Let’s take a look at a topic that is on the mind of many Trans people…
Hormone Replacement Therapy or HRT is a very hot topic that often comes up when we speak to those in the trans community. For those of you looking to take that next step in your male to female transformation or if you’re just curious about HRT, we would like to offer a better understanding and hopefully answer some of your questions around this type of therapy.
What is Hormone Replacement Therapy (As it relates to Male to Female)?
Hormone Replacement Therapy is by definition a form of hormone therapy that is used to change the secondary characteristics of transgender and transexual people from masculine to feminine. The purpose of this form of HRT is to cause the development of the secondary sex characteristics of the desired sex, such as breasts and a feminine pattern of hair, fat, and muscle distribution. It cannot undo many of the changes produced by naturally occurring puberty, which may necessitate surgery and other treatments. The medications used in HRT of the MTF type include estrogens, anti-androgens, and progestogens. In basic terms, HRT is like going through puberty a second time, but as the desired gender.
What results can you expect from HRT for men?
For many, the desired outcome is that HRT will make you feel more at ease with your yourself, both physically and mentally.
Below we’ve listed some of the general physical side effects from hormone replacement therapy. However, it’s important to remember that everyone is different, and some will experience the effects of HRT more than others / different physical effects to others. Experiencing changes can also take time, months for minimal effects and even years for maximum effects, so please bear this in mind if you’re considering HRT.
A change in body fat distribution
The face and hip area will redistribute fat into areas that are more common in women. The face will have a less masculine look over time as this happens.
Development of natural breast tissue
There are many factors that can affect the development of breasts, but breasts may begin to form depending on these factors. In many cases, a trans woman may also undergo augmentation surgery to get their desired size result.
Decreased testicular volume
You may notice this relatively quickly when undergoing treatment.
Decreased muscle mass and strength
As genetic females have less muscle mass than men, you may notice that your pre-therapy strength decreases as you progress through your treatment plan.
Slowed growth of facial hair and other body hair
You may find you need to shave less regularly, or that the hair starts to grow back finer and softer than before. You may even notice that hair on areas such as the chest doesn’t really grow back over time.
Skin changes
Your skin will become softer and less coarse.
All of these changes and the length of time until you see results do vary from person to person as each person’s physical makeup going into HRT varies. Understand that this is a journey that can take a few years to give you the results you are looking for.
What are the possible side effects of HRT?
Just like many medical treatments, Hormone Replacement Therapy has its share of negative side effects. It will be up to you with the help of a good health professional to decide if the good outweighs the risks, and if you want to move ahead with the therapy. Diseases like breast cancer are serious things to think about, but this can be discussed with your doctor. Other possible side effects of HRT include:
- Liver, kidney and heart disease or stroke.
- Risk factors associated with heart disease such as obesity, diabetes or high cholesterol.
- Gallbladder disease.
- Any kind of circulation or clotting conditions.
- Blood clots.
- Decreased libido.
- Decreased sperm production.
As treatments continue over the long term, these risks continue to increase. If you have any of these risks and still want to move forward, a good health professional will probably advocate starting at a lower dosage and increasing progressively whilst monitoring for side effects.
Other issues that may come up are emotional ones. As your body changes, the estrogen levels may also have an effect on your mental wellness. Outbursts and emotional breakdowns may become more regular. If you ever feel like you are struggling with your mental health please seek professional advice.
The effect of HRT on having a family
Lastly, if there is a desire for having children one day, once the process starts, you can become impotent and have an extremely low to an almost non existent sperm count. Plan accordingly before starting treatments if there is any possibility you may want to have children of your own one day.
What about over the counter estrogen supplements?
HRT was first introduced to help genetic females deal with the menopause. It is prescribed in that sense to prevent or hold off going through menopause. When it is being used for M to F transitioning, it is prescribed by a doctor in a high dosage that would be impossible to get over the counter.
There are, however, supplements known as ‘bioidentical or ‘natural’ hormones’ that are derived from plants and are available over the counter. They claim to do what HRT does. Beware of such claims though as none of these over the counter solutions are FDA approved, aren’t recommended, and don’t have high enough concentration or have scientific studies to back-up their claims. These supplements are low dose and so the probability of them working is very small in helping you physically transition.
If you are serious about transitioning, we highly recommend you take all precautions and start out with your family practitioner or a specialist HRT health professional.
Which brings us to…
Where do I begin with Hormone Replacement Therapy?
Like we said earlier, HRT is a journey. A very long and challenging one. The requirements vary as this is still a fairly new process. Most HRT specialists will require the person transitioning to live for a time as the gender they want to transition to to make sure they they are as mentally and physically prepared as they can be. Part of the current recommendations will include seeing a therapist specialized in gender therapy to assess you before, during and after the process. Given the possible side effects full medical screening will be given to assess suitability and risk at the outset.
We hope that we were able to answer some of your questions regarding Hormone Replacement Therapy. We highly recommend further reading and investigating as well as talking to a professional who handles HRT before beginning any form of treatment.
For more on crossdressing and transformation, please take a look at our Crossdressing Tips and Advice Blog.