Okay so I see some posts about executive dysfunction that kinda misrepresent what it is, so I wanted to clarify.
Executive dysfunction is not: laziness, lack of motivation, lack of willpower, lack of self-control, bad attitude, an excuse to not do something
Executive dysfunction is: an actual deficiency in the function of the frontal lobe that can be seen and measured in an MRI scanner, associated with neurodivergencies such as autism and ADHD, and mental illnesses
When you can’t do something because of ED, it’s not because you aren’t motivated enough or lack self-control. It’s because your brain literally isn’t running the commands needed to make your body move and do the things you need to. You may be hella motivated and determined to do something and you still won’t be able to because you don’t know where to start or how to proceed to the next step or what to do at all. You may be very hungry, know that you have a frozen pizza in your fridge, yet not be able to do the “fairly simple” steps to cook that pizza because of ED.
Executive dysfunction cannot be helped with more motivation, rewards, hard work or whatever. The part of your brain that is supposed to break the task into steps and guide you through them isn’t working right now, and no amount of rewards or discipline will make it work. The only things you can do is accommodate for the lack of this function: either ask someone near you to guide you through the steps of your task, or have a list of steps prepared beforehand, while your frontal lobe was more merciful. Shouting, crying, blaming, punishing yourself, etc won’t do one bit to help it.
And for people who don’t know what it’s like to have ED and have people around them who do have it, here’s the thing: instructions have to be very precise. I know you never pay attention to this because you don’t have to, but here’s the deal - even the smallest steps have to be akwnoledged. For example you may think that an instruction to make tea looks like this:
1. Fill the kettle with water and boil it.
2. Put a tea bag in your cup.
3. Add sugar if you want
4. Pour hot water into your cup
5. Take the bag out after a minute or two
6. Enjoy your tea
But it has many, many intermediate steps that a typically functioning frontal lobe will figure out, but a person affected by executive dysfunction won’t be able to do. So instead that instruction will look more like this:
1. Open the kettle
2. Open a bottle of water/turn on tap water
3. Fill the kettle with water
4. Turn off the tap water/close the water bottle
5. Close the lid on the kettle
6. Push the button to turn it on
And so on. So that one step in the first instruction is actually six steps in the second instruction. And giving a person with executive dysfunction the first instruction probably won’t help them at all. And btw this is might be the reason that person in your life leaves the lights on or doors open or products out of the fridge all the time - their brain just doesn’t guide them through it.
So, things to remember:
1) Executive dysfunction is a real thing and it’s not the person’s fault
2) It cannot be helped with motivation, self-control, discipline, rewards or punishments
3) It can be helped with careful, thorough instructions prepared by yourself beforehand or by someone else without ED
4) It is very difficult and frustrating for the person experiencing it first and foremost
5) If you have ED, be kind to yourself. Learn ways around it. Rest from time to time. Don’t be afraid or ashamed to ask for help. And be honest to yourself about whether you can or cannot do the thing yourself. Trust me, it will help you in the long run.
Tips for young trans boys going on HRT [From two dudes already going through it]
Ok so since not everyone is actually fortunate enough to go through an actual Gender Service, I’m going to write some Will and Probably Won’t things that come with going on T. For ref, I’ve been on T a year and my bf has been on for two. Let’s start;
You’ll wake up one day and sound like Morgan Freeman.
Going on T will deepen your voice.
For some people it may happen quite suddenly, for others gradually. Most likely you’ll sound like you have a bad cold for a while and then it’ll even out and be different. If you like to sing, be aware of voice cracks and suddenly being unable to sing as high as you used to. Some guys get lucky and still retain singing prowess, but be aware there’s a high chance you won’t.
Each person’s vocal change is different. My voice cracked literally after the first injection, whilst my bf had to wait a while for changes. Don’t be worried if it appears your voice isn’t changing and be aware it may not go incredibly deep. It will probably be more noticeable to others than you and eventually it’ll feel like your normal voice. Your pets will recognise your voice, they will always come to know you.
Face shape will change drastically to become more masculine.
After a while on T, you may experience some change in face and body shape.
A lot of trans boys I know seem to believe they’ll wake up one day and just have the perfect masc face. Everyone is different, I can’t stress this enough. You may experience a huge change in the face, you may experience almost nothing. My bf always had a very round ‘moon’ face and his cheeks have started to slim down but his facial shape is more or less the same. As for myself I’ve not noticed anything too considerable yet.
The same goes for the broadening of the shoulders. If you’re very slender to begin with, you’re probably never going to be Dwayne “The Rock” Johnson, but you might experience some changes. Again, don’t be disheartened, everyone is different.
