If you’re reading this, there’s a good chance you were feeling confident—maybe even relieved—about starting hormones… until suddenly, you weren’t. One moment you’ve waited months for your appointment, and the next you’re wondering if you even need it. I want you to know right away: you’re not broken, you’re not “faking it,” and you’re definitely not alone. This moment of doubt can feel confusing and scary, especially when starting hormones means so much to you. I’m holding space for you here, because this experience is far more common—and far more human—than you might think.
Feeling cold feet before starting hormones is incredibly common. It’s usually not a sign you’re making the wrong choice, but a natural response to fear, uncertainty, and the magnitude of medical transition. Doubt often shows up right before meaningful change.
Now that you know this reaction is normal, let’s slow down and gently explore why it happens. When you understand what your cold feet are actually trying to tell you, they stop feeling like an obstacle—and start becoming valuable information that can guide you forward with more clarity and self-trust.
You’re Standing at a Major Threshold
By the time you’re considering hormones, you’ve usually spent years living with questions that never fully quieted. You’ve reflected, researched, imagined, hoped, doubted, and circled back again and again. So when the medical appointment finally arrives, it can feel like a deeply emotional milestone—one that carries relief, validation, and a quiet sense of finally. And it is all of those things. At the same time, it marks a shift into a very different kind of territory.
Social transition often happens in layers and on your own timeline. You can choose who knows, how much they know, and when. Medical transition, however, brings change into your body itself. Hormones work gradually, but they work steadily, and they begin shaping not just how you feel internally, but how you may be perceived externally. Even if those changes take time, your nervous system often understands the significance immediately.
Crossing this threshold can stir something very primal. There is a part of you that recognizes this as a point where intention turns into action. You’re no longer only imagining a future—you’re taking a step that begins to anchor that future in your physical reality. That can feel grounding and affirming… and also incredibly vulnerable.
Pausing here doesn’t mean you’re unsure of who you are. It often means you do know—and that knowing carries weight. You’re acknowledging that this step matters, that it has meaning, and that it deserves your full presence. Your hesitation is not a flaw; it’s a sign that you’re taking yourself seriously.
When something has the potential to change your relationship with your body, your emotions, and your life trajectory, it’s natural for caution to surface. Fear often shows up not to stop you, but to ask you to slow down, to breathe, and to recognize the magnitude of what you’re choosing. This threshold asks for courage, yes—but it also invites gentleness. And both can exist together.
When Medication Conflicts With Your Self-Image
For some of you, the hesitation isn’t really about hormones themselves—it’s about what being on medication means to you. You may have built a strong sense of identity around being self-reliant, resilient, or “naturally” healthy. Perhaps you’re someone who listens closely to your body, avoids unnecessary interventions, or believes deeply in letting things unfold without medical involvement unless it’s absolutely essential.
If that’s part of who you are, the idea of taking hormones can stir up an unexpected inner conflict. It can feel like you’re crossing a personal line, or betraying a value you’ve held for a long time. Even if hormones make complete sense intellectually and emotionally, there may still be a quiet voice inside that whispers, “I shouldn’t need this.” That voice can be heavy with guilt or self-doubt, and it can make cold feet feel very convincing.
What’s important to understand is that this conflict doesn’t come from weakness or denial—it comes from integrity. You’re trying to stay true to the version of yourself that values autonomy, agency, and care for your body. The discomfort arises because you’re being asked to redefine what those values look like in a new context.
Needing medication doesn’t mean your body has failed you, and choosing hormones doesn’t mean you’re giving up control. For many people, it’s actually an act of deep self-responsibility—responding to what your body and mind have been asking for all along. Sometimes self-sufficiency isn’t about doing everything alone; it’s about making thoughtful, intentional choices that support your long-term wellbeing.
When these values collide, the answer isn’t to force yourself through the discomfort or to shame yourself for feeling it. It’s to slow down and listen. Both parts of you are trying to protect something precious. With kindness and curiosity, those parts can begin to work together instead of against each other.
Fear of Visibility and Loss of Control
For many people, cold feet don’t come from doubt about who you are, but from fear about how the world might respond once your body begins to change. Hormones can feel like a spotlight—one you didn’t ask for and can’t easily dim. Even when changes are gradual, the possibility of being seen differently can stir deep anxiety long before anything visibly shifts.
