Hello, I'm posting on here for the first time (apart from my introduction post) as I'm interested in finding out if anyone is, or was, in a similar situation to me or might have any advice.

I've had gender dysphoria to varying degrees since I was a teenager, dealing with it in various ways such as choosing a male name, wearing  men's clothes (or masculine clothes designed for women), having short hair, etc. I've had other mental problems such as OCD, anxiety and depression, which I've treated with anti-depressants (I've been off them for 10 years now though), CBT and psychoanalytical therapy. A couple of years ago I registered with a gender clinic and have now been prescribed a low dose of testosterone gel, after about a year of counselling with them.

I don't have such intense body dysphoria as I used to, because I've come to terms with my anatomy as being just "my body" rather than a "woman's body". But I'd love to not be seen as a woman in society. I would prefer to be read as male more frequently by the general public. When I look at myself, I think I look fairly masculine, but it seems others don't always read me that way and that gets me down sometimes. So that's why I'm considering HRT.

However I am also a bit worried about starting HRT. I think my tendency towards anxiety and obsessive thoughts are making the situation worse. I would really love to be able to pass as male, or at least look more ambiguous so people don't instantly gender me as female, without having to risk the side effects of T. I don't want all of them and I know you can't tell which ones will happen unless you try it. So it feels like a bit of a gamble to me. The clinic haven't been that helpful in terms of guidance, pretty much just saying it's up to me! It's also hard to get frequent appointments with them due to severe short-staffing, so I don't feel very supported.

The main things I want are to have a more masculine face and body shape, and a lower voice. I can already grow a fair bit of facial hair naturally - not as much as a cis male but I have to shave every day to look clean-cut! But I don't especially want a beard. I'd like to feel better in myself too, less anxious, and I've heard some people online and in real life say that T has done that for them. Although I guess that's very subjective and personal.

Possible side effects I'm worried about: acne (I am prone to it even pre-T), head hair loss, possibly gaining fat, and maybe not liking genital changes that might happen.

I have connected with a voice coach, who at our first meeting said I should be able to get into an androgynous or even male range without T! And I'm getting that on the NHS (I'm in the UK) so it'll be free. So that's one glimmer of hope for me at the moment.

So as things stand now, I have the gel, I've tried a bit of it to see how it feels to apply it, and that's about as far as I've got! For me, the question is not "am I transgender?" but rather, "what should I do about it?" I know some people socially transition before starting hormones, but I don't really know where to start with that, beyond what I've already done in terms of my presentation. I'm quite a reserved person IRL, so to announce to people that they should see me as a man now feels difficult for me. 

I wouldn't start the gel until you are ready to deal with the consequences. For some people, including myself the effects were practically immediate, and I mean irreversible ones like genital growth within 2 or 3 days. You can not pick and choose what you want with T, it's all or nothing, and messing around with it for a few weeks and then changing your mind isn't advisable as it might have caused irreversible changes within that time.

I never asked anyone ever to call me a man. I don't put myself in the position of begging for people to acknowledge me in the way I want like that. That just gives them the opportunity to a) dwell on it and b) use it offend you if they choose. They can make up their own minds by what they see or feel from my presence. Thankfully with T/surgery the consensus after 1.5 years is that I look and sound exactly like a male 100% of the time no questions asked.

If you get acne you can get creams to deal with it. Epiduo on prescription is excellent for this. 

I would not hope too much that voice training will help you achieve a truly masculine voice. Mine was on the low end before T and it was still never read or heard as male. It needed approximately a year on T before it was - the indicator was when strangers on the phone automatically called me "sir". It happened about a year in and hasn't changed since. Even with lots of voice exercising and experimenting I was not able to get this to happen without long term T.

Thanks for your reply. I am aware you can't pick and choose the effects, or have any way of knowing which ones will affect you and when. I've joined an FTM group IRL and it does seem T affects everyone differently. I met one guy who complained that he never passes after 2 years on it. Some of the other guys pass though. In a worst case scenario, I'd be disappointed to have the negative side effects without appearing male or at least more androgynous. Although it sounds like it worked out pretty well for you. Were you on a full dose of gel? My doctor has said being on a low dose should make changes come more slowly.

I'll give the vocal coach a try as she said I can still take T anyway while having the coaching. She said it's not just the lower pitch that makes a voice sound masculine, but also other factors like resonance. It'll be interesting to see what I can achieve in any case.

I used to have acne when I was younger and nothing worked on it except the passing of time. Eventually it went away when I was in my 30s. But Epiduo wasn't available then so I never tried it. Thanks for the tip. I've heard some guys take Finasteride or failing that, saw palmetto, to offset hair loss, but I don't think it works all the time.

Yes I was put on what the supervising doctor called " a low dose for now" i.e. four pumps daily, but this acted right away. I expect it did because my hormones were already out of whack before I started HRT - I had low estrogen levels already, so the T probably acted faster and more dramatically because of that, and wasn't competing with female functions at the time, or didn't have to try to shut them down first.

Even on whatever they call a low dose it ends up accumulating quickly in the system daily so that you can end up on "the high end of the [male] T range" within 6 months.