The fat in your breasts will break down from going on T and make you look a lot more flat, if your chest is small you may not even have to wear a binder.
If you have A cups, then maybe the breakdown that happens with T will mean you don’t have to bind. However, the breakdown from T alone is very small unless you’re on it for years. Also be aware that a lot of the fat in your body in general is going to start focusing on your stomach. It’ll become easier to gain muscle once on T, but if you don’t exercise, the weight you lose from other areas will go to your stomach. But also, muscle weighs more than fat, remember that. You may drop clothing sizes, which can be a pain if you’re already quite small and have trouble finding masc clothes to fit you, trust me I know.
Also a note on binders: Do not use bandages or cheap binders. Do not. Binders can cause damage after prolonged use when you’re using a proper binder nevermind anything else. Bandages are made to contract and not let in moisture, they are not good for being tight around the chest! Cheap binders are also usually not breathable and will hurt more than they should! It could cost a lot, but forking out for a proper binder from places like lesloveboat is really going to be worth it. There is the sports bra method if you can’t get a binder because you’re not Out yet and couldn’t justify getting a binder to your parents etc but even then it’s not as safe as a proper binder.
Any binder shouldn’t be worn for longer than recommended, and will most likely rub especially when the T starts to make you sweat more. There’s also going to be an increase in acne on the chest around where the binder fits. If your chest ever really starts to hurt, find somewhere to take the binder off. I don’t care where you are, if you’re getting huge chest pains, take the damn thing off. If you damage yourself the chance of being able to get surgery reduces drastically, not to mention a whole lot of health problems you don’t want to deal with. It’s harsh, but it’s a lot better for you. Get a binder in the next size up and try again.
My periods will stop immediately and I’ll never have them again.
Eventually your periods will stop, though you may spot occasionally whilst you still have the necessary organs.
Though everyone is different, don’t be disheartened if you still have a period or two after starting T, you’ll stop eventually. You could also go a while without a period and then spot before stopping again. If the spotting continues for a while, or if you start to experience severe cramping, go and see a doctor.
I’m going to get angry and aggressive a lot when on T!
Your emotions will be doing a whole lot of different things. Your may get angry, and you may also find your sex drive increases. You might also get upset more often or at things that never upset you before, or aren’t necessarily sad. I cried listening to that Chick Chick song, it’s ridiculous. It won’t last forever, be patient with yourself, there’s nothing wrong with you it’s basically just puberty (again).
Last things -
Hair growth all depends on the person, the face being the last place that will probably grow hair and even then you’ll probably only have a tiny fluff for a long time, unless you’re lucky. My bf is experiencing hair in places now that I started growing extremely quickly right away. It could be to do with my having dark hair and him being a redhead tbh. But you will grow hair, all over. All over. Be prepared for that. You will get hair in places you never had much if any hair before. I have hair on my chest now. Not a whole lot but it’s there. The stomach is another hotspot for hair growth on T.
You will get acne, you will start to stink, sweat more and you may get growing pains. Look up Male Puberty, seriously, it’ll give you a good idea of some of the stuff that will start happening to you. Until your hormones calm down, your acne will not ultimately improve even with skincare. If you’re under 21, you might grow a little and the pains will be considerable. I gained like maybe an inch so I’m still short af but that’s something.
Your clit will start to get bigger. I know talking about the female genitalia we have is a big dysphoria bomb for a lot of us, but you need to read this. Your clit will get bigger, maybe considerably, maybe so much that the lips won’t hide it any more (if they ever did). It will rub against your underwear and/or your packer. For me it’s just mildly irritating, though for my bf it actually hurts (stings) him. It will be really sensitive either way. Be aware of that.
Some people you don’t see every day or aren’t very close to may not recognise you when considerable changes occur. Use this to your advantage! Reintroduce yourself!
If you self-inject, be prepared to mess up. There will be pain, swelling and bruising. If you have a nurse to inject you (like we do) there’s a change that they too might occasionally catch a nerve and you may bruise. Do not inject directly into a vein.
It’s perfectly fine to cry because of growing pains, pain from rubbing etc. You can be a man and still cry and complain but at least be aware of what to expect.
Most changes will be so gradual that you’ll never look in the mirror and see a stranger, it’ll be like this was always the way you were.
If you do however, start to become really distressed by the changes or start to see nothing but a stranger in the mirror, please reconsider whether HRT is the right thing for you. The last thing you want is to be stuck with changes that are actually distressing you. It’s ok if you thought you wanted/needed this but then realised you didn’t/don’t.
