Changes to Cognition Due to Hormone Therapy

In the last article, I promised to discuss how my cognition — my thoughts, emotions, and methodology of observing the world around me — have changed since I began Hormone Replacement Therapy (HRT) in July, 2022. I was surprised by how rapidly inner changes occurred. I still experience revelations regularly, which has led me to consider what truly has changed. I have quite a bit more to discuss around that, and this article is intended to set the stage for some of those thoughts.

I have two exceptional examples to present. First I will present my typical behavior from — say — one year ago, then the behavior that I have observed since beginning HRT. Before I discuss either example, however, there is a major point that I want to emphasize first: I have been able to catalog these examples because I was capable of observing my behavior in the first place. Not being able to view how my behavior affected the rest of my existence has always been a significant barrier in my life. This is an important development.

Male Jousting

I mentioned previously that I have worked as a software developer for many years. Part of being a software developer is (I believe) proving to yourself and your colleagues that you are worthy of being in the field. This takes several forms, but there is one that I call Male Jousting. In Male Jousting, it is critical not to lose an argument. In fact, it is fair play to redefine terms, change the rules, change sides, contradict your earlier statements — whatever it takes not to lose an argument.

Male Jousting — for me, anyway — always comes with a significant sense of anxiety. My heart pounds, my head buzzes, my breath is short. Knowing I face a conversation in which Male Jousting could occur brings on a low-grade panic attack. I seem to have suffered through these conversations, as I have been fairly successful in my career, but I dread interactions that demand or devolve into Male Jousting.

Perhaps two weeks into HRT, I had a concern about a recommendation I was writing, and I called up a peer of mine to discuss it. I laid out my thoughts; he dismissed them. I explained my concerns another way; he said they didn’t matter. I gave examples of what I thought could occur; he believed I was catastrophizing. Then I glanced up at the clock and saw that we had talked twenty minutes, so I thanked him for his time, said I didn’t think we’d agree, and went back to what I was doing.

I had worried about that conversation before I began it. I expressed that worry to my wife, and we discussed how it went afterward. As we talked, I realized that I had not been anxious. I had not been interested in changing rules. I had not been vitally invested in being right. When I got to that third try and was demurred, I let it go. To say that this was atypical behavior for me is doing a disservice to understatement. This conversation was the first indication that something may have changed as a result of HRT.

Observing Tension

I have a long history of agreeing to attend a gathering or event of some sort, then finding an excuse to get out of it. I have never cared for crowds; I am most certainly an introvert. Even when I want to support the person or the cause, I can come up with a reason why I “shouldn’t” go, typically in the form of some kind of distress. For example, I have too much to do, like laundry or weekend work. Or maybe I am too tired from being so busy — heck, I’m working on the weekend, right? Perhaps I don’t have anything to wear because I did weekend work instead of that laundry I still have to do. This manifests as anxiety first, then I dodge the event, and feel guilty afterward.

This past weekend, there was an event I agreed to attend. I was feeling on edge because I did not leave enough time to prepare comfortably, and I met heavy traffic driving to the event. When I got there, I sat down for a moment and realized that I was feeling upset. I was clearly frustrated, which had built up tension. I realized that I needed to relax or I would not enjoy the event. I took a few deep breaths, decided to myself that I would dispel the tension, and joined the crowd. I had a great deal of fun, laughing and cheering. I was happy and in the moment.

What Changed?

What happened in these two examples? I had identified an emotion that I was feeling, I analyzed its source, I decided on action I could take to mitigate it, and I cleared my head. This is known in psychology circles as “normal human behavior.” It is what every self-help book teaches. It is what we expect of ourselves and our peers. Why am I going on so much about it? Am I really so impressed with my behavior?

In short, yes, I am very impressed with this behavior. In the last article, I discussed the need to experience something prior to being able to understand it. I am coming to realize that what has happened in the last three months is that I am beginning to experience things that I have not in the past. The next article will discuss the inability to experience my own life in detail, but believe me when I say that these changes are revolutionary. I am developing skills that allow me to experience my life, which will allow me to change my life in ways I have failed to do before. This newfound self-awareness both excites and frightens me. I am excited that I have an opportunity I did not have before; I am frightened because now I actually care about the results.

Is It Chemistry?

An important question to ask is whether these changes are purely chemical. That is, did changing the balance of hormones in my body affect my mood? Was it simply a placebo effect from taking action after years of suffering? Or is there something more subtle, such as being able to see my true nature when I look in the mirror? Am I able to feel my true spiritual self?

I read an anecdote on Reddit about a cisgender male whose testosterone levels had dropped with a corresponding rise in estrogen levels. He was logy, crabby, and addled. As soon as he received a testosterone shot, he felt better in all regards. My story is the opposite — as soon as I began HRT, which reduced testosterone levels and boosted estrogen levels — I felt energetic, affectionate, and mentally acute.

I have an XY genotype, just like the Reddit author, but the same balance of hormones affects us differently. I believe that indicates that something deeper is going on — that there is a connection among the chemistry, neurology, and physiology that ties into identity. What has been most surprising to me is having gained the ability to feel more acutely. I can feel emotions and physical pain that I did not feel before. The insensitivity to my own body and mind lies at the center of my transgender experience. I suspect that this phenomenon can be extended to other situations as well, and have named the phenomenon The Reflection, which will be the subject of the next article.