I feel bad about my neck. All the time. If you saw my neck, you might feel bad about it, too, but you’d probably be too polite to let on, unless you are the kind of person who says things like “Welcome to womanhood” in a tone that actually means “Shut up” when a trans woman references her own experience with sexism, in which case you might let on after all. In that case, you might say something to me like, “Well, what do you expect?” or “You get what you paid for.” And you’d be right, sort of, but it’d still be rude.
If I said something to you on the subject—something like “I absolutely cannot stand my testosterone-induced neck acne”—you’d likely respond by saying something nice, like, “You can barely notice it,” or “Well, at least it’s not on your face.” You’d be lying, of course, but I forgive you just the same. I tell lies like that all the time, mostly to friends who tell me that they’re not sure yet if top surgery is right for them, but would I recommend it if they were thinking about it, and if so should they consider free grafts or medically tattooed nipples, and how important was prioritizing sensation to me, and do I think they might qualify for peri or keyhole and what have I heard about Mosser and is it true that most surgeons want you to go on T first, and if so is the neck acne on T really that bad? My experience is that “I can barely notice it” is code for “If you think you’re going to trap me into acknowledging how bad your neck acne is by asking me for suggestions on how to treat it, you’re dead wrong.” It’s dangerous to engage with such subjects, and we all know it. Because if you said, “Yes, your formerly smooth neck has since bloomed into a map of angry red blotches,” I might end up being one of those people you read about in the tabloids in court suing their endocrinologist. Furthermore, and this is the point, it would be All My Fault. I am particularly sensitive to the All My Fault aspect of things, since I have never forgiven one of my friends for seeing almost immediate results with Hibiclens.
Sometimes I go out to lunch with my boyfr— I got that far into the sentence and caught myself. I suppose I mean my transmasc friends. We are no longer boys and have not been boys for fifteen years, although you wouldn’t know it to hear us refer to ourselves in the third person. Anyway, sometimes we go out to lunch and I look around the table and realize we’re all wearing turtleneck sweaters, like the cluelessly handsome barista in a Coffee Shop AU. Sometimes instead we’re all wearing scarves, like Johnny Weir in 2009. Sometimes we’re all wearing hand-knitted mittens from our equally transmasculine boyfriends and look like an advertisement for “carefully calculated queer coziness.” It’s sort of funny, because we’re not neurotic about identity, and whenever any of us exhibits a tendency to rename himself after a character from A Separate Peace, someone else gently sits on his chest until the urge passes. We all look good for our age and various hormone levels. Except for our necks.
Oh, the neck acne. According to my dermatologist, the neck starts to go at 220ng/dL of testosterone, and that’s that. You can slather yourself in Dr. Jart correcting cream, order those little overnight acne patches from Sephora, you can hire a facialist to perform the most hygienic and regular of extractions, but short of a surgically implanted turtleneck, there’s not a damn thing you can do about the neck. We try to tell ourselves that chaos is not the only governing force in our lives, but our necks are the truth.
My own experience with my neck began shortly after I turned thirty. I started taking hormones that shot me into a sort of second puberty, and while I’d had plenty of experience with the occasional spot on my nose during the original go-round, this was my first time dealing with zits below the jawline. If you learn nothing else from reading this essay, dear reader, learn this: Never start testosterone therapy without first taking as many pictures as possible of your neck. Because even if you honestly believe that your well-being is more important than vanity, even if you record your first “Six Days on T” video thrilled beyond your own imagining, grateful to be alive, full of blinding insight about what’s important and what’s not, even if you vow to be eternally joyful about being on the planet Earth and never to complain about anything ever again, I promise you that one day soon, sooner than you can imagine, you will look in the mirror and think, Do they manufacture testosterone that leaves the neck out of it?
Assuming, of course, that you do look in the mirror. That’s another thing about being at a certain point in my own transition that I’ve noticed: I try as much as possible not to look in the mirror, preferring instead to toggle the “Male” filter on FaceApp and consider the results a binding promise of what I will look like two years from now. If I pass a mirror, I avert my eyes. If I must look into it, I begin by squinting, so that if something really bad is looking back at me, I am already halfway to closing my eyes to ward off the sight. And if the light is good (which I hope it’s not) I often do what so many folks two years into testosterone replacement therapy do when stuck in front of a mirror: I place my fingers carefully over the acne and stare wistfully at the smooth skin in between. (Here’s something else I’ve noticed, by the way: If you want to get really, really depressed about your neck, sit in the car, assuming you have access to one, and look at yourself in the rearview mirror. What is it about rearview mirrors? I have no idea why, but there are no worse mirrors where necks are concerned. It’s one of the genuinely compelling mysteries of modern life, right up there with the unstudied connection between people with PCOS and trans men. Maybe it has something to do with control. In a selfie, you’re holding the phone, and it knows it can’t get away with so much as a mirror, which is farther away and harder to throw.)
But my neck. This is about my neck. And I know what you’re thinking: Why not just decrease your dose? I’ll tell you why not. I don’t have the time to go back to crying eleven times a day. The fact is, it’s all one big ball of wax. If you lose the neck acne, you run the risk of crying eleven times a day again, and I would rather cry three times a week and have neck acne. One of my biggest regrets—bigger even than my marriage to Carl Bernstein—is that I didn’t spend my pre-transition years staring lovingly at my neck. It never crossed my mind to be grateful for it. It never crossed my mind that I would be nostalgic about a part of my body that I took completely for granted.
Of course, it’s true that now that I’m older and transitioning, I’m wise and sage and mellow. And it’s also true that I honestly do understand just what matters in life, which is slowly virilizing my body through the careful administration of a specific sex hormone. But guess what? It’s my neck.