In the winter of 2023, it finally became unavoidable that I needed to go on testosterone if I wanted to stop feeling sad all the time. How did I know? How does anyone know anything? The same way, I guess, that some women know they want a baby, even though they’ve never had one before. I hesitate to call the feeling biological because I don’t know if it was. I thought a lot about it, of course. I did research. I listened to and spent time with trans people, I trawled forums, I figured out what doctors to see and what forms I’d need to fill out. I thought about what I wanted my life to look like, about the changes my body might go through, about how it would affect my relationships. It does sound a lot like having a baby: you choose to change your body, and your whole life, because of a feeling, a want, a need. I think about my mom, whose feet grew — and remained — two sizes bigger when she had children (from a 9 to an almost impossible-to-shop-for 11). She didn’t know that was going to happen to her; she didn’t even know such a thing was possible, and yet I like to think that she doesn’t regret her decision. All of our bodies change throughout our lives; I just decided to be in control, more or less, of how it happened for me.

This makes the whole thing sound simpler than it was, though. It took probably three years to wade through all of the feelings, to even allow myself to consider the possibility without shame. And then, after I finally worked up the courage to tell my partner (who said she knew I was going to go on T, and was just waiting for me to bring it up), the problem then became — like it is with so many other things in my life in France — one of logistics. If I’d realized I wanted to medically transition while I lived in the United States, I would have turned to my trans friends or any number of U.S.-based micro-influencers who’ve charted their journeys online to find out how to go about it. Even though I’m fluent in French, my vocabulary is limited by the scope of my experience; I can trace back my knowledge of certain phrases in French, like “the hot water heater is leaking and my bathroom is flooded,” or “my cat has regenerative hemolytic anemia,” to very specific situations. I didn’t have the vocabulary for what I wanted to do in French, beyond the words that are basically common to English — transgenre, téstosterone. That, and it meant a whole load of medical appointments in a system I only have a basic understanding of. So I went to ask one of the only people I knew who took T, someone who I felt comfortable enough to ask for help: my hairdresser, Vic.

As the biggest city in France, Paris has the biggest LGBT population in the country. But even then, Paris is a small town; it has just over 2 million residents, and the queer community is proportionally small. Here as much as anywhere else, everyone queer is just one or two exes removed from each other. And until they moved away, Vic was the one who cut everyone’s hair into a mullet.

At our next appointment, I nervously admitted that I wanted to go on T and asked Vic if they could tell me how it works in France. They were, of course, happy to help, and laughed that their friends referred to them as a vault, that their knowledge of what to do and who to see predates the internet. Vic explained the basics and followed up a few days later with an email of all the details: which doctors to see, what order to do things in, what forms to fill out, what forums to read. I checked for availability with the doctors they recommended and discovered that I could probably start T before the year was over.

Thanks to Vic’s cataloguing of trans-friendly doctors, I didn’t have to see any kind of psychologist or psychiatrist to convince an endocrinologist to give me hormones. This is no longer something that is legally required in France, but many doctors still ask for it. I went to go see my new, young, woke GP, who asked if I’d started socially transitioning (yes), if I’d done research into hormones and their effects (yes), and if I had any questions for her. She sent me off with a letter and a blood test to take with me to my new endocrinologist. My appointment with him was much the same — he asked what kind of effects I hoped to get from T, told me what may or may not happen to me, what early signs to look out for. It felt too easy. (The situation for top surgery, is much more complicated, since a double mastectomy performed outside of cancer treatment is technically considered a “mutilation.”) After all of the emotional turmoil I’d been through, the mental preparations of how I’d defend my identity to medical professionals, it felt anticlimactic.

There’s also this: in France you can transition for free, so long as you tell social security that you would like it to be considered an affection de longue durée, a long-term affliction. It’s a formality held over from when being transgender was considered a psychiatric condition in France; now it’s moved into the “miscellaneous/other” column under the umbrella of chronic ailments. I didn’t like being branded this way, but as a second-year master’s student I did like the sound of free healthcare. There are visits with endocrinologists, regular, in-depth blood tests that cost well over 100 euros even in the land of socialized healthcare, plus the medication itself. So my doctor filled out the paperwork, and now my friends joke that I am chronically trans.

Another crucial thing the ALD covers is the cost of visiting a nurse. Nurses here sometimes work out of little storefronts or converted apartments; you can book one to change a bandage, or ask them to make a home visit, for example. They can also give injections: the prescription for testosterone, for example, is followed by a line that reads “To be administered by a registered nurse.” In all my research and conversations about logistics, I had somehow not come up against this question: who was actually going to be doing the injecting? On YouTube and Instagram, all the transmascs posted videos of themselves injecting T into the soft part of their lower bellies, in a moment they almost all talk about as powerful or meditative or ritualistic. In Stone Butch Blues Jess does it himself and gets on with it. And yet here I was being told to go to a clinic. When I finally had the little glass vial in hand I was too excited to wait, too impatient to figure out what I was really supposed to do, so I just made an appointment with the first available nurse I could find. She was young and friendly, but I couldn’t get over the feeling that someone was going to catch on to what I was doing and try to stop me. So after the appointment, I looked up how to do it myself in the forums Vic had sent me, and ordered some needles.