There’s a particular vulnerability in knowing that your body may begin to communicate something about you before you’re ready to explain it yourself. You might worry about being asked questions you don’t yet have the words for, or being perceived through assumptions that don’t fully reflect who you are. For many, this brings up fears around safety, acceptance, and whether others will treat you with the same care and respect once they notice something is changing.
Loss of control is often at the heart of this fear. Up until now, you may have managed your identity very carefully—choosing when to disclose, how to present, and what parts of yourself to keep private. Hormones can feel like they take some of that control out of your hands, even if only temporarily. That can be especially unsettling if you’ve learned, for very good reasons, that staying in control is how you stay safe.
Even when you intellectually know that hormones aren’t an instant or irreversible leap, your nervous system may still react as if they are. Fear doesn’t operate on timelines or medical facts—it operates on perceived threat. And when the stakes involve your body, your relationships, and your place in the world, that fear can feel intense and immediate.
Having these fears doesn’t mean you’re not ready or that you’re making a mistake. It means you’re aware of the realities of living in a world that doesn’t always make room for complexity or nuance. Your caution is a form of self-protection, and it deserves gentleness. From that gentleness, clarity often begins to emerge.
Wanting It Deeply… and Being Terrified at the Same Time
One of the most emotionally disorienting parts of cold feet is the inner contradiction it creates. You may find yourself thinking, How can something I’ve dreamed about, prayed for, or quietly longed for still scare me this much? It can feel almost betraying—to yourself—to hesitate at the very moment you’re closest to what you need.
But this tension isn’t confusion; it’s complexity.
Transition holds the promise of relief—of breathing more freely in your own body, of feeling more aligned, more present, more yourself. And at the very same time, it asks you to step into uncertainty. Hormones don’t just change how you feel internally; they can shift your relationships, your routines, and the way others interact with you. Even when those changes are ultimately positive, the process of getting there can feel destabilizing.
A part of you may be focused on survival. It scans for danger, remembers stories of rejection or hardship, and imagines worst-case scenarios as a way of trying to keep you safe. Another part of you is focused on truth and vitality—on what it means to live fully rather than just endure. These two parts aren’t enemies; they’re both responding to the same reality from different angles.
Fear often gets mistaken for doubt, but they’re not the same thing. Fear says, This matters. Fear shows up when something has the power to change your life, not when something is trivial. The presence of fear doesn’t erase your desire—it actually confirms how deeply invested you are.
When you hold both truths gently—that you want this, and that you’re scared—you allow yourself to be human rather than forcing yourself into certainty. You don’t have to silence the fear to move forward. You only have to listen to it with compassion, and then decide which part of you needs care rather than control.
The Familiar Pain vs. the Unknown Pain
There is a very human tendency to choose what is familiar over what is uncertain, even when the familiar hurts. Gender dysphoria, as heavy and exhausting as it can be, has likely become a known landscape for you. You know its rhythms. You know how it shows up in your thoughts, your body, and your daily life. Over time, you’ve developed ways—conscious or not—to endure it. That doesn’t mean it hurts less; it means you’ve learned how to survive alongside it.
The pain you imagine with transition, on the other hand, hasn’t been lived yet. It exists in your mind as a collection of possibilities, stories, and fears. Because it’s undefined, your nervous system often fills in the blanks with worst-case scenarios. The unknown feels dangerous not because it is dangerous, but because you don’t yet know how you would cope if those challenges arose.
What makes this so difficult is that staying where you are can feel like the safer option, even when it’s quietly eroding you. Familiar pain feels manageable because it’s predictable. But predictability doesn’t equal safety, and endurance isn’t the same as wellbeing. Remaining in the same place may reduce short-term fear, yet it also keeps you locked into the very discomfort you’re longing to ease.
Movement introduces uncertainty, but it also introduces possibility. When you take steps toward alignment, you’re no longer just enduring—you’re responding. Pain that comes with movement tends to carry meaning, direction, and the chance for integration. It’s pain that teaches, reshapes, and eventually softens as you grow into new ways of being.
You don’t have to believe that everything will be easy to choose forward motion. You only have to recognize that change allows for relief to enter the picture. Growth rarely comes without discomfort, but stagnation rarely brings healing. Choosing yourself doesn’t eliminate pain—it transforms your relationship to it.
