Risk and Faith
So this past week I had my first doctor’s appointment to discuss the medical aspects of what is called, in the modern vernacular, FtM (female-to-male) transitioning. And the big thing that’s been on my mind is testosterone - or T, as transmen tend to familiarly call it - and the choices it involves.
Hormone therapy - testosterone for transmen, estrogen for transwomen - is usually the first step in making a physical gender transition. Testosterone taken into a female body gradually begins to masculinize that body, in ways both subtle and obvious; it encourages the growth of facial hair, new patterns of muscular development, and a slew of other fascinating changes. In many ways, T is the Holy Grail of FtM transition.
Now, I should probably mention - for those of you who know me in real life, but don’t necessarily know the details - that I have not, as of yet, touched a drop of the stuff. (No, really, officer! *hic*) Yes, this lovely scraggly thing that one friend likes to call my “magnificent beard” is something that my body has been quite happy to produce for me without any outside prompting - I just had to stop shaving. (Now there’s a message and a metaphor from the Universe, don’t you think?) And I must confess... I really like the silly little thing. I like it a whole lot.
For one thing, it helps to remind others - especially those who don’t see me very often - that I am now openly identifying as male, and asking to be treated as such. It’s a handy-dandy pronoun-reinforcer! It also helps me remember not to compromise my journey, as I choose - and keep choosing, every day that I don’t just give in and shave - not to hide back in the old, safe, limiting identity, but to keep moving forward into my own truth. (I actually shaved it off once, and only once, after coming out - an act occasioned by fear of the reaction at my workplace if I didn’t - and it felt horrible, like going back to live in the closet all over again. So for now, I guess this is my badge of courage, and I’ll continue to wear it proudly!)
Among other effects, taking testosterone should gradually convince my body to fill in that scraggly little beard. Which frankly wouldn’t hurt my feelings at all!
Ah, but T is a fickle friend; it’s not always kind. Because at the same time, it may also set out to cheerfully rid me of what little hair I still have on top. (You’d think I’d be resigned to that by now - it’s been thinning since I hit puberty - but I’m finding an unexpected inner thread of resistance to the idea of suddenly accelerating the process!)
Alas, you don’t get to choose what changes you get. You can only take or leave the whole kit and caboodle.
And so, inevitably, T will also prod my voice into doing what male voices generally do, albeit usually at a much younger age: they begin to stumble blindly toward the basement (occasionally by way of the attic).
That last bit - the vocal changes - is one reason why a few transmen choose never to take T at all... and why I had originally thought I might be one of them. Because, overall, the record is not good for singers. Hormonal transitioning is widely considered a crapshoot for FtM vocalists; there is no guarantee that the singing voice will not be seriously damaged in the process.
Why? Well, when testosterone is administered to an adult who was not exposed to it during the original period of adolescence, the body will still try to make all of the usual male-puberty-stuff happen, including the lengthening and thickening of the vocal folds and the enlargement of the larynx. However, the body of an adult is not quite as malleable or responsive as that of an adolescent. One common result: a phenomenon one researcher calls “entrapped vocality” - a phrase that quite frankly gives me the heebie-jeebies. It occurs when growth in the vocal folds (fleshy, easily changed) outstrip the growth in the larynx (cartilaginous, not easily changed) that is necessary to accommodate them. Think “big voice in a small box” and you may understand why this image freaks me out! The outcome is loss of control, loss of projective power, poor tone, etc., etc., etc.
Now add in the fact that the vocal changes caused by testosterone are irreversible - and that’s scary as HELL.
I’ve spent all of my life so far with a voice that’s... well, it’s a pretty damn decent one. Not perfect, certainly; I can point out its weaknesses to you if you’d care to hear them. But overall it’s a well-built instrument that I was given, possessed of a high degree of strength and clarity, and I have honed it over the years into something that can provoke tears and laughter and sometimes even gasps of admiration. Though I play other instruments, this is my first and best.
More importantly... it’s also one of the few parts of myself, my physical self, that I’ve continued to value, throughout all these years of disowning most of the rest of me. And in a life full of false starts and uncertain paths, music is one thing I know I can do and do well! My singing ability lies pretty close to my core identity, my root feelings about who I am.