In the U.S., testosterone is usually administered subcutaneously (hence the stomach injections); in France, if you don’t use gel (which isn’t covered by social security, and therefore expensive), it’s intramuscular. This means you have to inject it in your upper thigh, or — more commonly — your ass. Cut to my girlfriend and I watching a video of a French person explain how to break open the glass vial, prepare your dose, and stab yourself in the upper butt with a five-centimeter hypodermic needle. Some images transcend language, but just to be sure, I invited over a classmate — a woman from Memphis I’d worked on a group project with once, who used to be a nurse — to have a cup of tea and supervise my first injection. I didn’t faint or seriously injure myself or fuck it up otherwise, so I had her approval and kept going on my own.

For a year, I did it myself, every two weeks, until one day I couldn’t make myself do it. I pushed through, thinking it was a fluke, I must have been stressed. But the next time around the same thing happened, and the next. In the time between my very first dose and this sudden loss of confidence, I had become attached to the idea that this was something I did myself, even though the whole cult of sentimentality around HRT makes me cringe a little. I loved being on T and thought stabbing myself in the ass with a needle made me really cool, but I also quietly liked knowing that I had something in common with other trans people around the world, across time, who took their healthcare into their own hands.

I also had become more suspicious of healthcare professionals who hadn’t been vetted by other people first. In the summer of 2024, about six months on T, I stopped by the pharmacy near my office to refill my prescription. This had historically been the most nerve-wracking part of the biweekly process: the pharmacist will see my name, will see the number 2 on my social security card that identifies me as a woman, and will demand to know why I’m taking testosterone. Nothing like that had ever happened before, but I liked to prepare for what I’d say. On this day, though, the pharmacist actually did refuse to give me the testosterone, on the grounds that the prescription hadn’t come from an endocrinologist. (The first prescription has to come from an endocrinologist, but the subsequent renewals can be from your GP.) She said “It’s for your safety,” with a smile that felt anything but innocent. My colleague, who was waiting outside, offered to go curse her out for me when I told them what had happened. What the pharmacist did was illegal, and my doctors told me I could file a complaint, but what was that going to do? Would she suddenly stop being a transphobe because I tattled to the government on her? I didn’t want to deal with it.

In the end, I found a nurse who was not only happy to do my injections, but despaired with me at the situation of trans people under Trump when I told her where I was from. She also told me that giving yourself intramuscular injections yourself is technically not allowed — who knew!

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Now well over a year on T, I feel calm for the first time since I was thirteen, but new questions and problems around my gender keep cropping up. Something I was not prepared for was how easily I would pass for a man in France — at least in Paris, where most of the under-35 male population resembles some flavor of Timothée Chalamet. In the neighborhood where we live, couples are almost invariably heterosexual. The women wear long floral sundresses from Sézane, or else the athleisure required by their weekend Pilates class. The men step out on a lunch break from their part-time remote corporate jobs wearing crisp, spotless Carhartt chore coats and one of three styles of translucent acrylic-frame Jimmy Fairly glasses.

My jacket is second-hand APC, but I do have those Jimmy Fairly glasses. So the moment I started to grow a featherlight moustache, it was game over: I became, if only in the eyes of my fellow Parisians, a man. Unfortunately, I became a very certain type of yuppie, hipster, bohemian-bourgeois man. Whereas before, I was addressed as “Monsieur – pardon – madame” — an initial assumption based on my short hair, almost immediately corrected upon getting a better look at my narrow face or hearing my high-pitched voice — I was now getting “Madame – pardon – monsieur,” or else no madame at all.

Being referred to as a man all the time has definitely taken its toll. Some days when I go out wearing a pink shirt and no binder I have to stop myself from laughing when I get called “monsieur.” Other times, on the rare occasions when I’m called madame, I find myself quietly offended, and then I have to remind myself that I’m not actually a man. The pressure to conform, to choose one of two possible genders, is subtly foisted upon me every time I leave the house. I don’t hold it against people; they don’t know any other way to speak or behave. But I wonder how I would behave if I didn’t tend to think of myself as “monsieur” now, if I was willing to face up to people’s bewildered expressions and stuttering if I presented them with a version of myself who refused to conform in the slightest. Maybe we need to move to a different neighborhood.

I don’t know if I wanted to make a larger point here. (Ha, ha.) I guess I just wanted to share something.