Reviewed By: Pramod Kerkar, MD, FFARCSI

To be transgender means that one identifies with a gender other than his or her biological or assigned gender. Transitioning refers to any physical, emotional or mental change that an individual makes so as to better reflect his or her gender identity. Hormone therapy is used when an individual is looking for transitioning for reflecting his or her gender identity in a better way. Masculine transitioning hormone therapy is for someone who was assigned female at birth but who identifies as a male or a man, some or all of the time. Similarly feminine transitioning hormone therapy is for someone who was assigned male at birth, but identifies as female or woman, some time or all the time. In this post we will know about the effects of hormone therapy on transgender people.

Masculine Transitioning & Feminine Transitioning Hormone Therapy: A Brief Note!

Female to Male Transitioning Hormone Therapy or Masculine Transition Hormone Therapy:

Hormones are chemical messengers that are produced by glands. Hormones are released into the bloodstream, where they direct the activities and development of other cells. The appearance and growth of body fat, breasts, hair, skin and reproductive organs are affected by the hormones.

In case of masculine transitioning hormone therapy, the testosterone levels are increased while the estrogen hormone levels are lowered in to a typical “Male” range. The testosterone hormones are administered by injection, skin patch or gel and also by pill. These hormones are medications that can be prescribed by general practitioners, gynecologists and endocrinologists. It must be mentioned that like other drugs, they can also cause side effects and must be taken with care.

Male to Female Transition Hormone Therapy or Feminine Transitioning Hormone Therapy:

Hormone therapy for feminine transitioning individuals increases the levels of estrogen, while lower the levels of testosterone in to a typical “female” range, thus resulting in internal and also visible changes to the body. Estrogen is the main feminizing hormone that is responsible for the development of secondary sex characteristics in the body. Progesterone is a third hormone that is directly linked to the reproductive cycle in a female and is not produced in a male.

#1. Physical Effects Of Hormone Therapy On Transgender People

Physical Effects Of Masculine or Female To Male Transitioning Hormone Therapy on Transgender People

Effects On The Body: The effects of testosterone are completed over several years and a lot of factors can influence the degree of change one experiences, including the number of hormone receptors in your body, your age, the dose. Testosterone affects the entire body; and it is impossible to pick some changes and not others.

Effects On Voice: Your voice may get deepen during female to male transitioning hormone therapy. In most people, some change can be noticeable after 3 months and there is no further change after one year. This change is permanent. One more way to change your voice is via voice therapy.

Effects On Hair: The effect of testosterone hormone on transgender people can cause hair loss and perhaps baldness. For some individual, this is a desired effect. If this is not your case, then you may consider a range of options like medication for preventing hair loss such as Finasteride, wigs or implants.

Effects On Body Fat/Muscles: Your body fat will be redistributed from the more typically “female” pattern (especially, under the skin, including legs, arms and hips) to a more typically male” pattern (i.e. surrounding internal organs and in the abdomen). Apart from this, your muscular mass may increase. These changes will be gradual, possibly beginning around 3 months after the therapy. Fat may redistribute towards its original pattern and muscle mass may decrease gradually in transgender people if they stop taking the testosterone hormone

Effects On Body Hair/Facial Hair: The person undergoing hormone therapy for female to male transitioning may develop a beard and may also develop more body hair. This could include hair on your chest, eyebrows, stomach, neck, back, pubic area, arms, legs and also ears and nose. Existing hair may become coarser. You may notice the changes in about one month and one year, and will not be completed for many years. This must be kept in mind that this change is permanent. If you stop taking hormones, though the hair may become less coarse, but they won’t disappear.

Effects On Skin: The hormone testosterone changes the skin in the transgender people, making it thicker and also sometimes a little oilier. This may also cause acne. You need to consult your doctor if acne is persistent. Together you may consider lowering the dosage of testosterone you are prescribed.

Physical Effects Of Feminine or Male to Female Transitioning Hormone Therapy in Transgender People

Effects On Body: Hormones will have a different effect on different individual undergoing transitioning, depending on dosage, their age, body type and will take a couple of years to fully take effect. Hormones, affect the entire body. It is impossible to choose some changes and not others.

Effects On Voice: Here, hormones will not have an effect on your voice. In case you are looking for a change, keep in mind that you can train your vocal cords to produce a sound more to your liking, by practicing the same.

Effects On Body Fat: Taking estrogen hormone will cause a redistribution of body fat in a pattern that is generally found in cisgender women (i.e. around abdomen, hips, buttocks, thighs, upper arms etc.). These hormone effects on transgenders are gradual and might reduce if you stop taking the hormone therapy.

