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With the raising awareness about gender identity and specifically the recognition of non-binary identities, new challenges are faced by medicine. Specifically, there are individuals who don't feel comfortable with their own sexual characteristic but they don't desire a full transition to the opposite gender. In this case, many patients seek a low dose hormone replacement therapy(or "microdosing").

Testosterone replacement therapy is considered safe in transgender men, but there isn't any study about long term effect of a low dose on non-binary biologically female individuals(reaching serum testosterone levels above female range but not in the normal male range and without hormonal suppression of the ovary function with GnRH analogs).

I wonder if anyone has experience with this. There are many questions that arise for example: will the ovary over time diminish permanently their estrogen production? Can this low dose therapy increase the risk of osteoporosis? Can it cause metabolic complications? etc.

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    I am glad you are looking into these potential effects. The endocrine system is complex. The long term safety of elective testosterone therapy at any level in a biologically female individual (elective meaning added without a clear medical indication, like having a testosterone deficiency at baseline) is not well known yet, and may not be for years to come. This is part of the reason many doctors are not comfortable prescribing these hormones until the long term safety profile is well known, as they ARE biologically active in more ways than on genitalia and hair pattern etc. – DoctorWhom Jul 29 '19 at 4:17
  • There ARE some case studies and retrospective cohort studies and such, but by the principles of biostatistics, most physicians look to more robust evidence with larger scale studies showing safety and efficacy of something before applying it to a population. – DoctorWhom Jul 29 '19 at 4:18
  • Just as an example of the biological activity of testosterone: It has an effect on the RANKL path, which is associated with bone remodelling, but the details aren’t perfectly understood. – Narusan Jul 29 '19 at 16:19

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