Stopping Hormone Therapy DOES NOT Make You Any Less Trans

Most mainstream information in the media surrounding trans identities focuses on hormone therapy and how a lot of folks choose to use hormones during their transition. One thing that is absent from most of these narratives is the fact that not all trans folks opt to stay on hormone therapy for the entirety of their lives, and some may opt to never initiate hormone therapy at all. It’s a common misconception that undergoing hormone therapy is what “makes” a person transgender. 

Transitioning isn’t Linear

While hormone therapy may be a part of one’s trans identity, it’s not actually a defining characteristic of being transgender. Too often “medical transition is often painted as a linear process for trans people.” It’s assumed that all trans individuals want all the desired effects of hormone therapy and that in order to reach a “valid” identity they must conform their bodies to fulfill gender stereotypes. In reality, the journey is not a linear process, one without a clear beginning or end, as many trans folks choose to go off hormone therapy “…for a number of reasons, such as access to care, a desire to get pregnant, medical complications, or contentment with the results of HRT they already received.” One of the main issues with this misconception of a linear process is that trans folks who don’t undergo HRT or other gender-affirming medical procedures are construed as invalid by society. This harmful misconception is untrue: Gender is simply a social construct and people are not required to fit into the confines of the limiting gender binary in order to be valid. In reality, gender identity is only validated and defined by the individual and what gender expression affirms this internal identity. Every and any expression of gender is valid if a person feels they portray their authentic selves in that given moment. This is why hormone therapy is a mere optional accompaniment to the trans identity rather than a necessity. 

Some individuals opt to start either estrogen or testosterone because they wish to transform their bodies to outwardly reflect their gender identity. A trans woman may elect to undergo feminizing hormone therapy for a multitude of desired effects such as to “…develop breasts, softer skin, rounder hips and more.” A trans man may elect to undergo masculinizing hormone therapy that can lead to “…increased facial and body hair…deepening of the voice… cessation of menstruation, [and] clitoral enlargement…”  among many other things. Hormone therapy can be helpful in helping individuals overcome gender dysphoria. But as discussed, not all trans individuals take hormone therapy. As is unfortunately common in this field, there is little discourse that reflects genuine stories of trans people who never elected to undergo hormone therapy or began therapy and later decided to stop. Mainstream media outlets commonly note that the only reason a person would stop HRT is that they regret their decision in transition. This harmful argument is “…often used as a political argument to justify anti-trans medical bills that suppress access to medical care for trans people.” While it is completely valid for an individual to change their mind during a gender transition and decide they want to de-transition, this is not the case for all trans folks who decide to stop HRT. Due to the lack of information surrounding the cessation of hormone therapy specifically, it’s become crucial to bring attention to the topic. The fact of the matter is that hormone therapy does not make an individual any more or less trans. Hormone therapy is simply an option that trans folks can choose to accompany them through their gender-conforming process. In order to understand the relationship between hormone therapy and trans identities let’s look at some experiences of trans folk who have gone on and off hormone therapy while living as valid individuals. 

Freedom and HRT

An article for Insider titled “You don’t have to constantly take hormones to be trans, 3 people who have gone on and off hormones say” by Canela López provides insight into what it means to be trans and where HRT can come into play. I appreciate that the article looks into trans folks who also identify as nonbinary, as most media surrounding transgender identities covers men and women and excludes nonbinary individuals. In the article, Lopez interviews Simon Moore, a 27-year-old nonbinary trans individual who uses they/them pronouns. Moore initially started testosterone hormone therapy in order to help them reach gender euphoria. However, Moore did not opt for the standard dose of T, rather they “…decided a microdose would offer a slower transition.” They were only looking to be on T for about a year to achieve the desired effect of lowering their voice. Rather than taking the standard 0.5 milligrams of testosterone every week indefinitely, Moore decided to microdose 0.3 mG of testosterone a week for just seven months. Once they achieved the desired effect of a deeper voice, Moore stopped taking testosterone. Once halting T therapy Moore’s deeper voice remained because the impact T has on one’s voice is permanent. As a nonbinary and trans individual, Moore did not wish to have entirely masculine characteristics that indefinite T therapy would have resulted in. When asked about their decision to wean off of testosterone they said:

“’I’m not really a ‘trans man.’ I never really wanted to be a full-on masc, like go to the gym, get ripped, and get the whole beard,” Moore told Insider. ‘I wanted something in between. I wanted to be comfortable.’” (Insider) 

Moore’s story is proof that a trans person does not validate their identity solely with hormone therapy. Gender identities are not one-size-fits-all as most people fall somewhere in between the male/female gender binary. 

Tuck Woodstock is a nonbinary trans individual who did not decide to start testosterone therapy until four years into his journey. Woodstock is a gender educator and knew that testosterone was a resource for him, but did not initially feel that he wanted to utilize it:

“’The reason that it took four years for me to start testosterone is because it took four years for me to want to start testosterone. It was very much, for me, an incremental journey where the way that I thought about my own gender inched very slowly away from womanhood.’” (Insider) 

Woodstock’s relationship with T is one that waxes and wanes; he will start and stop T therapy at the times that feel right for him. One of the reasons he has stopped T is due to the significant voice shift that the therapy causes on his voice. Woodstock is also a singer and finds it difficult to sing while remaining on T therapy consistently. He also wants to take time to “…relish the changes his body is going through while on testosterone and likes to take breaks.” (Insider) His story is a great example of taking time to celebrate one’s body in every form. For many of us, it can be difficult to feel comfortable in your own body, especially if you are on a journey to find and understand your gender identity. Transness is not about fitting the gender mold that societyhas mistakenly put forth for years, but rather it’s about exploration and love for one’s body and finding what works for you. 

Kayden Coleman is a trans man who took testosterone for 5 years before he decided to take a break and eventually restarted therapy again after that. Coleman was initially super excited by all of the changes he saw in his body while on T but eventually “…the weekly shot became more of a hassle, especially once certain changes, like hair growth and voice deepening, plateaued.” The first time Coleman stopped taking T was before he underwent top surgery in 2013. The second time was when he “…moved states, briefly lost medical coverage, and became pregnant.” After stopping T Coleman still felt valid in his identity as a trans man because it wasn’t about the actual hormone therapy itself but rather, similar to others, the effects that T had on his voice and body. T helped Coleman move toward gender euphoria but he did not need it to validate his identity. In regards to the relationship between transness and hormones Coleman said the following: “’Trans people should feel free enough to start and stop hormones as a form of self-care.’”

Coleman beautiful point further validates the notion that hormone therapy is not needed to validate a person’s gender but rather is a resource a person can choose or not choose to use. At the end of the day, the decision to start HRT is “…a personal one based on a multitude of factors, including your aesthetic goals, your medical history, and your desires.” (them.us) Transness is not one size fits all, just as gender is a spectrum. Remember that Transgender people “…are those who identify as a gender that isn’t congruent with the sex they were assigned at birth – be it male or female.” (Jefferson Health) Their gender identity does not need to fall into a clean-cut category in order for them to be seen as a valid trans person. Transgender is an umbrella term that encompasses varying identities of “gender nonconforming,” “nonbinary,” and “genderqueer,” – all of which refer to those who identify outside of the male-female binary. Gender is about self-expression, and that’s one of the reasons why people’s gender identity often changes throughout their life. At the end of the day being the most authentic version of yourself at any given time is the only thing necessary to be valid as a human being.  

By Alyssa Morterud