Every 30-60 days, it’s important for me to see my doctor for a routine check-in. I know my body quite well, but during transition I am by no means an expert. It’s important to keep up with visits even if I’m noticing progress and feel everything is fine. There, I get blood tests to evaluate my hormone levels, and more importantly, if I’m a healthy human being. I won’t compromise my health and safety because of this transition. In my first follow-up after starting medication, the results of my test were interesting.

My blood showed a significant leap in estradiol, from 28 to 78.5 pg/mL, three times what it was before starting! This is significantly higher than the average levels for cisgender males and females, because large quantities of estrogen trigger the body to change. The medical experts have noted that this excess is safe, as tests of my cholesterol and heart rate show. Estradiol levels have definitely changed, but testosterone is a different matter.

My testosterone level is unchanged. This makes sense, because I haven’t experienced many side effects of testosterone loss. I feel no physical losses in strength yet, which I had anticipated. As a performing artist who deals with feats of strength, I worry sometimes about the potential for sacrifice in that area. In my desire to be the best version of myself, I have to maintain realistic goals and accept the losses that may come.

The lack of change in testosterone is amazing to me, because in just 40 days I look in the mirror and see changes. I’ve gained a little weight, especially in my lower body. My partner has definitely noticed physical changes. She knows me better than anyone, and it’s actually been pretty fun on a weekly basis to discover occurring changes. I’m more shapely in subtle ways despite my unchanged testosterone levels.

My libido is unchanged as well, but a real side effect I may face is a decrease in sexual desire and function — a scary prospect. As I progress, I make sure to discuss this with my partner. We feel that our relationship can tackle any problem, and this is just one more hurdle to face together. I’m prepared to deal with changes as they come, but as of now, my strength, libido and testosterone remain constant.

Emotionally, I’m not sure what feelings can be attributed to what chemical balance in my brain, but I don’t feel any more emotional than pre-transition. It’s not as much about being “more emotional” as it is how I process the emotions I’ve always felt.

The best way to describe it in a word is “heightened.” Negative things sometimes feel like a big deal, even though I know and recognize that they aren’t in the grand scheme of things. At times, regardless of rationale and reason about the situation, the feeling doesn’t subside.

Several weeks into starting hormones, I was at an afternoon practice and I couldn’t land a new aerial rope trick I was working on. It really threw me off. Through the whole group practice, all I could think about was how I need to make changes in my life to be more on time. Through the evening this intensified until it was all I could think about.

I felt distracted and didn’t express this to my partner. At work that night, the feeling had evolved into complete despair. All I could think about was how awful a performer I am, asking myself why I don’t give it up, and how much I was letting her down in our art.

I couldn’t shake that irrational feeling. Despite knowing the feeling was misguided, it wouldn’t subside. My girlfriend asked via text if I’d eaten since practice; I had not. I ate, and all was well. The real problem was a basic necessity that I hadn’t even noticed.

I’m still processing my responses to emotions during this transition, and basic drives like hunger are important to keep an eye on as things progress. After discussing the possibility of testosterone blockers with my doctor, we’ve decided to instead double the dosage of estrogen that I take orally: from 4mg daily, to 8mg.

Progress so far has been subtle, but my body is definitely changing. As I make steps toward my goals to live as I want, I remind myself that my ideal body image and where I end up may differ. I make conscious decisions to strive for an identity, but in a way, I’m just along for a ride. My anatomy is in the driver’s seat, with medications giving directions to the destination that is my female body.