Microdosing (Low Dose) Testosterone Hormone Replacement Therapy (HRT), Explained by FOLX
For trans people seeking subtle, slower changes on testosterone HRT, microdosing is a wonderful option.
This article was reviewed by Jess Schwab, DNP. Images illus by Leo Mateus.
Are you looking for the estrogen version of this article? Click here to learn about microdosing (low dose) estrogen!
Many live somewhere on the gender spectrum beyond male and female. Nonbinary and gender-variant experiences (many that fall within the transgender umbrella) within or beyond the binary can entail exploring bodily changes in all different ways.
Many along the gender spectrum may be considering taking or are currently taking testosterone gender-affirming hormone therapy (GAHT) as a tool for their body to reflect their truest self. With testosterone GAHT, people can typically expect changes, including facial hair and body hair growth, and a deeper voice. More often nowadays, we’re seeing people who are interested in subtle changes, or those who want to ease into changes to slowly see how they feel, opting for microdosing testosterone.
Microdosing testosterone is a tool for more subtle or slower changes at smaller doses.
Microdosing or low-dose hormone therapy has become a tool for many trans, nonbinary, and other gender-expansive people navigating gender-affirming healthcare. In fact, the World Professional Association for Transgender Health (WPATH) now includes nonbinary people and the need for personalized approaches in their Standards of Care.
Some consider microdosing when they want certain effects of GAHT but not others. While it is hard to know for sure in advance exactly how changes will happen, we can work with people to try to achieve the best outcome with the tools we have.
Compared to standard doses of testosterone, these lower doses are often half or less that amount. This can go down to 0.1 mL weekly for injections and with topical application via testosterone gel, the doses can get even more micro. These decreased doses allow the physical changes to develop slowly and over a longer period of time. Some people will use GAHT for a short time to achieve certain effects, such as facial and body hair growth and voice changes (or bottom-growth), then will discontinue before further effects take place. Just like higher doses, low dose T can help alleviate gender dysphoria and improve mental health.
Those “masculinizing” their features can explore low-dose testosterone. One aspect of low-dose testosterone that may be bothersome to some is that it may not stop monthly bleeding. Bleeding can be stopped if desired with higher doses of T, medications also known as birth control, or surgeries like uterine ablation, which removes the uterine lining, or hysterectomy, which removes the uterus with or without other related organs.
There are two options to microdose testosterone with FOLX.
There are just as many ways to microdose as there are to typically dose. The main difference is in the concentration of hormones taken. Typical low-dose regimens are listed below, but lower amounts of testosterone/doses can be tried if desired. Just like higher testosterone doses, the effects of testosterone vary greatly from person to person; though there are expected, anticipated changes, they are not prescriptive nor one size fits all. Additionally, some physical changes are still reversible while others aren’t (such as voice changes and bottom growth).
Those looking to microdose testosterone can do so with topical testosterone gel or testosterone injections, both of which are available to FOLX members.
For those curious about how others have approached microdosing and low-dose GAHT, there are a few great anecdotes in recent years. In this piece by Them, NB/GNC people talk about their medical transition, costs, and hurdles they face in the current medical system. This article from Vice provides a more personal inside look.
For those ready to get started with FOLX for microdosing testosterone, the process begins here. For existing FOLX members with questions about their dosage, message or schedule time with a clinician medical provider. For those who’ve just got some more questions, including non-FOLX members, read up on testosterone here and/or feel free to reach out to us at firstname.lastname@example.org.