Last (gosh this was long). Every guy is different. Some changes come fast, some don’t. Some may be huge changes and some only small. Don’t compare yourself to other trans guys especially your own friends/loved ones. Every guy is different, be proud of your changes as they come and don’t let anyone bring you down just because those changes aren’t ~*significant*~ to them.
Their brains are wired differently and some things that work for them won’t work for us. There’s a chance those tips and tricks won’t do anything for you, which might make you feel like a failure. You aren’t! If something doesn’t work, move on. It’s okay.
2) If you have executive dysfunction, laziness and lack of motivation is not your problem
When you struggle with executing tasks it may feel like you are lazy and aren’t motivated enough, but that’s not necessarily true! You might be hella motivated and still not be able to do a task. Trying to motivate yourself in that case will only make you more frustrated.
3) Get distractions out of the way
Little things that would not distract a neurotypical person might distract you, in which case you won’t be able to work to your full capacity. Build a sensory friendly environment with no noises, bright lights, bad smells, etc. Use ear plugs or music if you need to. Get stim toys if you stim a lot to concentrate. Good environment is very important and is probably the reason why you struggle at school/college/uni where your senses might be overstimulated.
4) If you tend to hyperfocus, learn when it happens
Hyperfocus can be incredibly useful for studying, so if it happens to you, try to identify when it happens. For me I tend to hyperfocus when there are absolutely no distractions (for me that often means when I have headphones on and I’m alone). Then replicate those factors to get more done.
5) Learn ways around executive dysfunction and limited energy
This is the most difficult part. Studying when you have problems with executing tasks and limited spoons (energy resources) is tough. Here’s how you can deal with it.
6) Understand your priorities
You will not be able to do as much as NTs do in one day. Deal with it now. Understand that simple tasks such as brushing your teeth or talking on the phone also require energy. So prioritize. Assume you can only do one thing today, the most important/urgent one, and do that first. Then the less important thing. And so on.
7) “Don’t half-ass things” is a lie
Half-ass things. Quarter-ass things. If you can only do one math problem today, do it. That will be one less math problem later. If you can only read a few pages of a textbook today, do it. It’s also easy to think “if I can’t write the essay and finish that project today, might as well do nothing”. That’s a lie too. Do a small thing but do something. Do something badly but still do it. You might be able to fix it later. There’s no shame in being disabled, no matter what society makes you think.
8) Do the most complicated thing first
If you have several tasks and one requires more executive functioning, do that first. Your planning skills are probably at best right after you wake up, before you have time to spend any energy. So that’s the best time to do tasks with many steps or to plan tasks ahead.
9) Rest and take breaks right
It’s important to take breaks in between work, but you have to do it right. You might be tempted to do something useful for a break to be productive - like take a walk or read a book or talk to someone. Do not, or at least do not unless you are absolutely sure. Switching to another task requires mental energy, so that will only deplete your energy sources.
For breaks, do something ridiculously easy. Go on social media. Listen to a song and sing along. Watch a YouTube video. Stim. Daydream. Even lay down and close your eyes for five minutes. Just don’t switch to tasks that also require energy.
10) Don’t try to learn by repetition
Studies show that learning by repetition doesn’t work for us. It will not help you make more connections in your brain. Instead, do different tasks. Read from a book. Write down important points from the book. Read them out loud. Try to repeat them without looking. Pretend to explain it to someone. Answer questions related to the material. Draw it. Watch a video about it. Make a mnemonic for it. Whatever. Just don’t sit there reading it again and again.
11) Be kind to yourself
Your energy levels and capabilities will fluctuate from day to day, and you can’t always know how it will turn out. On some days I can write an essay from scratch in one sitting. On others I struggle to make myself a cup of tea. That’s normal, and it’s not your fault. Blaming yourself for it will only upset you and make it less likely that you do at least something today.
Imagine it like this: you are playing a game, and the difficulty setting randomly switches every day. On some days it’s on easy and you get through five levels with no problems. On some days it’s on very difficult and you can’t even get to the first checkpoint. That’s okay. Say to yourself, “my abilities haven’t changed, the difficulty changed”. Today, just get to that checkpoint. Tomorrow you might get through five levels.
12) Learn from other autistic people
For any other problem you might come across, other autistic people are the best source of knowledge. Allistic parents, teachers, friends, mentors, etc are likely to not understand your problem at all, or give you bad advice. Instead consult the real autism experts - actually autistic people. There are plenty of us who got through school, college and/or uni. Reach out to them. They will help.