A reader writes: “I am a 59-year-old African American lesbian giving serious consideration to transitioning to a male. Are you aware of any females beginning their transition who are my age?
“I do realize there will be generational, cultural, and racial considerations. My questions largely have to do with being post menopausal and beginning T. Are there challenges that younger trans men don’t have to deal with? Will T be more effective since I am post menopausal? Are there any health considerations or concerns?
“As I begin my transition, I will bind my chest. I’ll see how it goes prior to deciding to (or not) having a double mastectomy. Is there an ‘older’ community of trans men support group? Any other suggestions would greatly be appreciated.”
There are definitely cultural and racial considerations that I am not qualified to address. I’ll have some suggestions with regard to those in a minute, and readers will have others, I’m sure.
As far as female-designated people who being transition later in life – yes, there are many, and some are older than you. Your age should not stop you from doing what you need to do. The oldest female-to-male transitioner that I am aware of was in his mid to late 60s. The oldest male-to-female transitioner that I am aware of was in her 80s. It can be – and has been – done.
An older trans guy named Jay, who has posted a video on YouTube, started T at age 65. And here is one from Dr. Jay, who started transition at 56, and here is a video from a guy who is transitioning at age 60. If you check out these videos, you will also find others from older trans guys who are transitioning (related videos appear down the right-hand side of the page). Dr. Jay has several videos, and he does talk about health issues related to starting T at an older age.
I’m not a doctor, and you should definitely talk to one, but testosterone in low doses is prescribed to some post-menopausal women to increase libido and to help maintain bone density and muscle mass. You would be taking a much higher dose, because you desire physical changes, but this just suggests that testosterone is not contraindicated for female-designated persons after menopause.
However, there are health risks to taking testosterone, and these risks are present regardless of the age when a person starts the hormone. Risks include increased cholesterol, increased blood pressure, and increased red-blood-cell count (a condition known as polycythemia that primarily occurs in older non-trans men).
Dr. Nick Gorton’s publication, Medical Therapy and HM for Transgender Men (link is a pdf), indicates that the polycythemia risk increases for older trans men, but that is for trans men who have been on hormones for a while. It is possibly true for those who are just starting, as well. Many of these risks can be managed with medication and with a change in dosage. If you have certain health conditions already, they could be exacerbated by testosterone, which is why it’s important to talk to your doctor.
It’s possible that T will be more effective because it is not competing with substantial amounts of estrogen in your system. On the other hand, your system has been exposed to estrogen much longer than if you were, say, 20 years old, so there might be some effects from T that will take longer to materialize. I think there is anecdotal evidence that the earlier in life you start T, the better your results will be, but because results vary for each person depending on his genetic programming, it’s really impossible to tell for sure. You kind of just have to start it and see what happens.
I would recommend reading Dr. Gorton’s publication, linked to above, and Hudson’s FTM Resource Guide to get really detailed information on T and what it can do, might do, and can’t do. Also, here are some guidelines for older trans guys from the Center of Excellence for Transgender Health. But your doctor is honestly your best resource with regard to any health concerns.
I thought there were some groups for older trans guys, at least on Facebook, and now I’m not finding any. I believe these support groups are out there, and I hope readers can offer some suggestions.
With regard to cultural and racial issues, and the intersection of these issues with trans issues, I would recommend checking out the blog blac (k) ademic by Dr. Kortney Ryan Ziegler. He is much younger than you and I, but he has some posts that might be helpful for you, and he also has some good links to other sources.
In addition, if you’ve got the money, I would highly recommend his film Still Black: A Portrait of Black Transmen. The guys interviewed in the film are of all ages (although I don’t think any are as old as us), but it’s an excellent film and gives you an idea of the issues that black trans men face that white trans men do not and that I cannot speak to from experience.
There is also a Black Transmen Conference coming up from April 30-May 4, 2014. It’s the third annual conference put on by Black Transmen Incorporated. A lot of guys attending might be younger, but when you get to our age, pretty much everybody is! There are also support group locations listed on this page for black trans men, and those groups might consist of all ages.
After all this, my primary suggestion to you is that you should do what you want and what you’re comfortable with. You are not too old to start hormones. You will not be too old in five years, either, so if you are not sure, you still have time. You might feel as if time is running out for you, but don’t rush something just because of that. I suggest that you read some information on hormones, talk to your doctor, and make an informed decision based on what you want for your life. Good luck!
This post originally appeared on Matt Kailey's award-winning website Tranifesto.com. Republished with permission.
