Other girls were disturbed by the effects of testosterone on their clitoris, which enlarges and grows into what looks like a microphallus, or a tiny penis. I counseled one patient whose enlarged clitoris now extended below her vulva, and it chafed and rubbed painfully in her jeans. I advised her to get the kind of compression undergarments worn by biological men who dress to pass as female. At the end of the call I thought to myself, “Wow, we hurt this kid.”
The overwhelming majority of our patients are white, but this girl was black. She was put on hormones at the center when she was around 16. When she was 18, she went in for a double mastectomy, what’s known as “top surgery.” Three months later she called the surgeon’s office to say she was going back to her birth name and that her pronouns were “she” and “her.” Heartbreakingly, she told the nurse, “I want my breasts back.” The surgeon’s office contacted our office because they didn’t know what to say to this girl.