I had my appointment with Dr. van den Berg in Victoria, BC earlier this week. It took about 20 minutes. I was expecting to be poked and prodded a little more. She asked me some typical questions about my health and my family’s health history, took my blood pressure and weighed me.

Next, she explained the different kinds of testosterone available:

  1. Injectable: Her preferred treatment. It works the most reliably and is the least expensive.
  2. Patch: It can fall off, and leaves a big mark on your skin, like a band-aid does.
  3. Cream: It’s not standardized (dosage can be variable) since it’s a compound made in the pharmacy, and has a shelf life but no expiry date.
  4. Gel: She didn’t say too much about it, but I know it’s expensive and you can pass it on inadvertently to people you come into contact with–OOOPS!
  5. Oral: The latest oral testosterone bypasses the liver, so the usual concern with this type of administration is not much of an issue anymore (contrary to what I’ve read on a lot of websites.) Nevertheless, Dr. van den Berg doesn’t tend to prescribe oral T to FTMs.

I didn’t expect her to prescribe anything other than injectable T, but some of this was new info to me (particularly about the cream and oral versions.)

She filled out a blood work requisition form, and that was it–I found myself being ushered out. There was no mention of risks, no informed consent forms, no questions about how much I actually knew about testosterone. Well, I had questions, so I whipped out my notebook and put a few to her, and then I left.

The results of the blood work will be sent to Dr. van den Berg and to my doctor. Dr. van den Berg will then send a treatment plan to my doctor: 50mg of testosterone injected once every two weeks for three months.

I know from what I have read, and from feedback from other patients of Dr. van den Berg, that her dosing is light. For example, the Medical Therapy & Health Maintenance for Transgender Men: A Guide for Health Care Providers recommends starting doses of 100-150mg. One of the guys I spoke to said that he found Dr. van den Berg’s low dosing a bit frustrating–changes don’t happen very quickly. That being said, I think I understand what she’s trying to do: ascertain the lowest possible dose required to achieve the desired changes. This makes a lot of sense to me, but I’m prepared to be a bit disappointed at the slow transformation.

Related: Starting on a low dose of testosterone is recommended for FTM singers