Mieke de Vries – “How To Give Yourself a Subcutaneous Testosterone Injection”
“How to Give Yourself a Subcutaneous Testosterone Injection” is an excellent example of the power of structure, as the author hangs the piece on the scaffolding of the “Transgender Health Injection Guide” by Fenway Health. The narrator moves us through the instruction guide, preparing a shot and injecting, all the while engaging us more and more deeply into the ways and means of trauma of the body, when mishandled, and also healing of the body when affirmed. With the difficult themes of suicidal ideation, self-harm, and sexual assault also come themes of affirmation, joy, connection, and identity. The final salvo leaves us with an invocation to heal. Daring, honest, and beautiful.
(Comments by 2024 judge, Lisa Bird-Wilson)
How To Give Yourself a Subcutaneous Testosterone Injection
Step 1: Setting Up for the Injection.
Find a comfortable, well-lit working place and inject at the same time of day each time.
Summon the scream in your 5-year-old throat as your dad zooms you around the front yard in a wheelbarrow, cold bags of peat moss and soil under your legs. Your fingers grasp the cold metal sides as your dad steers you on a wobbly ride. The air is warm and sweet with the smell of lilacs. Your squeals of delight rise in the air alongside your father’s laughter. You are loud and unaltered in the company of your dad.
You wish your father could now see you change with his eyes. He cannot, but: your father is in your living. Your father is in your thickening vocal cords, in every word you speak. (Scream.)
Step 2: Preparing the Injection Dose.
Take the cap off. Clean the rubber stopper. Draw air into the syringe.
Revive the hunger swallowed down your 7-year-old throat for food and for her, an older girl in your gymnastics class. She smiles and waves her hand when offered the snack, saying no thank you. Her friends do the same. When the snack is offered to you (take the snack, eat it), you say no thank you, despite your empty stomach. She has permed blond hair pulled back into a high ponytail. You feel warmth in your body as you gaze at her from across the room. This is your first crush on a girl, the first of many times you will feel something you have no words for.
Resurrect the spells in your 12-year-old throat, breath and words stuffed down inside of you. Same as your body, stuffed into a practice room in the basement of your elementary school with four male classmates. Your calloused fingers pluck the strings of your stepdad’s bass guitar. The boys say things that make you blush and avoid their eyes. In this sealed-off room, your teacher cannot hear them. (Speak, say what you feel.) You remain silent. You long to be part of their boy universe, to be one of these mediocre boys who belongs simply because of his boyhood. Their crass conversations don’t appeal to you, but you are drawn to their world. Their confidence and ease, their ability to be unremarkable and still be popular and desired.
You do not have to give up your femininity to be a man. This is not a transition, but an excavation of your selves that were buried for their transness.
Insert the needle. Push the plunger down. Turn the vial upside down. Pull back the plunger.
Reclaim the laugh pushed out of your 19-year-old throat to make your demand seem flirtatious. Give them back! Your voice is breathy and high-pitched. Without your underwear and pants on, you feel vulnerable in a panicked way. (Laugh in his face.) You reach for your clothes in his hand and he yanks them away, laughing. He runs out of his small cabin and you follow him outside, under a full moon that casts shadows. You pull your shirt down to cover your bare lower half.
Release the tightening of your 21-year-old throat, claustrophobic under his weight. His tongue aggressive in your mouth. His muscular arms, tree planter arms, lock your body against his sleeping bag. You squirm beneath him and try to shift his weight off of you, but he pins you down with a firmer grasp. (Tell him to fuck off.) I—I think I should go, I need to get up early for my driving course. Your voice is tentative. No, no, you should stay. Don’t worry about your course, you can sleep here. Don’t go, you should stay, he says over and over as he kisses you and shoves his tongue into your mouth and hefts his weight upon you and pushes his erection against your body, trying to find a way in. He is persistent. You speak and he ignores you. You finally slip out from underneath him as he keeps repeating himself, telling you not to go. You pull on your boots, retreat to your own tent, and lie in your cold sleeping bag.
Check for air bubbles. Pull the syringe out of the bottle, remove the needle, and place the subcutaneous injection needle on the syringe.
