(Greetings: This blog existed in some form before I transitioned. I’ve decided that I want to maintain that history, but this post has been changed to be less jarring to, well, me mostly)

This is a follow up to my post last year about the discovery and treatment of my prolactinoma, a benign tumor in my head.

A UNIX Eunuch

Until about a month ago, I had essentially been a eunuch. A tumor called a prolactinoma (aka prolactin secreting pituitary macro adenoma) had been growing on my pituitary gland for approximately 10 years. The end result of that is that for the past ~10 years, my testosterone levels were low, eventually reaching a level so low they didn’t bother calculating the actual number anymore, instead listing it as “<20”. Testosterone is responsible for a lot more than you might think, and I go over a lot of that in my first post on this subject. This post is more about exactly what you think testosterone is responsible for.

New Treatment for a New You (Well, a New Me)

First, some results. As of January 19th, my prolactin was 17. This is great, because normal for an AMAB (assigned male at birth) person my age (31) is between 5 and 15. My endocrinologist from Johns Hopkins instructed me to continue the cabergoline I’ve been taking at the same dosage, since 17 is close to normal but ~5 is ideal.

Unfortunately, my testosterone was still in the double digits despite having tried a medication (clomiphene) that can stimulate production - but only if the pituitary isn’t damaged. My endocrinologist prescribed me injections of testosterone (I requested injections instead of patches or gels because you have to be careful around pets, women, babies or basically anything that is alive when on them) to be taken every two weeks. I just had my third injection this afternoon, and I have my first set of labs since starting the injections next week. However, anecdotal evidence suggests that the shots are working.

As I said earlier, I have spent most of the last decade being essentially a eunuch. I didn’t feel a sense of physical attraction to anyone. If I was attracted to someone, it was always on an emotional/intellectual level. Combine that with the weight problems associated with my condition (or resulting from the other problems the condition causes) and already low self esteem and you have a perfect storm of loneliness brewing. With two exceptions (an online relationship I had as a nerdy teen in high school, and another in the mid 2000s), I have never been in a relationship. I’ve never even been on a date. In high school that was mostly a result of awkwardness and terror, and in college I just never met anyone that I clicked with. Then, part way through college, the tumor started developing. It caused massive shifts in my physical and mental health, and put me on an emotional roller coaster that I am still not fully off of.

I spent the better part of that decade coming to terms with being alone, especially the 2–3 years immediately before my diagnosis. You start to think about things like retirement and end of life, and what those are going to be like by yourself. They say everyone is alone in the end, but most people aren’t alone the entire way. That was the existence I was trying to prepare myself for, and I have to say I was finally getting comfortable with it. Not excited, but ok.

Then, a month ago, everything changed.

31 Going On 13

A year on dopamine agonists, and he’ll be a sex-crazed creep just like the rest of us.

-House, “Better Half”, Season 8

So now I’m 31 years old, overweight (but working on it, and it is going well) and I’ve never been on a date - and I’m getting testosterone injections. Every insecurity I hadn’t concerned myself with in a decade came roaring back, and now I’m no more experienced but with less time. All the treatment did was make me want something that I will never have, because I found out what was wrong too late to matter.

Or at least those are the things I thought of in the initial panic. Injections are every two weeks, and especially initially there are some serious peaks and valleys. Those will go away with time and with monitoring of my levels. In the time since the initial injection and that initial panic, I’ve begun to realize some of the benefits. My recovery time during Crossfit feels like it has already greatly improved. My mood in the past couple weeks has been far more positive. I have goals in my life that aren’t “make more money so you can buy cooler stuff”, which while fun is unsurprisingly unfulfilling.

At the start of this process, last May, I wasn’t sure what I wanted to do. I knew the tumor wasn’t supposed to be there, and I wanted to treat it, so that I would get the physical and mental health benefits - but I wasn’t convinced on the sexual aspect. Hormones affects so much of our lives - mood, determination, drive and many many more things - far more than I am comfortable with. I’ve had to wrestle with a lot of things in the past year most people have hammered out pretty well by the time they are 20.

I’m excited* to see how this turns out.


*also terrified