For guys with some differences of sex development (DSD), doctors suggest taking some extra hormones– usually some form of androgens, such as T. Usually, it’s offered when young men don’t produce a lot of T or because their bodies don’t respond well to the T the body produces.
In some guys with DSD, but not in all, that extra T can help the body develop more, during puberty and after. Remember that each body develops in its own way, and it can be hard to tell how your body will develop and respond to T.
It’s important that you talk with your doctor about the effects of taking extra T on your body and how you in general feel about it (also ask your doctor about possible side-effects). If you do decide to go on with this, also check what type/format of HRT (such as gels, creams, injections, patches) would work best for you – ultimately, you know your body best and this needs to be your decision.
What can I expect if I start taking extra T? What are possible side-effects?
Remember that each body develops in its own way, and it can be hard to tell how your body will develop and respond to T. For some guys with differences of sex development (DSD), taking T can help the body develop more, during puberty and after.
Puberty’s effects generally kick in within 1 year after you start taking T is and will continue for about 2 years.
Usually, the first puberty sign is that your testes become a little bit bigger in order to pump out the supply of T needed to help your body go through puberty and adulthood. The skin of the scrotum (the ball sack) also gets a bit thinner. You’ll start to grow pubic hair and underarm hair, and your whole body grows and gets more muscular. As puberty winds down, the growth plates in the bones close, and you stop growing taller.
You can also expect gaining weight and strength. That’s why T is also taken by some people who try to bulk up and gain weight for sports – but this is a real mistake for people whose bodies are already making enough T on its own.
There can be some side effects. Some guys develop pimples (also called acne). Other guys also get temporarily ‘man boobs’ (also called ‘gynecomastia’), which happens to a lot of guys in puberty – with or without DSD- and they usually disappear. The same can happen with baldness.
Other guys may also experience some emotional changes with T, such as having mood swings, or have the feeling they’re easily irritated or even behave aggressively.
Check back with your doctor on how T affects your body, feelings and mood. Like us, they want you to feel good in your skin.
Can guys grow breasts?
Hormonal changes during puberty, especially those due to estrogens (yes, all guys produce these too) can cause the breast area to swell a bit: both nipples and the surrounding area may feel painful and tender to touch (with a difficult word called ‘gynaecomastia’). You may even have the impression you have man boobs.
Some guys might experience this. But, they are only a big issue if you make them one. It usually is a temporary phase in puberty—what is happening is usually a sign that you’re body is growing and maturing.
Certain hormonal medication (called aromatase inhibitors) may help reduce the swelling. If you feel self-conscious, don’t bottle it up. Talk about it with your doctor. They will check if there are any other health problems (e.g. if you are a bit overweight, it can cause them to appear bigger. Your doctor can advise you on ways to shape up safely.
For some guys, surgery is something they think about – but there are risks, as with every surgery, and there are usually scars. A doctor will give you more details about this, the risks, and potential things to consider.