Low Dose HRT And You by Sage Cotugno
on 12/16/2025 at 12:02 am- Comic »
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Sage Cotugno is here today with a lovely autobiographical piece on their low-dose HRT process.
Two HRT comics back to back =D It’s a cHRTmas miracle. We didn’t plan to have these comics one after another, but I do genuinely think it helps to show just how much each persons process is different and unique. There’s so many ways to make it work, and I think it’s really powerful to have so many artists share their stories.
Anyway, I think todays comic is just wonderful, and I hope if you feel the same, you go hit Sage up on their socials and thank them for the comic! Heck in the same, beat, I’d really recommend checking out their regular webcomic Glass Scientist too…
As ever, here at the bottom of the post; I want to remind you all that we’re a Patreon supported site – and it’s only through the support of individuals like you that we stay afloat! Please consider Supporting us on Patreon for the cost of one coffee each month, and we’ll keep trying our best to make comics like these for the folks who need them!
Places where we show up, so you can stay up-to-date, see what we post and even do some re-posting to help us out!
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Always looking to get more Reddit exposure too! Feel free to post work form our Updated-comics catalogue or Ping me!)
↓ Comic Transcript
Today’s comic is drawn by Sage Cotugno, an Asian American trans mask non-binary person, with pronouns They/Them, who is depicted as both free and post-HRT in the comic. The comic is drawn with clean, sharp lines and colored in blues and oranges that make the whole thing pop.
Page 1
Narration - I came out as a non-binary in 2019, but didn’t start HRT (hormone Replacement Therapy) until two years later
We see a younger sage having their hair buzzed from behind. They’re thinking to themselves:
Damn, my head looks like a giant egg.
Next, we're shown two stereotype depictions of different men. One is a lumberjack with a big, giant ax, bushy beard, and huge chest. The other is a elf like woodland creature elegantly holding a hand to their head to dramatic effect with sparkles around them.The Lumberjack has these notes floatinga round them:- Huge Beard and muscles- 24/7 flannel lifestyle- Part-time paper towel model, full-time American hero
The Elf-man has these notes:- Cat-ears somehow??- Deadly cheekbones- Heir to the moon kingdom.
Narration - I hesitated in part because I had never wanted to look like a traditionally masculine man.
I pictured myself as more of a soft, anime prince boy.
Sage shows themselves at the Gender Buffet, picking up different bits of food and adding it to their plate
Narration - I wished I could pick and choose which masculine traits I would end up with…
Suddenly, a huge wave with the label T-Gel Tsunami comes crashing down onto Sage
Narration - But I knew from my research that it was more of an all-or-nothing kind of deal.
Page 2
We see a small sage sitting on top of the hill looking out at the clouds, Lion King style, forming in the clouds themselves, is the Elfish masculine trope that Sage craves.
Narration - I began to suspect my soft boy dreams were some quixiotic fantasy like wanting to be a dinosaur or a wizard. Surely real trans people don’t want things like that!
A doctor springs out of the page, with their hand in the air
Narration- But then my doctor said...
Doctor- Actually, lots of them do!
In this next panel, we see a giant banner with the word low-dose HRT on top of it. It is adorned with needle and pill visualizations. Behind it is the doctor showing off the banner while Sage looks on, and imagines a bull’s-eye of hitting the perfect place for their trans-masc dreams.
Doctor- There's two roots trans folk often take: They either want to go 'all the way' towards one end of the binar, or land somewhere in the middle. People in the secondary category often choose…
Sage interrupts- Gasp! So it’s like a magical soft boy pill??
Doctor - well, not exactly…
In the final panel, the doctor shows off an example behind them as Sage looks on with curiosity and skepticism on their face. The example is of a generic person dipping their toe into a pool.
Doctor- No matter your dosage, all the effects of HRT will show up eventually. But low dose helps you ease into the changes more slowly, allowing you to adjust or stop by any time!
Sage- I was hoping for a magic pill, but OK!
