First, there is ample documented evidence of examples of cross-gender/cross-sex identification and behaviors in numerous different cultures and time periods. Not all cultures have conceptualized of sex and gender in the same manner as current Western culture. In some cases, cross-gender and other gender roles that may be considered atypical by today’s Western culture have been held in high esteem. Cross-gender traditions and myths have also existed in religious traditions that pre-date Christianity. (For a few starting points on cross-gender traditions and history, check out Cross Dressing, Sex, and Gender by Vern Bullough and Bonnie Bullough, Transgender Warriors by Leslie Feinberg (particularly the footnotes for interesting source materials), Changing Ones: Third and Fourth Genders in Native North America by Will Roscoe, and Neither Man Nor Woman: The Hijras of India by Serena Nanda.)
Second, we also know that nature sometimes produces human bodies which cannot be neatly categorized as male or female (such bodies are often labeled as intersex), as well as a diverse array of gender traits and behaviors within all sexes. Variance with regard to sex and gender can be found in humans as well as other animals. (For some interesting readings on the topic of biological, gender, and sexual diversity, check out Evolution’s Rainbow: Diversity, Gender, and Sexuality in Nature and People by Joan Roughgarden, The Riddle of Gender: Science, Activism, and Transgender Rights by Deborah Rudacille, and Sexing the Body: Gender Politics and the Construction of Sexuality by Anne Fausto-Sterling. Add Biological Exuberance: Animal Homosexuality and Natural Diversity by Bruce Bagemihl if you also want to learn more about the wealth of variance in sexual activity seen in nature.)
It seems fitting that people of cross-gender and cross-sex experience or identity may be thought of as one part of natural variance in sex and gender expression, as well as a longstanding part of historical, cultural, and religious variances found throughout the world.