When Cold Feet Turn Into Self-Gaslighting
I’ve seen this pattern unfold again and again, and it’s always tender. Someone finally reaches the point of scheduling a hormone appointment—something that may have taken months or years of inner work—only to cancel it at the last moment. Almost immediately, there’s a strange sense of calm. The urgency softens. Dysphoria quiets down just enough to make you wonder if it was ever that bad.
This is where self-gaslighting can quietly slip in.
Your mind, trying to reduce fear and restore a sense of safety, begins to reinterpret your experience. You may tell yourself you were overreacting, being dramatic, or confusing curiosity with necessity. You might start collecting “evidence” that you’re fine as you are, even reframing past distress as something you should just push through. In that moment, it can feel very convincing—because the relief is real. But the relief isn’t coming from resolution; it’s coming from avoidance.
What’s happening beneath the surface is a protective mechanism. By minimizing your needs, your psyche is trying to pull you back from a perceived edge. It’s saying, If I can convince you this isn’t necessary, then you don’t have to face the fear right now. That strategy can bring short-term comfort, but it doesn’t address the deeper truth that led you to seek hormones in the first place.
And for most people, that truth doesn’t disappear. Dysphoria tends to return, often in waves, sometimes more intensely—especially after you’ve had a glimpse of a possible path forward. When it does, there can be an added layer of grief or frustration, knowing that care was within reach but is now delayed again.
Recognizing this pattern isn’t about shaming yourself or forcing action. It’s about gently noticing when fear is rewriting your story. Awareness gives you the chance to pause and ask yourself whether the calm you’re feeling is genuine alignment—or simply a temporary retreat from something that still matters deeply to you.
My Gentle Recommendation
If you’re feeling cold feet, my first and gentlest encouragement is this: try not to cancel your appointment. Simply showing up doesn’t commit you to anything beyond a conversation. That appointment is an opportunity to be seen, heard, and informed by someone whose role is to support your health—not to rush or pressure you. You deserve accurate, personalized information that reflects your body, your history, and your concerns.
So go. Ask the questions that feel scary or awkward. Ask about timelines, effects, reversibility, and safety. Ask about your specific fears. There is a big difference between information gathered in a clinical, supportive setting and the often overwhelming, conflicting narratives found online. Knowledge grounded in your own medical reality can soften fear in ways reassurance alone cannot.
If hormones are prescribed, remember this: receiving a prescription is not the same as starting treatment. You are still in control. You don’t have to take that first dose right away—or at all—until you feel ready. There is power in allowing yourself time to sit with the decision rather than forcing clarity on a deadline.
Holding the prescription can be a surprisingly profound moment. It brings the abstract into the tangible. Pay attention to what stirs inside you when you realize the option is truly there. Do you feel a sense of calm? A surge of excitement? A tightening in your chest? A push-pull between longing and fear? None of these reactions are wrong. They are information—quiet signals from different parts of you that deserve listening, not silencing.
If you’re working with a therapist, this is especially rich material to explore together. Those mixed emotions can help you understand what you need most right now: reassurance, time, support, or permission to move forward gently. You don’t have to decide everything at once. Sometimes the most caring choice is to stay present, curious, and kind with yourself as the answer slowly unfolds.
Cold Feet Don’t Mean You’re Making a Mistake
Cold feet have a way of making everything feel urgent and catastrophic, as if hesitation itself is evidence that something is wrong. But in reality, cold feet are one of the most common responses to meaningful change. They tend to show up precisely when a choice matters—when it has the power to alter your life, your sense of self, or your future in a real and tangible way.
Think about how often people experience doubt right before moments that later become defining chapters of their lives. Standing at the edge of something transformative naturally stirs uncertainty. Your mind is trying to take in the scale of what’s ahead, and that processing can feel like fear, second-guessing, or a sudden urge to retreat. None of that means the desire underneath has disappeared.
With hormones, this reaction can feel especially loaded because the decision involves your body and your identity. It’s easy to interpret hesitation as a warning sign, when more often it’s simply your system slowing you down so you can move forward with awareness rather than autopilot. Carefulness is not the same as regret.
