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I haven't seen this answered before, but I apologize if this has been asked already. I've seen a lot of people say that they started testosterone at a low dose, but their dose is way higher than mine, and I'm confused about dosage levels? I've seen "low dose" being described as being around 20-50ml by some people and 200ml by another person. I've been on t for six months and I'm only at 0.3ml? I thought that was a normal starting dose, but now I'm confused. Is my dose abnormally low or...?? I plan on asking my doctor about it, but I won't be able see them for a few weeks, so I was hoping you might be able to clear things up a little until then.

Lee says:

200 mL of testosterone is definitely not a dose that people can take.

Imagine someone trying to inject the contents of this water bottle! You'd need an IV infusion!

[Image description: A mini-water bottle being held be Lee. It says that it contains 8 fluid ounces of water which is equivalent to 273 mL. /End ID]

Even taking 20-50 mL of testosterone isn't possible.

Most people on weekly testosterone injections are injecting less than 1 mL because that is the amount that's typically safe and comfortable for someone to self-inject with.

Large-volume injections of 3 mL or greater are rare, and are not typically not administered in an outpatient setting.

0.2 mL is different than 2.0 mL is different than 20.0 mL. So when we start talking about doses, remember that the decimal point is really important!

Anway, moving on!

If you told me that you're taking 0.3 mL of testosterone, and I told you that I'm also taking 0.3 mL of testosterone, you might assume that we're taking the same dose.

But the frequency of testosterone injections will affect dose comparisons!

If you're injecting 0.3 mL of testosterone subcutaneously every week but I'm injecting 0.3 mL of testosterone every other week, that means that my dose is half of yours because I'm on the equivalent of 0.15 mL weekly.

In the USA, most people doing testosterone shots are doing a subcutaneous T injection once a week, or doing an intramuscular T injection every other week.

So if you're discussing your dose with someone else, and they say that they're taking 1.0 mL biweekly, that would translate to 0.5 mL weekly.

That means you have to be careful about a direct comparison about the volume of testosterone when you're having a conversation with someone!

Ok, now let's move on to another hypothetical.

If you told me that you're taking 0.3 mL of testosterone every week, and I told you that I'm also taking 0.3 mL of testosterone every week, you might assume that we're taking the same dose because we're injecting the same volume of testosterone at the same frequency.

But the concentration of the testosterone will affect dose comparisons!

Most testosterone vials in the US have a concentration of 200 mg/mL. That means if I'm injecting 0.3 mL of 200 mg/mL testosterone weekly, I'm taking 60 mg of testosterone per week.

But not all testosterone comes in a concentration of 200 mg/mL.

My mother is taking testosterone because she has low hormone levels, but because she is cisgender and not looking to have masculinization occur so she's on what you could consider a truly low-dose of testosterone.

Her testosterone cypionate comes from a compounding pharmacy, and the concentration is 50 mg/mL.

So if she's taking 0.3 mL of testosterone every week, that means her dose is 15 mL weekly, which is four times the dose I'm taking.

(At this point, I should note that this is hypothetical-- while my mom and I are both taking testosterone, neither of us is taking 0.3 mL and I'm just using that number as an example).

Ok, so here's another example:

While there are different forms of testosterone, at this point let's just say that we're both taking a more-or-less equivalent form of testosterone like testosterone cypionate and testosterone enanthate.

So if you told me that you're taking 0.3 mL of 200 mg/mL testosterone enanthate every week, and I told you that I'm also taking 0.3 mL of 200 mg/mL testosterone cypionate every week, you might assume that we're taking the same dose because we're injecting the same volume of testosterone at the same frequency and you'd be right.

So now that we've established that we're taking roughly equivalent doses of testosterone, we'd have to get into the blood work.

Equivalent doses don't always produce equivalent results at the same rate.

Two people on the same dose of T might have two different T levels after their first bloodwork, and one of them may have to do a higher dosage while the other may decrease their dosage, but in the end they’d both end up with the same levels even though they’re taking different amounts of T.

People who have a higher dose of T don’t necessarily experience changes faster than people on a lower dose- it all depends on how your body processes the T. The important bit is what your blood work shows your T levels to be, not the dose of T.

So if you and I are both injecting 0.3 mL of testosterone, but my testosterone levels are in the low 200's and yours are in the high 800's, that means that 0.3 mL is a low dose for me and an average dose for you.

There is no particular magic dose that is considered a "low dose" for everyone.

Low-dose T is taking a lower-than-typical dose of testosterone so your T levels are above that of the average cis woman’s, but below the average cis man’s.

If you’re on too low of a dose then there’s some risk that your body will just convert the T into estrogen and you won’t get any changes, or that there could be other health risks, but if you are being monitored by a provider who you’ve discussed taking low dose T with it should be safe.

If you take low-dose T, the changes associated with being on testosterone will take longer to happen but you will end up with all of them except possibly the stopping of menstruation, which happens for some people but not all.

Again, taking low-dose testosterone will still cause genital growth, and all of the other changes listed in the Testosterone FAQ- but your period may continue unless you use birth control, or have a hysterectomy, etc.