Page 3
Sage sits down and looks over the details in a brochure. It’s a lot of information that floats behind them as they sit there and the doctor talks over it.
Narration- Before I started HRT, the doctor talked to me through all the effects I should expect to see.
Doctor- Some changes will reverse themselves if you stop. Others are permanent. Pay close attention to the permanent ones! If you don’t like the direction they’re heading in. That’s a good time to stop or make adjustments!
We see a slightly different hued, Sage talking into their phone with a smile!
Narration- From there, I got my prescription and started tracking my progress.
Sage- This is my voice three months on TI
Narration- Most of the changes (like voice drop and body fat distribution) felt fantastic!
Sage pulls their hairline apart and looks at it with concern.
Narration- But a few made me nervous. I was particularly concerned about hair loss.
Sage is back, sat in front of the doctor now a little more worried than before, but the doctor looks pretty chill.
Narration- When I noticed my hairline starting to change, I sent a message to my doctor. They recommended I start Finasteride a common treatment for transmascs.
Page 4
Sage looks down at their tummy, from their belly button down they’re growing thicker and more hair.
Narration- Other unwanted changes turned out to be less of a big deal in practice
Sage- I don’t love the extra body hair, but it’s worth it for the things I do like. Besides, I was pretty hairy to begin with.
Sage sits down and starts to lift weights
As they grunt, we see some narrationNarration - And some I ended up liking way more than I expected.
Sage sits up after their Set and flexes an arm, showing off their muscles. They look very happy.
Sage- I never cared about muscles growing up… But once I started going to the gym, the one-two punch of HRT and weightlifting made a huge impact on my silhouette. It ended up being my favorite part of transition!
Page 5
We are now shown four panels back to back of four different people each with their own little bubble and story to tell. Above it is some narration that gives the following four panels and context.
Narration- Of course, medical decisions are an extremely personal choice. Many trans people choose not to go on HRT at all.
Concerned, mohawk buzz-cut, Person one- I really don’t want my voice to change. The trade-off isn’t worth it for me.
Worried, Beanie, Person two- I have a long history of medical trauma.
Excited, extroverted, Person three- I don’t experience physical, gender dysphoria. My transition focuses on other aspects of my life
Finally, fancy hat, busy, Person four- I’m going through a lot right now. I don’t have time to make big choices about my gender.
Sage finishes their comic with a big illustration of themself, lying down on a blanket in the grass, as they hold up their phone with a grin. We see the scene from above.
Narration- But as for me, medical transition has been one of the best decisions I’ve ever made. And if any of this resonates with you, low-dose HRT might be a great option for you too!
Today’s comic was drawn and written by Sage Cotugno, whose work can be found on Linktr.ee/ArythusaTodays comics were transcribed by Matthew Nolan on December 15, 2025
Page 1
Narration - I came out as a non-binary in 2019, but didn’t start HRT (hormone Replacement Therapy) until two years later
We see a younger sage having their hair buzzed from behind. They’re thinking to themselves:
Damn, my head looks like a giant egg.
Next, we're shown two stereotype depictions of different men. One is a lumberjack with a big, giant ax, bushy beard, and huge chest. The other is a elf like woodland creature elegantly holding a hand to their head to dramatic effect with sparkles around them.The Lumberjack has these notes floatinga round them:- Huge Beard and muscles- 24/7 flannel lifestyle- Part-time paper towel model, full-time American hero
The Elf-man has these notes:- Cat-ears somehow??- Deadly cheekbones- Heir to the moon kingdom.
Narration - I hesitated in part because I had never wanted to look like a traditionally masculine man.
I pictured myself as more of a soft, anime prince boy.
Sage shows themselves at the Gender Buffet, picking up different bits of food and adding it to their plate
Narration - I wished I could pick and choose which masculine traits I would end up with…
Suddenly, a huge wave with the label T-Gel Tsunami comes crashing down onto Sage
Narration - But I knew from my research that it was more of an all-or-nothing kind of deal.
Page 2
We see a small sage sitting on top of the hill looking out at the clouds, Lion King style, forming in the clouds themselves, is the Elfish masculine trope that Sage craves.
