Trouble With T
When puberty was on the horizon and Muir’s anxiety about developing a girls’ body rose, we chose to have him go on puberty blockers. Three decades of research shows that pausing puberty is safe for little kids with precocious puberty; less than a decade suggests that it’s safe for trans kids. In pausing puberty, the blockers might also pause bone development and brain development. There might be side effects that won’t be apparent for years.
But when weighed against the dangers having a female body would pose to his mental health, the risks of later having top surgery if he were to develop breasts, and the social dangers of not quite passing for male in a man’s world, these were risks I was willing to accept. I was okay with a small rod being implanted into his upper arm, a magical device that would simply delay puberty until he was old enough to start hormone therapy and begin his full transition.
I was even okay with giving him a small dose of testosterone once a week, which our endocrinologist suggested as a precaution against the loss of bone density. Dr. R had often successfully used estrogen for this purpose with M to F kids, but he had less experience using testosterone for F to M kids. It was such a tiny dose, we were assured, that it would cause no physical changes, only protect his bones.
Both he and his dad live under a delusion that I’m incapable of handling the messier aspects of life, the painful ones, the things that might require to pierce the skin of my precious only child, so it was decided that I wouldn’t be the one to give the weekly injections of T. I acquiesced.
And then, a month or so into the treatment, Muir fractured his wrist while skiing. A week after he had a cast put on, he noticed that his hand was slightly swollen. When I picked up his other hand to compare them, I found it felt different than usual; solid, heavy. When I looked at him more closely, I noticed that his face was swollen, that he had a slight double chin. We headed to the pediatrician’s office, but nothing could be found. Both the pediatrician and the PA at the gender clinic told us that it had nothing to with the testosterone, that such a small dose couldn’t possibly have this effect. But he’d gained ten pounds in a month. His voice had dropped. He’d grown a faint mustache.
I was terrified.
Our endocrinologist was at a conference abroad, but the same day he returned, he scheduled an immediate meeting of all the people involved in Muir's care. Behind the scenes, we later learned, they were scouring medical journals and pouring through research to try to find answers. They, too, were panicked. But it turned out that the answer was simple, and we hit upon it within the first five minutes of our appointment. Instead of a .05 dose of T once a week, Muir had accidentally been given .50. This massive dose had sent his body into a hormonal surge.
Bryn, who had made the dosage mistake, was immediately overwhelmed with guilt and despair, and burst into tears. I was surprisingly calm. We had answer, and it could be remedied by simply stopping the testosterone. And, contrary to his assumption that I would come at him with rage and hysteria, I didn’t blame Bryn. I was the only one of us who didn’t.
Everyone was relieved. We stopped the injections, began getting weekly blood tests, and Muir's T level plummeted back down. His new body hair didn’t go away, but he shaved the mustache and it didn’t grow back. Of course, some changes were permanent. His voice. And the impact on his reproductive system. The option to someday carry a child was now gone.
Muir has never wavered in his insistence that having a baby who shares his DNA is meaningless to him. As early as kindergarten, when many female-bodied kids were already holding elaborate imaginary weddings and naming future babies, he was planning to build a family through adoption. That his ovaries had been “damaged” by the testosterone was inconsequential. He was more worried about the dark hairs on his toes.
Since Muir told us he was a boy, I’ve never questioned his gender identity. I never worried that he was too young to make the decision, or that he might change his mind when he’s older. But now that the crisis has passed and things are back to normal, I find myself awake in the night sometimes, my mind churning with new anxieties. They range from fears that this trauma to his body will later manifest in illness or disease to a deep sorrow that, should he someday want to grow a child in his body or use medical technology to contribute to creating a child that would be carried by someone else, that possibility is lost.
I have no attachment to being a grandmother someday. The sadness I feel isn’t for myself. It’s for Muir, and what sometimes seems like an injustice of nature that his outside doesn’t match his inside. That we have to fiddle with his biology just so he can be who he is. But most of the time, I can set these fears and sorrows and confusions aside: they are far less powerful than the joys of enabling Muir to live his truth.
It’s harder for Bryn. He’s still grappling with the guilt of the accidental misdosage and the potential harm he inadvertently might have caused. In his worst moments, he says he regrets ever letting Muir start the blockers, that we should have insisted he wait until he’s an adult to begin his physical transition. I know this isn’t logic talking. A mistake happened, I tell him. That’s all. As much as we both wish we could avoid them, we can’t.
Even before we knew we were going to be parents, we knew we would make mistakes. All parents do. Sure, we didn’t know that we might make mistakes that would turn our delicate, effeminate child into a more-or-less teenage boy in less than a month, but there you go.
Other parents make other mistakes. This one is ours. No doubt, it won’t be the last.