It’s also important to ground yourself in the reality of timing and choice. Especially with feminizing hormones, early changes tend to unfold gradually, and many of the effects within the first few months are considered reversible. That window of time exists for a reason—it allows you to notice how you feel emotionally and mentally without locking yourself into immediate permanence.
You are not being asked to leap blindly. You’re being invited to take a step, pause, and check in with yourself along the way. Giving yourself permission to explore does not diminish the seriousness of your journey—it honors it. And trusting yourself doesn’t mean feeling fearless; it means believing that you can respond with care no matter what emotions arise.
You’re Not Alone
If you’ve experienced cold feet, I want you to know how deeply seen you are here. This moment—this mix of hope, fear, anticipation, and doubt—is shared by far more people than you might realize. It often just isn’t talked about openly, which can make it feel isolating, as though you’re the only one hesitating while everyone else moves forward with certainty. That simply isn’t true.
If you feel able, I invite you to share how cold feet showed up for you. Maybe it was a sudden wave of calm that made you question everything, or a spike of anxiety right before your appointment, or an urge to postpone “just a little longer.” However it appeared, your experience matters. When you speak about it, you help loosen the grip of shame—not only for yourself, but for others who are quietly struggling in the same place.
There is something profoundly healing about realizing that our most vulnerable moments are often shared ones. When we name them together, fear softens, isolation fades, and compassion takes root. Community doesn’t erase uncertainty, but it reminds us that we don’t have to carry it alone.
You deserve patience, understanding, and gentleness as you navigate this. Wherever you are in your process—moving forward, pausing, or simply listening inward—you are not behind, and you are not doing this wrong. I’m grateful you’re here, and I’ll speak to you very soon.
With care,
Edith
If you are looking for more lifestyle-related posts here on Pink Femme, you can find them all here.
If you enjoy reading transgender coming out stories or romance stories with a trans-positive element, take a look at my author page on Amazon where you will find all the novels that I have published so far.
Keep up to date with all my latest femme news with the fabulous Pink Femme Newsletter. Each Monday you’ll receive an email from me that will include a chapter from the novel that I am currently writing. I will also alert you to interesting information from articles that have not yet been published on Pink Femme. The Pink Femme Newsletter is the only place to see chapters from the novels before they are published. Sign up today: PINK FEMME NEWSLETTER.
Thank you for your visit to the Pink Femme website. I’m determined to keep all of the valuable information on here free for anyone to access. No pay-walls. That said, if you are able to help keep the lights on, so to speak, I would really appreciate your support. Here is the Pink Femme Patreon page with a really cheap support tier. Every little bit helps to cover the costs of keeping Pink Femme alive on the internet. Hugs to all of you.
When it comes to my choices for makeup and beauty products, I only use L’Oréal Paris (Available on Amazon). I have really sensitive skin and never once have I had any negative reaction to any L’Oréal product.
References
- American Psychological Association. (2015). Guidelines for psychological practice with transgender and gender nonconforming people. American Psychologist, 70(9), 832–864.
- American Psychological Association. (2021). Understanding transgender people, gender identity and gender expression. APA Public and Professional Resources.
- Budge, S. L., Adelson, J. L., & Howard, K. A. S. (2013). Anxiety and depression in transgender individuals: The roles of transition status, loss, social support, and coping. Journal of Consulting and Clinical Psychology, 81(3), 545–557.
- Lev, A. I. (2004). Transgender emergence: Therapeutic guidelines for working with gender-variant people and their families. Haworth Clinical Practice Press.
- Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. (Often applied to transgender populations in later research via minority stress theory.)
- Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton & Company. (Relevant to understanding fear, safety, and nervous system responses to major life changes.)
- Ashley, F. (2019). Gatekeeping hormone replacement therapy for transgender patients is dehumanising. Journal of Medical Ethics, 45(7), 480–482.
- Coleman, E., et al. (2022). Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. World Professional Association for Transgender Health (WPATH).
- Festinger, L. (1957). A theory of cognitive dissonance. Stanford University Press. (Foundational theory relevant to internal conflict, ambivalence, and self-justification before major decisions.)
- Siegel, D. J. (2012). The developing mind: How relationships and the brain interact to shape who we are. Guilford Press. (Useful for understanding integration, fear responses, and identity development.)