Recollect the wails escaped from your 23-year-old throat, drowned out by the sound of the water on ceramic. Body aching, curled in a spiral in the tub. You want to die. You need an end to this grief for recently dead friends, an end to the shame and self-hatred, intrusive thoughts, panic, steady depression. You cannot share these feelings with anyone, especially not the family you are living with, your mom and stepdad always concerned for you and so generous in letting you move back in. You cannot tell your dad, or your brother, or the friends you left in another province. You don’t want them to worry about you, pity you. (Tell them you want to die.) So, you cry in the shower. In six months, T will be the first one with whom you will ever speak of these feelings. Lying side by side in his bed, you see the scars on his wrists and gently ask him. He tells you, and then, you tell him. He is the first person to know this part of you. Your body settles into a pleasant relief, lying next to someone who has felt it too. And though you won’t even know it yourself until years later, your body recognizes the inherent safety of your queerness settling beside T’s queerness.
Your depression is not shameful. Your suicidal thoughts are a survival instinct, a part of you that needs an escape to survive this pain, that must think of dying in order to keep living. These thoughts can coexist with your joy. They do not negate the peace and ease you sometimes feel. Those afraid of these thoughts haven’t had them. Their fear prevents them from speaking about suicide and this silence begets silence. Your voice is powerful, despite what you have been taught.
Step 3: Selecting and Preparing the Injection Site.
You can give yourself a subcutaneous injection on the fronts of your thighs or your abdomen.
Repossess the rising feeling in your 28-year-old throat, a sick fear flaming like heartburn, as you read his email. He apologizes for hurting you, vaguely. (Tell him he raped you.) He says he needs nothing from you. He says he hopes you are well. You reread his brief email several times, trying to decode the meaning, why he is apologizing so many years after your last contact. At first, your mind is blank. Like a wall is there, hiding the past, protecting you. But hours later you lie in your partner Emily’s arms and she listens as you recall for the first time memories that have been obscured unconsciously. Saying the words aloud to her, these memories suddenly become real. You weep in her arms, safe finally in your first queer relationship to acknowledge these wounds. Stories pour out of your throat. You say not consensual, but deep in your body you know the unvarnished truth of it, the violence. You tell Emily about the one who emailed you, and the tree planter and how he was fired later that summer for nearly raping another tree planter, and the guy under the moonlight beside his cabin, and the guy from the music festival, and the friend of your friends, and, and, and.
You are not a bad person for dreaming of your rapist, again. You owe no one an explanation, an admission, a confession. You are not shameful for feeling the dissonance of a past attraction with a current revulsion. You are not shameful for wanting him to read your essay that includes him. You wish this had not consumed so much of your energy and time. You did not ask for this.
Step 4: Give the Injection.
Clean the injection site skin. Pinch a fold of skin. With one quick and firm motion, insert the needle directly into the skin.
Release the words in your 33-year-old throat and sing along to a Madonna song at your first live drag show. (Sing loudly.) You feel safe to sing as other queers in the audience sing along too, cheering for the drag queen. She leaves the small stage to come to the back of the bar, her dress shimmering under the coloured lights. You can feel the magic emanating from her and want to possess this effervescence. Later, she pulls a wig out and plops it on a kid sitting next to you and Emily. Their parent pulls out their phone so the kid can see themself with the blonde wig. They grin in approval at their new appearance. The way they move the phone around to see themself from all angles makes you smile. You long for this delight in one’s own appearance.
Recant the words held in your 33-year-old throat as you sit across from the walk-in doctor. He asks why you are here and you tell him you are trans and want a referral to an endocrinologist. You show him the name and number of a doctor in Vancouver. He looks at you blankly. So, you are…? he asks you, trailing off. You do not need to explain yourself. (Say nothing.) But you do. I was assigned female at birth, you respond. He looks at his computer for a while, looks at the name of the doctor, and eventually says that he needs a diagnosis of gender dysphoria before he can refer you. You leave feeling powerless, angry at how gatekept this process is. You wish you didn’t have to prove your transness, have it legitimized by a medical professional. Though you must undergo their evaluations, you are not sick. You can centre your euphoria. You must pass their tests and answer the questions right, but they cannot decide what your transness means to you.
You have always changed yourself and your body. You have stopped your words before they could reach the air. You have made yourself silent and small to avoid offending others. You have altered your voice to appease. You have changed yourself for others, unconsciously. Now you get to change your body intentionally, in only the ways you want to. Your body is for you now, and you only. Now you can resurrect your body, rouse all the sleeping hurts and heal them, say the unsaid words.
Scream. Take the snack, eat it. Speak, say what you feel. Laugh in his face. Tell him to fuck off. Tell them you want to die. Tell him he raped you. Sing loudly. Say nothing.