Narration - I began to suspect my soft boy dreams were some quixiotic fantasy like wanting to be a dinosaur or a wizard. Surely real trans people don’t want things like that!
A doctor springs out of the page, with their hand in the air
Narration- But then my doctor said...
Doctor- Actually, lots of them do!
In this next panel, we see a giant banner with the word low-dose HRT on top of it. It is adorned with needle and pill visualizations. Behind it is the doctor showing off the banner while Sage looks on, and imagines a bull’s-eye of hitting the perfect place for their trans-masc dreams.
Doctor- There's two roots trans folk often take: They either want to go 'all the way' towards one end of the binar, or land somewhere in the middle. People in the secondary category often choose…
Sage interrupts- Gasp! So it’s like a magical soft boy pill??
Doctor - well, not exactly…
In the final panel, the doctor shows off an example behind them as Sage looks on with curiosity and skepticism on their face. The example is of a generic person dipping their toe into a pool.
Doctor- No matter your dosage, all the effects of HRT will show up eventually. But low dose helps you ease into the changes more slowly, allowing you to adjust or stop by any time!
Sage- I was hoping for a magic pill, but OK!
Page 3
Sage sits down and looks over the details in a brochure. It’s a lot of information that floats behind them as they sit there and the doctor talks over it.
Narration- Before I started HRT, the doctor talked to me through all the effects I should expect to see.
Doctor- Some changes will reverse themselves if you stop. Others are permanent. Pay close attention to the permanent ones! If you don’t like the direction they’re heading in. That’s a good time to stop or make adjustments!
We see a slightly different hued, Sage talking into their phone with a smile!
Narration- From there, I got my prescription and started tracking my progress.
Sage- This is my voice three months on TI
Narration- Most of the changes (like voice drop and body fat distribution) felt fantastic!
Sage pulls their hairline apart and looks at it with concern.
Narration- But a few made me nervous. I was particularly concerned about hair loss.
Sage is back, sat in front of the doctor now a little more worried than before, but the doctor looks pretty chill.
Narration- When I noticed my hairline starting to change, I sent a message to my doctor. They recommended I start Finasteride a common treatment for transmascs.
Page 4
Sage looks down at their tummy, from their belly button down they’re growing thicker and more hair.
Narration- Other unwanted changes turned out to be less of a big deal in practice
Sage- I don’t love the extra body hair, but it’s worth it for the things I do like. Besides, I was pretty hairy to begin with.
Sage sits down and starts to lift weights
As they grunt, we see some narrationNarration - And some I ended up liking way more than I expected.
Sage sits up after their Set and flexes an arm, showing off their muscles. They look very happy.
Sage- I never cared about muscles growing up… But once I started going to the gym, the one-two punch of HRT and weightlifting made a huge impact on my silhouette. It ended up being my favorite part of transition!
Page 5
We are now shown four panels back to back of four different people each with their own little bubble and story to tell. Above it is some narration that gives the following four panels and context.
Narration- Of course, medical decisions are an extremely personal choice. Many trans people choose not to go on HRT at all.
Concerned, mohawk buzz-cut, Person one- I really don’t want my voice to change. The trade-off isn’t worth it for me.
Worried, Beanie, Person two- I have a long history of medical trauma.
Excited, extroverted, Person three- I don’t experience physical, gender dysphoria. My transition focuses on other aspects of my life
Finally, fancy hat, busy, Person four- I’m going through a lot right now. I don’t have time to make big choices about my gender.
Sage finishes their comic with a big illustration of themself, lying down on a blanket in the grass, as they hold up their phone with a grin. We see the scene from above.
Narration- But as for me, medical transition has been one of the best decisions I’ve ever made. And if any of this resonates with you, low-dose HRT might be a great option for you too!
Today’s comic was drawn and written by Sage Cotugno, whose work can be found on Linktr.ee/ArythusaTodays comics were transcribed by Matthew Nolan on December 15, 2025