U Up? is Healthline’s new advice column, which helps readers explore sex and sexuality.

“Can one really lose their mind from horniness?” This was the question I posed in a restaurant bathroom stall after losing my temper when a Grindr hookup cancelled on me with an infuriatingly reasonable excuse.

I was a trans man on the edge.

Six months on testosterone, a hormone replacement therapy regimen I follow with an endocrinologist, had taken me from a slightly-above-average libido experienced by cisgender women in their early 30s, to a raging madness of thirst.

Many transmasculine people report this when they start HRT. The insanity probably sounds familiar if you’re currently going through puberty or looking back with mortified dread. That’s because hormone replacement therapy can feel like a second puberty.

I didn’t used to be this way at all. When I was pretending to be a woman, I was on estrogen-based birth control from 17 to 27. I was never in the mood for sex with either of the two (yep) partners I had in that decade-long period. They both even accused me of being a closeted lesbian, which time has proven to be a misguided notion.

After starting HRT, when it comes down to doin’ it, I’m increasingly physically and romantically attracted only to people as masculine, or more masculine, as I am.

I discovered I can no longer function well in a strictly monogamous relationship, which is wild considering I’m a recovering serial monogamist.

I’m also far more open-minded than I used to be — if everyone is able and willing to consent, I’m fascinated to explore anything and everything my partner fantasizes about. As my body feels more correct, I enjoy sex more and worry about labels and expectations less. I feel like a different person sometimes!

Does this happen to everyone who takes hormones? There are a few studies about this topic, but the sample sizes are often small, which isn’t surprising, since the groups who use hormones are marginal and there’s still stigma around discussing sexuality candidly.

Also, sex and libido are very personal and subjective experiences, which can be difficult to measure in a study.

I wanted to get the down-low on how people’s sexualities are impacted on different types of HRT, so I conducted a few informal interviews. I did my best to find people of different ages, races, gender identities and sexualities, who are taking hormones for a variety of reasons — from medical transitioning to treating endocrine disorders.

Here’s what they had to say about going on HRT and their sex lives. (Names* have been changed).

How did HRT affect your sex life?

Sonya* is a cisgender woman in her late teens who’s been taking Tri-Lo-Sprintec and a weekly estrogen shot to treat a thyroid condition over the past couple of years.

Sonya reports feeling hypersexuality up until she started HRT. She was surprised not only by the change in her libido, but also that her preference for women shifted over mostly to men.

Overall, though, she shares: “To me it hasn’t changed my sexual habits much other than my libido dropping some, because it mostly was to treat my facial hair growth, weight gain, and body odor, but it’s been enough to notice.”

Then there’s Matt*, a 34-year-old queer, married cisgender man who’s been taking testosterone for around two years. He started HRT when his partner requested he see a doctor to help battle his fatigue and moodiness. He identified as a serial monogamist who enjoyed intimacy most in committed relationships.

After T, though, “It’s like someone had totally rewired my brain and I wanted to f*** EVERYONE. I got married young, and the T led to this weird crisis of ‘Wait, is this how everyone else felt in high school and college? Is this how anonymous sex happens? This makes so much sense now!’”

I also spoke to Frankie*, a transfeminine queer person (they/them pronouns) who’s been taking Estradiol since 2017. Before hormones, Frankie says “Sex was complicated. I was not sure what I wanted to do or what I felt. I would defer a lot to the other person.”

After starting estrogen, they felt more in tune with what their body wanted (or didn’t). Before estrogen, they were only involved with men. After, there was a seismic shift at first toward feeling lesbian-identified, “but then [I] got on Grindr and, uhh, guess not!”

Overall, Frankie credits these changes in their libido and sexuality to moving to a safer area with other queer and trans-identified people to pursue just as much as the hormones.

Finally, I talked to a trans woman named Rebecca*. She’s 22 years old and has been taking estrogen via a patch delivery system for about 7 months. Although she hasn’t experienced much of a libido change, her interest in sex prior to HRT was almost entirely kink-based rather than intimacy-driven.

Now, she has a deeper connection in her polyamorous relationships by identifying her need for emotional connection and intimacy, and enjoys the act itself more than ever. I identified a lot with Rebecca’s experience: that the orgasms feel different physically with estrogen than with testosterone!

“Not only is [sex] now satisfying, even affirming, but orgasm is also longer, more intense, and I may have even had a double orgasm once recently. An orgasm has become a proper send-off to a scene or encounter and it’s something I look forward to and enjoy building to, rather than something I do just to do it,” Rebecca said.

Of course, these experiences only represent a few of the hundreds of fabulous and diverse people who responded. Some people reported only minor changes, and some people like me had huge shifts in hypo- or hyper-sexuality.

I hope interest goes up for proper research, because larger scale studies and programs will be necessary as we begin to see the long-term effects of different HRT systems on the human body — especially trans bodies.

In the meantime, I’m going to go take a cold shower. Again.

Reed Brice is a writer and comedian based in Los Angeles. Brice is an alum of UC Irvine’s Claire Trevor School of the Arts and was the first transgender person to ever be cast in a professional revue with The Second City. When not talking the tea of mental illness, Brice also pens our love and sex column, “U Up?”