Transgender hormone management
We have many years of experience in helping transgender patients use hormones in the process of transitioning from one sex to another.
As per standard protocol, we ask that you have had a full evaluation from a psychologist and a letter form them certifying that you understand that the changes that happen with taking hormone can be permanent and you under the risks and benefits of taking hormones.
We are able to provide this service in all of our three locations. We do accept insurance to help with hormone management for transgender individuals.
- Transgender Female (MTF) Hormone Therapy including estrogen and spironolactone to block effects of testosterone.
- Transgender Male (FTM) Hormone Therapy including testosterone and an estrogen blocker like Anastrazole or Femara.
We may be able to start or continue hormone therapy and provide referrals for gender-qualified therapy and resources if needed. If you are currently on hormone therapy, you can utilize our services for ongoing medical care.
What physical effects will hormone treatment have on me?
If you are a trans woman, cross-sex hormones will be helpful in making your appearance more feminine; if you are a trans man they will make your appearance more masculine. However, whether you are a trans man or a trans woman, you will need to be realistic about the extent of the changes you can expect. Although hormones taken in adulthood can help to keep your bones healthy, they cannot alter your skeletal shape or your height.
In trans women, estrogen has feminizing effects but in some people the effects can be subtle and can take many months or years to gradually come about.
Fat may be distributed on the hips.
The size of the penis and testicles may be slightly reduced.
Some trans women find that erections and orgasm are harder to achieve.
Muscle bulk and power may be reduced.
Breasts may feel tender and lumpy and may sometimes increase modestly in size.
The growth of facial and body hair may become weaker. This is regarded by many trans women as helpful in supporting the hair removal process using electrolysis and/or laser treatment and other hair removal techniques.
Male pattern baldness may be slowed or stopped, but is not necessarily reversed.
It should be noted that for trans women there is no noticeable effects on voice feminization with hormone treatment; for most trans women it is often recommended that you seek vocal coaching for a more passable feminine voice.
In trans men, testosterone may cause the following effects:
It promotes beard and body hair growth.
Male pattern baldness may develop.
The clitoris increases slightly in size.
Libido may be heightened.
Muscle bulk increases.
The voice deepens, but not usually to the pitch of other men.
Periods will stop, although there may be some breakthrough bleeding requiring adjustment of dosage.
Some individuals develop acne.
The way you respond to hormone treatment will help you and your doctor decide if it is right for you. If the effects are unhelpful or even unpleasant, this could indicate that this treatment is not right for you.
Did you Know?
You can stop taking hormones at any time. On the other hand, if you start to feel better, psychologically and physically, this is a good sign that continuing with hormone therapy will benefit you, and that your treatment is on the right track. You and your doctor will still need to be sure about this because further treatment will cause some or all of the physical changes mentioned above. Some of these begin to happen after a few months and may be irreversible, such as the deepening of the voice in trans men and breast growth in trans women. However, most changes are slow to develop.
In fact, trans people sometimes feel frustrated by the slow pace of change brought about by hormone treatment. Remember that, as with puberty, physical changes are spread over a few years, so high doses of hormones do not necessarily produce better or quicker results. For instance, the adult breast shape of non-trans women is only achieved after several years of exposure to estrogen during puberty, and they have very different breast sizes. It is similar for trans women, some of whom will never develop anything more than very small breasts.
If you are a trans man, you may actually find that taking excessive testosterone is counterproductive, since the body’s natural mechanisms may convert some of the testosterone to estrogen.
Frequently Asked Questions:
What are hormones?
There are many different hormones produced in the body by a system of glands. These release hormones directly into the bloodstream so that they are carried all round the body. Among these are the sex hormones: the male hormone, testosterone, produced by the testes; and the female hormone, estrogen, produced by the ovaries.
Men also have a small amount of female hormone because some testosterone is converted into estrogen. In both men and women, the adrenal glands, which sit on top of the kidneys, produce small quantities of testosterone. So, all men and women naturally produce both testosterone and estrogen.
What effects do naturally produced hormones have?
Broadly speaking, testosterone has masculinizing effects, and estrogen has feminizing effects.
Along with genetic factors, sex hormones affect the development of the reproductive system, the brain and physical characteristics such as height and build, the way fat is distributed in your body and your muscle bulk.
Before birth, in boys, a strong form of testosterone prompts the development of the penis and testicles. Without this input of testosterone, girls develop the clitoris and labia, ovaries, uterus and vagina.
At puberty, sex hormones prompt the development of what we call ‘secondary’ sex characteristics. In girls these include breasts, periods, a more rounded shape, underarm hair and an inverted triangle of pubic hair; in boys they include facial and body hair, a prominent Adam’s apple, a deepening of the voice, an enlargement of the penis and testicles, erections, a diamond shape of pubic hair and increased height and muscle bulk.
Throughout life, sex hormones help to support the reproductive systems and general health and wellbeing. As we get older, hormones naturally diminish.
What is the aim of hormone therapy for trans people?
The aim of hormone therapy is to make you feel more at ease with yourself, both physically and psychologically.
You may be experiencing discomfort because you are not happy with your male or female appearance; or maybe you are not comfortable in your gender role as a man or as a woman. Perhaps both these factors – your appearance and your gender role – are in conflict with your inner sense of being a man or a women (your gender identity).
You may have lived with this conflict for many years and be desperate to get some help.
If this is how you are feeling, hormone treatment (testosterone if you are a trans man, and estrogen if you are a trans woman) may help to overcome your distress. This kind of treatment is sometimes referred to as ‘cross-sex’ hormone therapy.
In addition, to testosterone or estrogen, hormone ‘blockers’ may be taken in the early stages of treatment to interrupt the hormone production of your own body, so that the prescribed hormones can be more effective.
Hormone therapy is usually the first treatment that trans people want to have and, for some, it may be the only treatment they need. Some people find that they get sufficient relief from taking hormones so that they do not need to change their gender role or have surgery.