I first started researching the vocal effects of testosterone in FtM transition way back in 2008, long before I knew I would ever be seriously considering taking the stuff. At the time, it seemed like a strangely random fascination. (One that, I might add, showed up at a suspiciously defining - or redefining - moment in my life, when I was just choosing to leave grad school and painfully letting go of those parts of my identity that I had built around that particular pursuit.) At that point, there just wasn’t a whole lot of information available. The odds didn’t look good.
Now there seems to be a little more data out there, much of it hopeful. I’m personally convinced that the most important key in avoiding potential vocal problems will be to move slowly at all times, starting with very low dosages and proceeding with very small increases throughout the process, and this is what I plan to propose to my prescribing physician. This is in sharp contrast to traditional FtM hormonal treatment, which is focused on making the transition quickly in order to to ease the very real and damaging social and emotional pressures that most transitioning individuals face.
I’m not sure whether this has been tried, in the specific way that I would like to attempt it. The most detailed account, by a British musicologist who himself underwent FtM transition around ten years ago, describes the benefits of a slow start for about the first six months - at which point he changed both administration method and dosing, and began to experience some of the typical problems (admittedly in a lesser form that, at the time of publication, he seemed to feel could be worked through). I’m not sure whether there is some reason, beyond the understandable desire to quicken the other elements of transition (which he clearly wanted), why it might be necessary to move into a very different pattern partway through. (Does the body get desensitized to small changes in dosage? Or what?)
I plan to ask. Because I think I can handle the long period of transition that my envisioned program would require. I’m used to living in liminal spaces, the betwixts-and-betweens; truth be told, I quite like them. And my aim is not to vanish, upon completing transition, into the waves of “normal” men and never let anyone know I was born physically a woman (“going stealth,” as some call it). Even if I should happen to "pass" well enough for stealth, I’ll most likely stay out-and-proud as being Trans, because I feel it’s important that Transgender persons be visible in the world... and because I wouldn’t know how to be normal if I tried, anyway. So if it takes longer to get there... my question is, get WHERE? I’m already here.
I have a church community that accepts me for who I am and has already begun to make that mental shift with me, little by little. I have amazing friends who have worked to make that shift consciously and quickly. I have supervisors and coworkers who are willing and supportive to go there with me. I have family members who are loving and understanding, if not all exactly thrilled.
And of course, I have this magnificent beard. :)
So I think I have enough information to move forward, and enough patience and support to do it right - but there are still risks. I could be wrong about how well I understand the problem. I could find that my body has a nonstandard response to T. I could end up with an incorrect dosage through error, mine or the physician’s or the pharmacy’s. Any number of things could go wrong, once this becomes a real-life scenario.
This decision demands that I face the reality of risk to an important aspect of myself, to satisfy a deeper one. Well, hell... welcome to the human race, where hard decisions are par for the course, and the course can be a little like Satan’s idea of a nice relaxing game of mini-golf!
And so I am finding that, in a very real sense for me, this is a spiritual choice, an act of faith. Not blind faith, the kind where you close your eyes and assume that “everything will be all right.” Rather, it’s a choice to move forward in the face of risk, with at least partial knowledge of the possible consequences.
Maybe trust is a better word. I have long used the idea of “trusting one’s weight” to a particular structure as a metaphor for this kind of step. One of my former jobs involved climbing an extremely shaky and beat-up wooden ladder, sometimes once or twice weekly, to service a necessary system. I was never really sure that the rickety old thing would hold me (a quite heavy person even at that time), but the job had to be done, and I was the one standing there, the one who knew how to do it. So again and again I took a deep breath at the foot of that ladder and made the decision to trust my weight to it, cautiously but with determination. The trust was not in my “belief” that it would hold me, since I was never entirely certain that it would; the trust was in choosing to make the climb anyway - step by nervous step.
In this case, I’m learning to trust in a lot of things that I have never felt fully able to trust before. My sure knowledge of my own direction, and my right to make a truly major life-decision for myself, regardless of the fears and opinions of others. The care and concern of my prescribing physician as a true Ally. My ability to make informed choices on risky paths, and to take responsibility for my choices and their results..
I’m beginning to trust that the Universe is comprehensible enough - not completely so, but sufficiently - that I don’t have to fear living in it... really living, not just surviving.
I trust that I have gifts to give in this world, and that I can give them best when I am being deeply myself, without holding back. And that I can exist boldly and joyously, not as a victim hoping for pity, but as a free soul manifesting its birthright, moving open-heartedly into the full experience of life.
