Transgender hormone therapy, also called cross-sex hormone therapy, is a form of hormone replacement therapy(HRT) in sex hormones and other hormonal medications. They are administered to transgender or gender non-conforming individuals to align their secondary sexual characteristics with their gender identity more closely. This form of HRT gives as one of two types, based on whether the goal of treatment is feminization or masculinization
- Feminizing hormone therapy– for transgender women or transfeminine people; consists of estrogens and anti-androgens
- Masculinizing hormone therapy– for transgender men or transmasculine people; consists of androgens
Hormone therapy aims to make you feel more at ease with yourself, both physically and psychologically. Perhaps both these factors – your appearance and your gender role – conflict with your inner sense of being a man or a woman (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 may help to overcome your distress. The patient needs to consult a psychiatrist before starting hormonal therapy.
Preparation for transgender hormone therapy
- The patient needs to consult a psychiatrist to confirm before starting hormonal therapy
- Consult hormonal therapist to achieve your expectation
- History taking, physical examination for liver and kidney function investigation
Transgender hormone therapy procedure
- After consultation and specific laboratory investigation completed, the doctor will start hormone therapy; Testosterone, Estrogen, or Anti-Androgen by precise dosage and preparation individually.
- The patient needs to take hormones therapy if he or she wants to maintain the feminine effects or masculine effects.
- If, at any stage, the patient decides to have your testes (transwomen) or your ovaries (transmen) removed by surgery. The dosage of hormones will usually reduce. However, it should still be enough to produce the effects that you need, keep you well, and protect you against osteoporosis (thinning of the bones) as you get older, and the patients have to stop hormone blockers.
Risk and complications
Hormone treatment for trans people at reasonable dosages is remarkably safe. The hormone products that you will prescribe are very like the natural hormones produced by the body. Most people taking hormones do not experience any significant problems.
In transwomen, estrogen has subtle feminizing effects:
- Fat may distribute on the hips.
- The size of the penis and testicles may be slightly reduced.
- Some transwomen find that erections and orgasms are harder to achieve. Muscle bulk and power may reduce.
- Breasts may feel tender and lumpy and may sometimes increase modestly in size.
- The growth of facial and body hair may become weaker. The facial and body hair is regarded by many trans women as helpful in supporting the hair removal process using electrolysis or laser treatment and other hair removal techniques.
- Male pattern baldness may be slowed or stopped, but is not necessarily reversed.
However, all medication has potential side effects, and some people may have serious adverse reactions to it. You need to be aware of the possible risks, however remote, before deciding to start treatment.
The most severe risks when taking estrogens are:
- deep vein thrombosis (DVT)
- pulmonary embolism (block in a blood vessel in the lungs)
- Altered liver function
In transmen, 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 most severe risk when taking testosterone is polycythemia (overproduction of red blood cells)
Post therapy care
After start hormone replacement therapy. The doctor will have to schedule a follow-up plan to reevaluate the symptoms and hormonal levels. Most cases required three months interval follow-up. Monitoring your health will help your doctor to ensure that your body is absorbing the medication, and the doctor can be adjusted, and additional medicines may prescribe.
A healthy lifestyle is essential. You should eat sensibly and take regular exercise. Drug taking, excessive alcohol consumption, and obesity are all factors that can undermine your hormone treatment and heighten the risk of complications. Also, if you are a trans woman and are taking estrogen, smoking reduces its feminizing effects.