People often take low-dose T so they can get used to the changes slower and have time to adjust, or because they don’t want to overshoot their goal of androgyny and end up in the masc side of things.

In my opinion, the term "low-dose testosterone" can be confusing because it gives people the idea that there's a particular dose that counts as low-dose for all people, but sometimes something that's a low dose for one person is an average dose for another person.

Sidenote: While I would prefer a term that addresses the testosterone levels instead of the dose, I do use the term "low-dose testosterone" because while it isn't perfect, it does describe the gist of what we're discussing-- someone being on a low dose (in terms of their own body) and I prefer it to the term "microdosing" which has recently been recently been popularized as an alternative to the term "low dose". The term "microdose" doesn't improve on what I see as the issues with the term "low dose" and it adds a connotation that the term low-dose doesn't have, but that's another discussion.

Anway, I've said a bunch of stuff that doesn't really answer your question.

If you're looking to a way to compare testosterone doses, this table is what you're looking for:

As always, I'd like to note that your testosterone dose should be determined by your testosterone levels, your level and rate of masculinization in relation to your goals, and your overall health (cholesterol levels, kidney functioning, etc), and that is very individual and it means that there may be a reason why your dose is not the same as the dose of the people you've been talking to.

Anyway, with all the caveats listed above, 60 mg of testosterone per week is not generally considered to be a low starting dose (assuming that you're on 0.3 mL of 200 mg/mL of testosterone which would be 60 mg).

I started testosterone on a low dose of gel which was 12.5 mg of testosterone gel daily. This is because I wanted to be on a low dose. I eventually changed my mind, about my goals as I've discussed here, and I eventually went up to an average dose of testosterone gel and then switched to injections.

Now I'm 4 years on testosterone and I'm taking 80 mg (0.4 mL) of 200 mg/mL testosterone enanthate weekly but my primary care provider said my T levels are too high on that dose so I might be moving down to 70 mg (0.35 mL) or 60 mg (0.3 mL) of testosterone soon.

You can (And should!!) bring up any concerns or questions you have about your testosterone dose with your testosterone prescriber.

Since I don't know how often you take testosterone or what concentration you're taking, it's hard to answer questions about your specific dose/situation

60 mg of testosterone weekly is a pretty normal starting dose, and not abnormally low. If your T levels are in the right range when you have your next blood work done, and you feel content with the changes you're experiencing, there's a good chance that you might not even have to change your dose.

But if you were on 60 mg of testosterone biweekly (AKA 30 mg weekly) then that would be a lower starting dose, which isn't abnormal either but it does mean that you likely have room to move up your dose at your next appointment if you aren’t satisfied with the rate of changes you’re getting.

Comparing your dose to other people‘s might be an interesting way to pass the time, and it’s good to be informed on your medical care and check the chart above to see if your dose falls in the low/average/high range so you can ask the right questions about why that is, but it doesn’t mean that someone else’s dose is better than yours if it’s higher, or worse than yours if it’s lower. As long as you’re happy with your changes and your blood work looks good, then don’t stress about the dose!

Why would a trans guy want to be a gestational parent?

I want to kick off this blog by talking about one question so many people have... "But, why??".

Why would someone who's a man want to be pregnant and birth a child?

Why would someone who's desperately trying to be seen as a man do one of the biggest things associated with being a woman?

What about gender dysphoria?

Why not adopt or get a surrogate? Or what if your partner is a cis woman, shouldn't she carry instead?

There's multiple answers to all of these questions depending on the trans person you talk to. Some will say "I would never want to be pregnant, I couldn't do it", some would say "it's just easier than adoption" some would say "having a child come from your body is a beautiful thing" and so forth

For me, I've known for a long time I wanted a child. This child was not planned, but they're coming nonetheless. I've known that options like adoption or surrogacy isn't very accessible and probably wouldn't be possible for me, and frankly I want a child that looks like me. Having someone surrogate can be extremely expensive and the hormones they put you through to collect eggs can be stressful and difficult, and isn't worth it to everyone.

I understand I will experience, and have experienced gender dysphoria because of it. I get weird questions, I get confusion, I get misgendered as my appearance changes and my breasts get bigger, and it's only going to get worse as I start showing.

I've had people ask me "but isn't this against everything you believe in??" And I was confused. I've never said I was against birthing, I never said I didn't want to have a child, and I never said I wanted to rid of my current genitalia. I've had people ask me what the child will call me, if it'll confuse them, etc.

To me, it'll all be worth it in the end. I'll have a child I can raise my way, with a healthy family, and trauma and ND informed parents who will always love them and help them when needed.

It's hard, of course it's hard. It's hard enough for cis women and for us trans guys (and nonbinary people), it's extra hard.

Basically at the end of the day, we have the choice to do what we wish with our bodies. We aren't harming anyone by being pregnant, and we aren't harming anyone if we choose not to get pregnant.

Remember to keep invasive questions to yourself, and remember we deserve the same respect anyone else does. Respect us, and everyone will be a lot happier in the long run.