Waiting to start testosterone while living with severe dysphoria is one of the hardest things a young trans person can do. The dysphoria is real, the exhaustion is real, and the wait does cost something. But there are ways to take the edge off each day while the medical process moves forward.
I want to tell you about a conversation Sammy had recently, because I think it is a conversation a lot of people are having privately, in their heads, and never quite saying out loud.
He was 17. He had already done the blood tests. He had a psychiatric diagnosis and doctors supervising him. By any measure, he was further along the pathway than most people his age. And still, every morning, he was putting on a binder, then a vest, then a jacket, then a coat, because none of it was quite enough and the constrained feeling was relentless. Most of the strangers he moved through the world with saw him as male, which is true and right, because he is. And then there were the teachers, the colleagues, people who knew his history, who would look at exactly the same person and suddenly find reasons not to see him. His voice is deep and strong. They called it feminine. His appearance reads as masculine to almost everyone. They said there was nothing specifically masculine about him.
That is not about his appearance. When someone who knows your history decides they can no longer perceive the person in front of them, that is a choice they are making. It has nothing to do with what you look like.
He described his dysphoria as severe. He used the word tantrums, and I think what he meant was the kind of overwhelming distress that builds and builds when your body keeps confronting you with itself and you have no immediate way to change what you are confronting. That kind of distress is not weakness. It is a completely rational response to a gap between who you are and what is happening to your body. And it is exhausting in a way that is genuinely hard to explain to someone who has never lived it.
He said he thought his life was worse than the life of the majority. I told him, through Sammy, that in this particular way it is. That is not self-pity, it is just true. He is carrying something that most 17-year-olds will never have to carry, and he is doing it while also navigating school and the particular cruelty of adults who ought to know better.
So what do you do with that, while you wait?
The first thing, and I think the most important thing, is to tell your doctors exactly what you told us. Not a softened version. Not "I find it a bit difficult sometimes." The full weight of it. The daily layering. The constrained feeling. The tantrums. The exhaustion. The way it sits on every single morning before the day has even started. Doctors are making decisions about timing, and the information that should be shaping those decisions is an accurate picture of what the dysphoria is actually costing you. If they do not know how severe it is, they cannot factor it in. The more honestly you can describe what each week feels like, the better placed they are to understand why speed matters.
And speed does matter. I am not going to tell you that there is no rush or that you should take this at your own pace, because puberty does not pause while you wait, and every month of an unwanted one is a permanent physical change you did not choose. The kindest thing I can say is: be honest with your doctors sooner rather than later, because the timing genuinely matters.
On the practical side, because practical things can at least take the edge off a hard day: binding combined with certain cuts of clothing does help some people. Dark colours. Structured shoulders. Jackets that sit squarely across the chest. Patterns that draw the eye upward or outward rather than inward. None of this is a fix. None of it makes the dysphoria go away or addresses what is actually causing it. But when you are managing a long wait, taking slightly less of the edge off each day adds up. If the binder alone isn't fully doing it, it is worth thinking about whether the layers on top are working as well as they could.
The other thing I asked, through Sammy, was whether there was a trusted adult in his life. Someone who knows what he is going through and is genuinely on his side. Not just aware of it in a vague, school-policy kind of way, but actually seeing him and understanding what the weight of this feels like. That person matters enormously. Not because they can speed up the medical process, though sometimes a parent or carer who advocates clearly and specifically for their child can make a real difference, but because carrying this alone is so much harder than carrying it with one person beside you who gets it.
He said thank you, and then the conversation ended. I hope he is okay. I hope his doctors know the full picture. I hope there is someone in his life who sees him clearly, the way strangers on the street already do.
What I keep thinking about is the particular bravery of continuing to move through the world, every single day, when the world keeps making it harder than it needs to be. Getting the blood tests done. Navigating the diagnostic process. Wearing the layers. Going into the classroom. Coming home. Doing it again. That is not a small thing. It does not feel heroic from the inside, I know that. It feels like survival. But from where I am standing, watching person after person do exactly this, it looks like something more than that.
If you are in a similar place, waiting, supervised, further along than it feels, please do tell the people treating you what it is actually costing you. And please find one person, just one, who you can be honest with. You should not be managing this entirely alone.
If there is a story that you would like to share or hear about, just let Sammy know.
Dr Helen Webberley is a Gender Specialist, Medical Educator, and advocate for trans people and their families. She is the founder of GenderGP.
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