Effects On Body Hair: Anti-androgens hormone therapy sometimes cause body hair to get finer. Beards are minimally affected by hormone therapy. There are two proven methods for eliminating facial hair completely in transgenders who are transitioning into female. These two methods are electrolysis or laser hair removal

Effects On Hair: Hormone therapy can reinvigorate your hair when transitioning from male to female. However, it won’t stimulate new hair growth.

Effects On Breasts: Hormone therapy encourages breast development in feminine transitioning individuals. As is the case with all women, if you are dissatisfied with your breast size, after they cease to grow, you can make use of both surgical and non-surgical methods for obtaining a desired breast size. These hormone therapy effects are gradual in transgender people and it must be noted that the effects might lessen in case you stop taking hormones.

Effects On Skin: With the hormone therapy, facial skin pores get reduced in their size and the skin become more sensitive and soft in male to female transitioning. You can start seeing the changes between one and three months.

Effects On Muscles: With hormone therapy, a loss of muscle mass is to be expected in the long term. These hormone therapy effects are gradual in transgender people.

#2. Emotional Effects Of Hormone Therapy on Transgender People

The emotional effects of masculine and feminine transitioning hormone therapy are similar. Changes in hormone levels can affect your moods and feelings both, positively as well as negatively. However, during hormone therapy in transgender people, it gets difficult to tell which mood variations are because of chemical change and which are because of other factors. For example, happiness could result from bringing the body more in line with the mind.

#3. Sexual Effects Of Hormone Therapy On Transgender People

Sexual Effects of Masculine or Female to Male Transitioning Hormone Therapy in Transgender People

Menstruation, Libido and Fertility: Menstruation should cease after 1-6 months on testosterone hormone. In case it does not, you must consult your doctor. Transgender people may experience an increase in libido and sexual appetite. It is still possible to become pregnant while taking testosterone. However, testosterone is toxic for a fetus and you cannot take it while pregnant. You may use birth control, depending on how you have sex. It must be mentioned, that there is a possibility that you may permanently become sterile as the long term effects of hormone therapy on fertility are not understood completely.

Sexual Effects of Feminine or Male to Female Transitioning Hormone Therapy

Erections, ejaculations, libido and fertility: There is often a noticeable change in the frequency of erections and there is a reduction in their duration and firmness. Since the quantity of semen reduces, there is a possibility of short term or long term infertility. You will begin to notice changes between 1 to 3 months.

#4. Effects Of Hormone Therapy On The Reproductive System Of Transgender People

Effects Of Masculine Transitioning Hormone Therapy On The Reproductive System Of Transgender People

Genitals: Testosterone hormone affects the clitoris, which may become more sensitive and somewhat larger. The vagina may get dryer and more fragile. So, if you have vaginal sex, you need to consider adding extra lubricant. It must be noted that testosterone does not protect you from sexually transmitted infections like HIV or Hep-C. So, always consider using latex barriers like a condom.

Breasts: Testosterone will not make your breasts disappear. Although they may become less firm, as the body fat shifts to a more typically “male” pattern in female to male transitioning.

Effects of Feminine Transitioning Hormone Therapy on the Reproductive System in Transgender People

Breasts: Within a few weeks of the hormone therapy, you will begin to develop small “buds” beneath your nipples. They may be slightly painful; especially to the touch. It must also be noted that the right and the left side may be uneven. This is the normal course of breast development and whatever pain you experience will diminish over the course of several months. One more thing it must be mentioned that the breast development varies from person to person and not everyone develops at the same rate.

Sperm Count: Within few weeks of hormone therapy, you must assume that you will become permanently or irreversibly sterile. However, some individuals may maintain a sperm count on hormone therapy or have their sperm count return soon after they stop taking the hormones. In case you want to parent a child from your own sperm, you must speak to your doctor about preserving your sperms in the sperm bank. You must also keep a strict note in the fact that if you are on hormones and still remaining active with a woman who is able to become pregnant, then you should always use a birth control method so as to prevent unwanted pregnancy.

Conclusion

It must be now clear that hormone therapy has some significant effects on transgender people. However, it must be noted that though hormones are a part of a transition process for some individuals, they are not a miracle drug that will turn someone in to a man or woman. Moreover, there are also some risks involved with hormone therapy and long term effects of hormone therapy can put strain on your liver or may cause liver diseases. There are also some other unwanted health risks of hormone therapy. So, you must consult with your doctor in a proper way so as to know the effects and side effects of the hormone therapy before undergoing it.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: July 20, 2018

This article does not provide medical advice. See disclaimer

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