You don't have to constantly take hormones to be trans, 3 people who have gone on and off hormones say
Medical transition is often painted as a linear process for trans people.
Three trans people who have gone on and off HRT told Insider the process was different for everyone.
"Trans people should feel free enough to start and stop hormones," Kayden Coleman said.
Before starting hormone-replacement therapy, Simon Moore, 27, thought hard about what effects they wanted to get from testosterone.
While they had always wanted a deeper voice, they didn't want all the added muscle and hair growth that sometimes comes with a full, longer-term dose of testosterone-based HRT. Like a growing number of nonbinary people, they decided a microdose would offer a slower transition.
"There is less emotional roller coaster. The vocal cords thicken slower and more gradually," Moore said.
Moore, who is nonbinary and trans, grew up in Moscow and moved to the US with their partner in 2019. They were able to access HRT for the first time in January through Plume, an online transgender-health service, they said.
It's been seven months since Moore started testosterone (commonly referred to as "T"), and they have decided to wean off it.
"I'm not really a 'trans man.' I never really wanted to be 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."
Transition is often portrayed as a linear journey that has a clear beginning and end.
But many trans people go on and off hormones 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.
Insider spoke with three trans people who have gone on and off HRT at various points for medical or personal reasons.
You don't need surgery or hormones to be trans
A popular misconception perpetuated by TV shows, films, and general misinformation is that being trans means someone needs to "medically transition," or get gender-affirming medical procedures, to be seen as valid.
The idea that gender-affirming care is one size fits all and people stop HRT only because they regret their decision is often used as a political argument to justify anti-trans medical bills that suppress access to medical care for trans people.
There is a small and vocal group of people who have "detransitioned" and actively say they are no longer trans. But research suggests a majority of people who stop HRT do so for other reasons. Some trans people never take hormones at all.
"Nobody needs to be on hormone therapy. Nobody needs to undergo any medical, surgical, or other procedure, or even therapy — despite what people have told us for many years — to be trans," Dr. Jerrica Kirkley, the medical director for Plume, told Insider.
Stopping treatment doesn't make a person not trans, Kirkley said.
Moore knew they wanted to be on testosterone only for a year to lower their voice
Like many young trans people who grew up with little trans visibility, Moore as a teen relied on YouTube videos on female-to-male transition to get information about gender-affirming care.
But Moore decided they wanted their care to look a little different.
On their YouTube channel, Moore blogged their personal HRT journey.
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.
Moore then stopped microdosing once they got a deeper voice. (Certain effects of testosterone, like facial hair and a deeper voice, are permanent, while others, like building more muscle, are not and require consistent doses of T over time.)
Moore is happy with their results. They told Insider that while they were stopping, they were open to the idea that what their future desires could differ.
"I think a lot of people kind of want you to pick a label, stick to it, pick a journey, stick to it," Moore said. "I don't need to."
Tuck Woodstock has gone on and off testosterone 3 times in the past 1 1/2 years to relish in each stage of growth
Tuck Woodstock, a 29-year-old journalist, host of the "Gender Reveal" podcast, and cofounder of Sylveon Consulting, started testosterone in July 2020, four years after he came out as nonbinary to close friends and family.
As a gender educator, Woodstock knew testosterone was a resource for years before they made the decision to go on 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," Woodstock said. "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."
Woodstock added: "Because that process was gradual, it took several years before I was interested in physical or medical transition, which I recognize is very different than most people I know who came out as trans nonbinary, trans men, and immediately started testosterone. That was not my experience at all."
In the past year and a half, Woodstock has stopped and restarted testosterone three times. This is partially because of being a podcaster and musician who relies on their voice heavily.
"When I hit a certain level of testosterone in me personally, it changes my voice so rapidly that it becomes harder to sing at all," Woodstock said.
In addition to giving their voice a break, Woodstock also wants to take time to relish the changes his body is going through while on testosterone and likes to take breaks.
"I think it's nice to take a moment and regroup because these changes often are at least semipermanent," Woodstock said. "And I like to make sure that I have a moment to spend in this version of my body before I progress on to a later version. It's not so much that I don't want them to actualize but that I want to enjoy every single moment of this journey individually."
Kayden Coleman, 35, took testosterone for 5 years before pausing, then started taking it again
Kayden Coleman, a 35-year-old trans medical advocate and educator, started taking testosterone in 2009.
While he was really excited about the changes that happened in his first year on T, he said the weekly shot became more of a hassle, especially once certain changes, like hair growth and voice deepening, plateaued.
Coleman stopped taking testosterone twice. The first time was after a surgeon told him to before he underwent top surgery in 2013, though he has since learned that may not have been medically necessary. The second time was in 2019, when he moved states, briefly lost medical coverage, and became pregnant.
"With testosterone, that first year is like, you cannot wait to take your shot because all these changes. Then, you kind of get to where you are, and you're like, 'OK, I'll take it next week,'" Coleman said. "Or like me, you'll get needle anxiety and really put it off."
When he stopped taking testosterone, he said he didn't experience many negative effects. Because Coleman already had a full beard and low voice, which are permanent effects of testosterone, he said going off it didn't change many things physically.
But he said he felt a lot more emotional going off T.
"When I'm not on testosterone, I'm like all over the place," Coleman said. "Testosterone kind of keeps me at a more level headspace."
Trans people don't have to get specific transition care to be valid
The way gender-affirming care is framed as a journey with a clear beginning and end point, Coleman said, harms trans people because it makes it seem like care needs to look the same for everyone.
"Trans people should feel free enough to start and stop hormones as a form of self-care," Coleman said.
"If I want to try for a baby, I should be able to," he added. "If I just don't feel like sticking myself in the thigh or butt cheek or arm or stomach with a needle for the next few weeks, I should just be able to not."
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