as for something i have personally experienced, i didn’t expect it to physically get harder to create tears when i felt like i was gonna cry. been on t for almost 15 years now. it’s gotten a little easier but still not anywhere near as easy as when i was young.
In general, not enough research is done on longterm health, especially since maintaining longterm access to healthcare can be difficult for many. but here is one study on it: https://pubmed.ncbi.nlm.nih.gov/38662108/