So, if you follow my blog, you probably know that Lee started testosterone back in April. It was a big step for him (and for us), and was accompanied by much celebration and good-natured ribbing.
“Is that a moustache I see?” asked his dad on day two.
“Yeah, but I’m still the only one with a penis,” remarked a smartass brother.
“Wait. Is that an actual muscle?” teased an older sister.
The testosterone we chose was administered in patches. They basically looked like big round band-aids, with a bubble in the middle that slowly released medication into his bloodstream throughout the day.
Shortly after he began, we noticed changes. A slight broadening of the shoulders, a squaring of the jaw line, a lowering of the voice. Increased agitation and moodiness. Some of this was clearly the testosterone. Some of it was typical teenage behavior… maybe enhanced (or maybe not) by the newly administered hormones.
But after a few months, we were a little disillusioned. The patches frequently fell off. They caused skin irritation and were easily forgotten in the hustle and bustle of a typical day. They couldn’t be applied before or after a shower. They often stuck to the sheets at night.
To me, all this simply seemed like the price we had to pay for an easy, painless administration of a necessary medication.
But my son thought differently. At camp this summer, he spoke with some of his transgender friends. These kids insisted that injections were more effective and worked more quickly (this rumor was debunked by our doctor). But these kids also managed to convince my needle-phobic, fainting-prone son that a shot was actually quite simple and pain-free.
At our next appointment, he asked the doctor about trying weekly injections instead of daily patches. To say I was hesitant would be an understatement. I had watched this child faint after a blood draw. He would have a full-blown panic attack when he had to get a shot at a well-visit. I once caught his clammy head before it hit the floor in a doctor’s waiting room; he had just had an injection. That was right before he threw up.
So when we talked to the doctor, my doubt was apparent. But she encouraged us to try it anyway. “Sometimes they surprise you,” she whispered to me, knowingly.
We agreed to order injectable testosterone, continuing with the patches until the new medication arrived. The doctor gave us the name of a mail-order pharmacy in Oregon, where we could get a full year’s worth of medication without insurance for about $80. A local hospital pharmacy could bill over $1200, with our co-pay nearing $150 per MONTH.
We were lucky to be working with experienced medical professionals who were able to point us in the right direction. If you’re navigating this for the first time, I STRONGLY suggest you explore several different options for your medication, as the cost can vary significantly between sources.
We ordered the medicine, and it arrived at our doorstep within a week, complete with needles and syringes and alcohol wipes; everything we would need to do at-home injections. A few days later, we packed up all of this paraphernalia and brought it to the gender doctor, so the nurse could teach us (read: ME) how to inject testosterone safely and efficiently.
The steps seemed easy enough; the nurse demonstrated each part of the process, and Lee was a champ. He was super anxious and near tears until the nurse said, “All done!” His eyes widened and a smile broke out and he proclaimed, “I didn’t even FEEL that!”
Once the nurse had completed the actual injection, then I had a chance to practice with a silicone bubble and an empty syringe. I felt like I might be capable of this, after all.
Before we left, the team offered to have us come back in a week, so I could complete my first actual injection with support and supervision. I really liked that idea, but it seemed a little extreme to drive two hours to have a nurse WATCH me do the injection. When I got home, I called our primary care doctor, hoping for a more convenient solution.
Our pediatrician has been incredibly supportive throughout Lee’s transition, and my hope was that a nurse in her office might be willing to provide this service for us. It would save me a few hours of driving and provide tremendous peace of mind. After a bit of initial confusion and a few voicemail messages, I got to speak to a nurse who assured me she’d be happy to help us out.
While I was grateful for her agreement, I was also a bit skeptical about her motivation. In my experience, most medical providers haven’t had a chance to work with actual transgender people. And while they are well-intentioned and interested in learning, I often feel like my child is being used as a guinea pig; for educational or research purposes. They seem more intrigued and enthralled than capable and professional.
So when we walked into our pediatrician’s office, I felt a combination of relief and wariness. The nurse called us into a room in the back, and I clutched my bag of syringes and needles, trying not to let my child notice the nervousness that I felt. The nurse was encouraging and friendly and obliging. She brought in a second nurse to help and my radar went up. There’s no way we need two nurses to WATCH me do a shot. Why were they both here? To see something they’d never seen? Just to lay eyes on the trans kid? I was skeptical.
Ultimately, my fears were unfounded. Regardless of why they were both there, they walked us through the process with encouragement and professionalism and a few helpful hints. They were kind and enthusiastic and helped the experience go smoothly.
In the months since, Lee and I have become an impressive injection team. He’s no longer nervous and he handles it like a pro. I’m still learning, but each time gets a little better. Lee gives me feedback. “That time it stung. I think we needed to let the alcohol dry longer.” “Today it hurts a little. I think maybe the angle was too deep.” “Mom, that was the best one yet! It didn’t hurt at all!”
And much to my surprise, the injections ARE easier than the patch. There’s less to remember and less chance for something to go wrong. There’s less reminding and less worrying and less chance that he’s forgotten or lost his medication.
But there’s something else, too. Although the administration is easier than I thought, there is something that’s harder. Maybe harder is the wrong word. More intense, perhaps?
When my kid was wearing a patch, it was easy to forget (or ignore) the fact that we are administering a drug that will change him. While the effects were not reversible, the patch itself somehow felt reversible. It was a sticker. A band-aid. We could take it off or stop it at any time.
And of course, we still can. But with these injections, this choice feels more intentional. Every time I fill a syringe, I need to be confident in our decision to manipulate his hormones.
I look at this young person, growing up, and figuring out who he is… and my emotions go haywire. He’s going through so much. He’s so strong. What will his life be like? Will he ever regret this decision? Will he ever resent me for the choices I made on his behalf? Of course I question myself. I think that’s the hallmark of a good parent. We all want to do what’s right for our kids. And most of the time, we can’t be one hundred percent sure of what that is.
I don’t really know the answers. I can only have faith. I am diligent and observant and prayerful. I trust in God and I trust my child, and I know that I am making the absolute best choices that I can with the information that I have.
And at night, when he crawls into bed and sleepily confesses, “Mom, I don’t know what I’d do without you,” my heart swells. He tells me he didn’t really know how lucky he was until he talked to friends whose parents were unsupportive. He tells stories of kids stealing or trading or sourcing illegal testosterone. He tells me that this medicine is saving his life.
I choose to believe him.