What did @mx.gialu actually say?
Honestly? Not much that's medically specific, and that's worth acknowledging upfront. The transcript captured in this video appears to be song lyrics or background audio rather than coherent medical claims. What we do have is the caption, where @mx.gialu shares that their first year on testosterone was hard, that they struggled with body dysmorphia while gaining weight, that they simultaneously felt gender euphoria, and that they started on a low dose before moving to what they call the "full" dose for the past six months.
Those are personal experience claims, not clinical ones. There's a meaningful difference. The creator isn't telling you what to do or dose. They're describing their own experience. That matters when we're evaluating what, if anything, needs correcting.
Does the science back this up?
The experiences described, weight changes during the first year of testosterone therapy and the coexistence of body dysmorphia alongside gender euphoria, are both documented in the clinical literature. This isn't just anecdote.
A 2021 study by van der Miesen et al. published in Psychological Medicine found that gender-affirming hormone therapy was associated with significant reductions in gender dysphoria and improvements in psychological wellbeing, but body image concerns didn't always resolve alongside gender euphoria. The two can genuinely coexist, which is what this creator describes.
On weight: testosterone therapy in transmasculine and nonbinary individuals is associated with increases in lean muscle mass and, in some cases, overall body weight. A 2019 study by Klaver et al. in The Journal of Clinical Endocrinology and Metabolism tracked body composition changes in transgender men over two years and found significant increases in body weight and fat-free mass. Early gains can feel disorienting when someone is also processing body image concerns.
So the broad strokes here check out.
What did they get wrong (or right)?
The creator got the emotional reality right. The tension between experiencing gender euphoria and struggling with body dysmorphia during testosterone therapy is clinically recognized, not a contradiction. Research consistently shows that hormone therapy improves gender-related distress while body image concerns, particularly those unrelated to gender dysphoria, may persist or even shift in new directions as the body changes.
The reference to a "full" dose is vague enough that it's not medically problematic. They aren't recommending a dose. They're describing a personal escalation from low to higher dosing under what we'd assume is clinical supervision. We have no reason to assume otherwise, and we're not going to fill in gaps with negative assumptions.
What's missing is any mention of monitoring. Testosterone therapy requires regular bloodwork, including hematocrit, liver function, lipid panels, and hormone levels. The absence of that context in a 466K-view video is worth flagging, not as a criticism of the creator, but as context viewers deserve.
What should you actually know?
If you're considering testosterone therapy, whether for gender-affirming purposes or hormonal optimization, here's what the research actually supports:
- Body composition changes, including weight gain, are common in the first one to two years. Klaver et al. (2019) documented this clearly. It's not a sign something is wrong.
- Gender euphoria and body dysmorphia can coexist. A 2022 review by Turban et al. in JAMA Network Open confirmed that gender-affirming care reduces suicidality and distress, but concurrent mental health support remains important.
- Starting at a low dose is a clinically common approach. Dose titration should be managed by a licensed provider based on bloodwork, not social media timelines.
- "Full dose" is not a standard clinical term. Appropriate testosterone levels vary by individual, by formulation (cypionate, enanthate, gel, patch), and by clinical goals. Anyone telling you there's a universal "full dose" is oversimplifying.
The creator's experience is valid. It's also one data point. Your physiology, your mental health history, and your clinical needs are different. Work with a provider who runs labs, not just vibes.