I trust that I can step forward into risk, with excitement and anticipation.
And there is music in that. A very sweet song.
Hormone therapy - testosterone for transmen, estrogen for transwomen - is usually the first step in making a physical gender transition. Testosterone taken into a female body gradually begins to masculinize that body, in ways both subtle and obvious; it encourages the growth of facial hair, new patterns of muscular development, and a slew of other fascinating changes. In many ways, T is the Holy Grail of FtM transition.
Now, I should probably mention - for those of you who know me in real life, but don’t necessarily know the details - that I have not, as of yet, touched a drop of the stuff. (No, really, officer! *hic*) Yes, this lovely scraggly thing that one friend likes to call my “magnificent beard” is something that my body has been quite happy to produce for me without any outside prompting - I just had to stop shaving. (Now there’s a message and a metaphor from the Universe, don’t you think?) And I must confess... I really like the silly little thing. I like it a whole lot.
For one thing, it helps to remind others - especially those who don’t see me very often - that I am now openly identifying as male, and asking to be treated as such. It’s a handy-dandy pronoun-reinforcer! It also helps me remember not to compromise my journey, as I choose - and keep choosing, every day that I don’t just give in and shave - not to hide back in the old, safe, limiting identity, but to keep moving forward into my own truth. (I actually shaved it off once, and only once, after coming out - an act occasioned by fear of the reaction at my workplace if I didn’t - and it felt horrible, like going back to live in the closet all over again. So for now, I guess this is my badge of courage, and I’ll continue to wear it proudly!)
Among other effects, taking testosterone should gradually convince my body to fill in that scraggly little beard. Which frankly wouldn’t hurt my feelings at all!
Ah, but T is a fickle friend; it’s not always kind. Because at the same time, it may also set out to cheerfully rid me of what little hair I still have on top. (You’d think I’d be resigned to that by now - it’s been thinning since I hit puberty - but I’m finding an unexpected inner thread of resistance to the idea of suddenly accelerating the process!)
Alas, you don’t get to choose what changes you get. You can only take or leave the whole kit and caboodle.
And so, inevitably, T will also prod my voice into doing what male voices generally do, albeit usually at a much younger age: they begin to stumble blindly toward the basement (occasionally by way of the attic).
That last bit - the vocal changes - is one reason why a few transmen choose never to take T at all... and why I had originally thought I might be one of them. Because, overall, the record is not good for singers. Hormonal transitioning is widely considered a crapshoot for FtM vocalists; there is no guarantee that the singing voice will not be seriously damaged in the process.
Why? Well, when testosterone is administered to an adult who was not exposed to it during the original period of adolescence, the body will still try to make all of the usual male-puberty-stuff happen, including the lengthening and thickening of the vocal folds and the enlargement of the larynx. However, the body of an adult is not quite as malleable or responsive as that of an adolescent. One common result: a phenomenon one researcher calls “entrapped vocality” - a phrase that quite frankly gives me the heebie-jeebies. It occurs when growth in the vocal folds (fleshy, easily changed) outstrip the growth in the larynx (cartilaginous, not easily changed) that is necessary to accommodate them. Think “big voice in a small box” and you may understand why this image freaks me out! The outcome is loss of control, loss of projective power, poor tone, etc., etc., etc.
Now add in the fact that the vocal changes caused by testosterone are irreversible - and that’s scary as HELL.
I’ve spent all of my life so far with a voice that’s... well, it’s a pretty damn decent one. Not perfect, certainly; I can point out its weaknesses to you if you’d care to hear them. But overall it’s a well-built instrument that I was given, possessed of a high degree of strength and clarity, and I have honed it over the years into something that can provoke tears and laughter and sometimes even gasps of admiration. Though I play other instruments, this is my first and best.
More importantly... it’s also one of the few parts of myself, my physical self, that I’ve continued to value, throughout all these years of disowning most of the rest of me. And in a life full of false starts and uncertain paths, music is one thing I know I can do and do well! My singing ability lies pretty close to my core identity, my root feelings about who I am.
I first started researching the vocal effects of testosterone in FtM transition way back in 2008, long before I knew I would ever be seriously considering taking the stuff. At the time, it seemed like a strangely random fascination. (One that, I might add, showed up at a suspiciously defining - or redefining - moment in my life, when I was just choosing to leave grad school and painfully letting go of those parts of my identity that I had built around that particular pursuit.) At that point, there just wasn’t a whole lot of information available. The odds didn’t look good.
