Why I Stopped Hormone Replacement Therapy

Stories, Gender Fluid, Medicine, Mind + Spirit, Non-ConformingRex Leonowicz
Image by Rebecca Lieberman

Image by Rebecca Lieberman

By Rex Leonowicz

“There’s no one way to be trans; your process is your own.”

I’ve repeated these words to myself over and over, waiting for them to feel true, waiting to feel some sense of legitimacy around myself and my choices.

When I first came out at 19, there is one thing I knew for sure: I wanted people to use “he” and “she” interchangeably when referring to me. What I wanted for my body was to move closer to an androgynous middle ground, which felt possible through hormone replacement therapy. I wanted to be everything. I wanted the freedom to change at any given moment, to be something else: both/and, either/or, neither/nor.

This proved difficult. My cis friends said it was “too confusing” and would ask, “What about they/them? How about he/him?”

So, I settled, I wore a trans-ness built up from other people’s expectations, from limitations. I was Rex, the FTM. I was one thing.

When I was a teen, I was diagnosed with post-traumatic stress disorder, major depression, and an anxiety disorder. My therapist was completely affirming of my identity, but she was concerned about how hormones would affect me emotionally, especially given the little research around psychological effects of HRT. I took this concern to heart and made it my own. I was afraid.

After six years of mulling it over, being uninsured, unable to access hormones, and not feeling grounded enough to begin such a process, in February of 2014, I stopped waiting for an elusive “stability” that might never arrive. I couldn’t wait any longer.

Changes seemed to spill in almost immediately. Within the first three months, my infernal period was gone, my voice was getting grainier. I was growing hair everywhere. My body weight was redistributing, and my face shape was changing.

There was a secret feeling, though, one I couldn’t place and didn’t know how to talk about. My emotional health was taking a nosedive, and I didn’t realize HRT had a lot to do with why. There was so much going on in my life at the time, too, that I didn’t think to attribute any of my mental health issues to T.

My emotional health was taking a nosedive, and I didn’t realize HRT had a lot to do with why.

It’s hard to conceptualize how a medication is affecting your brain, your moods—it’s so subjective. It’s not something you can see or touch. I did know that I stopped feeling like myself, I stopped being able to understand my emotions.

As someone with PTSD, it’s really important for me to be able to track my emotions, to understand where they’re coming from, in order to stay grounded and not spiral. Not being able to relate to my feelings meant I couldn’t express them either. I had no release. I couldn’t even cry anymore.

Being in puberty “2.0” brought back my experiences of puberty 1.0, which triggered flashbacks from that time period. It pushed me to exist in the past and I got lost there. I had nightmares every night for months on end.

All these traumas and memories were rushing up to the surface, but there was no outlet for them. It was like these feelings of panic and intense pain were just getting reabsorbed by my body, putting me in a kind of shock. I didn’t know what was wrong, and had no sense of control. So, I left my body, a familiar enough coping mechanism for me.

This was antithetical to anything I’d heard from my trans, masculine-of-center friends. What others had described as feeling positively energized, for me meant I was agitated and had heightened anxiety. I’m very sensitive to stimulants (I can’t even drink mildly caffeinated sodas or teas), so testosterone made it almost impossible for me to sleep. My mind was always racing and I had a hard time concentrating. I was in full-fledged stress mode most of the time. I was having panic attacks, especially at night, when by myself.

All of this also made me feel really confused and depressed. How could this thing which was, in some ways, beginning to bring into existence my desired physical body make me feel so wrong and unlike myself internally?

I toyed with the idea of stopping HRT, but it made me feel like a “bad” trans person, like my process of self-actualization was a failure.

I felt more burdened than ever, more on the brink of breaking down than ever. I toyed with the idea of stopping HRT, but it made me feel like a “bad” trans person, like my process of self-actualization was a failure. Stopping felt like giving up, and I never give up. I was also worried about what people would think.

So, I continued.

This past summer, there were some problems with my health provider, my insurance company, and my pharmacy, and I was having a hard time refilling my T prescription. I hadn’t had a dose for a month because of it. Being a step ahead, I decided to stop altogether after a year-and-a-half of treatment.

I don’t recommend going rogue. It just kind of happened that way for me. Being out of therapy for six months and on a long waitlist for a therapist, it felt like a bad idea to be going through what I was without any support while being on HRT. It felt worrisome to be in mostly-meltdown mode all the time. I’ve been off T since early August, and finally am coming back to myself emotionally. I’m working on figuring out an exercise and herbal regimen to maintain the changes I’ve developed and (more slowly, which is the pace I need right now) bring about more of them.

Trump-ocalypse has made it more important than ever for me to prioritize my mental health, especially over others’ expectations for what my process as a trans person should be.

Instead of curling into fear or despair, I feel even more empowered to be unapologetically me—in all my complexities and inconsistencies—ambivalent former-FTM, he, she, s/he, they/them—all-gendered, no-gendered androgynous alien witch survivor—on hormones, off hormones, and figuring it all out one step at a time.



Rex is a trans/queer/non-binary femme artist & writer from queens, ny.  Some of their work can be found at Teen Vogue, It’s Night in San Francisco, but it’s Sunny in Oakland, The Queer South, and Lambda Literary’s Poetry Spotlight., @rexylafemme on twitter & instagram