In my last post, I wrote that I did not support the idea that trans* individuals need to address mental health problems before they can start hormone therapy. The trouble with this is that you end up having a chicken or egg debate. Can testosterone treatment exacerbate preexisting mental instability, or can testosterone treatment actually ease said instability?
The answer is, I guess, that it differs from individual to individual and from one diagnosis to another. However, when you take the blueprint of therapy and take a look at their modus operandi, the logic seems to depart from the assumption that testosterone can exacerbate trouble, not from the possibility that testosterone might ease any instability.
I conducted a little poll on different FTM Facebook groups, dedicated towards those who had experienced significant mental and emotional turmoil before they started testosterone, and asked if the testosterone had had a positive or rather a negative impact on their stability. Fourteen people replied to my post, all of whom had additional diagnoses.
They said they suffered from the following: bipolar disorder, depression, OCD, emotional regulation (anger), mood swings, anxiety, autism, CPTSD and suicidality. Twelve of my fourteen “respondents” said that their symptoms had significantly decreased due to hormone replacement, one said he felt temporarily worse, and one said he felt the same.
I am not exactly a scientist (I did study sciences for four years, but didn´t graduate… partly due to instability!). But no one replied that their symptoms got worse while on testosterone, or that they had a harder time dealing with preexisting problems. Several said that their mood did depend on the level of testosterone taken.
They reported: higher incidence of irritability, depression and anxiety with low T levels, whereas too high a level could instigate aggression. The solution to this, in most cases, was to receive a lower amount of testosterone during a smaller time frame (once every week, rather than a higher dose every two weeks).
Concluding; testosterone can magnify preexisting trouble, but in most cases, it seems that it can also really help. For this reason I don´t think that the chicken should be first and the egg second, or vice versa. Rather, I think that both diagnoses (gender dysphoria and any additional ones) should be addressed simultaneously.