Now there seems to be a little more data out there, much of it hopeful. I’m personally convinced that the most important key in avoiding potential vocal problems will be to move slowly at all times, starting with very low dosages and proceeding with very small increases throughout the process, and this is what I plan to propose to my prescribing physician. This is in sharp contrast to traditional FtM hormonal treatment, which is focused on making the transition quickly in order to to ease the very real and damaging social and emotional pressures that most transitioning individuals face.
I’m not sure whether this has been tried, in the specific way that I would like to attempt it. The most detailed account, by a British musicologist who himself underwent FtM transition around ten years ago, describes the benefits of a slow start for about the first six months - at which point he changed both administration method and dosing, and began to experience some of the typical problems (admittedly in a lesser form that, at the time of publication, he seemed to feel could be worked through). I’m not sure whether there is some reason, beyond the understandable desire to quicken the other elements of transition (which he clearly wanted), why it might be necessary to move into a very different pattern partway through. (Does the body get desensitized to small changes in dosage? Or what?)
I plan to ask. Because I think I can handle the long period of transition that my envisioned program would require. I’m used to living in liminal spaces, the betwixts-and-betweens; truth be told, I quite like them. And my aim is not to vanish, upon completing transition, into the waves of “normal” men and never let anyone know I was born physically a woman (“going stealth,” as some call it). Even if I should happen to "pass" well enough for stealth, I’ll most likely stay out-and-proud as being Trans, because I feel it’s important that Transgender persons be visible in the world... and because I wouldn’t know how to be normal if I tried, anyway. So if it takes longer to get there... my question is, get WHERE? I’m already here.
I have a church community that accepts me for who I am and has already begun to make that mental shift with me, little by little. I have amazing friends who have worked to make that shift consciously and quickly. I have supervisors and coworkers who are willing and supportive to go there with me. I have family members who are loving and understanding, if not all exactly thrilled.
And of course, I have this magnificent beard. :)
So I think I have enough information to move forward, and enough patience and support to do it right - but there are still risks. I could be wrong about how well I understand the problem. I could find that my body has a nonstandard response to T. I could end up with an incorrect dosage through error, mine or the physician’s or the pharmacy’s. Any number of things could go wrong, once this becomes a real-life scenario.
This decision demands that I face the reality of risk to an important aspect of myself, to satisfy a deeper one. Well, hell... welcome to the human race, where hard decisions are par for the course, and the course can be a little like Satan’s idea of a nice relaxing game of mini-golf!
And so I am finding that, in a very real sense for me, this is a spiritual choice, an act of faith. Not blind faith, the kind where you close your eyes and assume that “everything will be all right.” Rather, it’s a choice to move forward in the face of risk, with at least partial knowledge of the possible consequences.
Maybe trust is a better word. I have long used the idea of “trusting one’s weight” to a particular structure as a metaphor for this kind of step. One of my former jobs involved climbing an extremely shaky and beat-up wooden ladder, sometimes once or twice weekly, to service a necessary system. I was never really sure that the rickety old thing would hold me (a quite heavy person even at that time), but the job had to be done, and I was the one standing there, the one who knew how to do it. So again and again I took a deep breath at the foot of that ladder and made the decision to trust my weight to it, cautiously but with determination. The trust was not in my “belief” that it would hold me, since I was never entirely certain that it would; the trust was in choosing to make the climb anyway - step by nervous step.
In this case, I’m learning to trust in a lot of things that I have never felt fully able to trust before. My sure knowledge of my own direction, and my right to make a truly major life-decision for myself, regardless of the fears and opinions of others. The care and concern of my prescribing physician as a true Ally. My ability to make informed choices on risky paths, and to take responsibility for my choices and their results..
I’m beginning to trust that the Universe is comprehensible enough - not completely so, but sufficiently - that I don’t have to fear living in it... really living, not just surviving.
I trust that I have gifts to give in this world, and that I can give them best when I am being deeply myself, without holding back. And that I can exist boldly and joyously, not as a victim hoping for pity, but as a free soul manifesting its birthright, moving open-heartedly into the full experience of life.
I trust that I can step forward into risk, with excitement and anticipation.
And there is music in that. A very sweet song.
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