Medical Management Of Mtf
Highlights
- Prior to beginning hormone therapy it is recommended that patients have an official diagnosis of gender dysphoria made by a mental health professional.
- The mainstay of cross-sex hormone therapy in MtF patients is estrogen and an anti-androgen.
- Absolute contraindications for hormone therapy must be ruled-out prior to initiation of treatment.
- Ever effort should be made to control medical conditions that may be exacerbated by estrogen prior to the initiation of estrogen.
- The physical changes caused by estrogen vary from patient to patient and range from irreversible to reversible. The total physical transition takes approximately two years.
- Routine follow-up is required with regular bloodwork and estrogen and anti-androgen dose adjustments as needed.
- Monitoring and Follow-up
Assessment
The assessment period is important for establishing a rapport with the patient, and establishing goals of treatment. The assessment period usually takes place over several office visits although the number of visits or time in between visits is less important than ensuring the following areas are covered.
Fast Tracking:
It may be appropriate to shorten the assessment period in the following circumstances:
Before beginning a discussion surrounding the details of hormone therapy it is important to have addressed the following areas:
Hormone Contraindications
Absolute contraindications to estrogen:
Hormone Risk Management
Risks:
Management:
Fertility
Changes In Your Emotions
Remember going through puberty?
Youre likely to face a similar emotional roller coaster during HRT. But these emotional changes vary among different people. The most common changes you can expect include:
- Development of new tastes and interests
- The occurrence of a wider range of emotions and feelings
- A change in your behavior when dealing with other people or in your relationships
Most people get over this phase after a short period. Use this time to understand yourself better and get familiar with your new feelings and emotions.
Expert tip: You can use psychotherapy to cope better with your emotional changes.
Main Body Changes Induced By Mtf Hrt
Attention:
We do not provide HRT at the 2pass Clinic. Please contact your doctor or specialist for more information.
The impact of Hormone Replacement Therapy on the Male-to-Female body varies greatly from person to person, and it is therefore wise to stay realistic. But there are six significant effects that are generally quite common!
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Transgender Health Program: Hormone Therapy
If you are transitioning, hormone therapy may be your first medical step, regardless of whether you plan to have other gender-affirming treatments. At OHSU, providers will tailor your therapy to your goals.
OHSUs Transgender Gynecology clinic and many OHSU primary care clinics offer:
- Providers trained in transgender hormone therapy.
- Gender-affirming services in convenient locations.
- Expertise in coordinating your hormone therapy with your overall health.
This page is about hormone therapy for adults, who can be treated by a primary care provider.
- If you are an adult who needs specialty care because of conditions such as hard-to-control diabetes, your primary care provider also may refer you to an OHSU endocrinologist.
How Your Mtf Transition Changes Your Body Step
Congratulations on your decision to take one of the biggest steps in your MTF transitionchanging your body.
You probably have a million questions:
What will be the first change?
How much will I change?
Will all my masculine features disappear?
We have the answers. Well guide you through the changes that youll experience, precautions you can take when going through these changes, and the steps to accept and love your new body more.
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Which Parts Of Gaht Are Permanent
Many transgender people seek GAHT for the near-permanent changes it causes. However, there’s only one change that will stick even if the person stops taking hormones.
“Many of the effects of hormone therapy are reversible if the person stops taking them,” Dr. Jacobson says. “The degree to which they can be reversed depends on the length of time taking them. Some breast growth and possibly reduced or absent fertility are not reversible.”
If breast development isn’t desired, Dr. Forcier says, the person might take a low dose of estradiol or other medications to meet their gender goals.
Pills Gels Patches Or Shots
You have options with how to take your hormones. Typically, gender hormones include:
- Testosterone comes as a gel, patch, or injection.
- Estrogen, and sometimes progesterone, come as a pill, patch, or injection.
- Spironolactone, which blocks testosterone, is taken as a pill.
Your insurer may cover certain types of hormones and not others.
Hormones at home? Yes, we can teach you how to give yourself a hormone injection at home.
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Notes Comments And Feedback
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What Changes Can I Expect From Feminizing Hormone Therapy
People assigned male at birth produce low levels of estrogen. Feminizing hormone therapy brings about physical and emotional changes that are more consistent with feminine anatomy and behavior.
With this treatment, you will receive hormones and other substances. They include anti-androgens medication, estrogen and possibly progesterone.
Anti-androgen therapy blocks male sex hormone production.
Changes from anti-androgen therapy include:
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At What Point In My Gender Transition Can I Start Feminizing Hormone Therapy
The timing is up to you and your healthcare provider. Some people affirm their new gender identity first by changing their names and dressing differently. But this isnt a requirement.
Adolescents may wish to consider starting feminizing hormone therapy at age 16. Starting at a young age makes it possible to:
- Block the effects of puberty for their assigned gender.
- Proceed with puberty in a manner consistent with their authentic gender identity.
What Can You Expect At Your Doctor’s Appointment
“The first visit is mainly educating the patient, asking questions, and telling them what is expected,” Usman says. “And then, once they have all the questions answered, they feel like they’re ready, they’re mentally and physically ready, that’s when we start initiating therapy.” That initiation point can be that day or weeks later. It’s really about the patient’s comfortability level.
Mulvaney first went to get information and ask questions about the process and then was prescribed spironolactone and estradiol. Spironolactone is a testosterone blocker and estradiol is a form of estrogen. “I went for the information, I got it, I got my mind put at ease. And then I started a few weeks later,” Mulvaney says. She adds that she started out with a low dosage “because I was still new to it. I was nervous. I just didn’t want to throw myself into it too fully quite yet.”
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What To Expect From A Regimen Consisting Of An Anti
The degree and rate of physical effects is dependent on the dose and route of administration, as well as client-specific factors such as age, genetics, body habitus and lifestyle.
Physical changes related to androgen blockade and estrogen may take months to appear and are generally considered to be complete after 2-3 years on hormone therapy. Feminizing therapy does not affect the pitch of the voice in trans women. Some clients may obtain benefit from voice therapy with a qualified and supportive speech and language therapist who can work with the client to modify their vocal characteristics.
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Predicted Hrt Timeline For The Physical Effects Of Hormones For Trans Mentestosterone Timeline: The Changes For Ftm Trans Men
Masculinising hormones induce physical changes that are more in line with a patients gender identity. Transmasculine patients can expect the following physical changes in their HRT timeline:
- growth in facial and body hair
- cessation of menses
| 1-2 years |
The degree and rate of the HRT timeline on physical effects depends in part on the dose, route of administration, and medications used. These are selected in accordance with a patients specific medical goals. and medical risk profile.)
There is no current evidence that response to hormone therapy with the possible exception of voice deepening in transmasculine individuals can be reliably predicted based on age, body habitus, ethnicity, or family appearance. All other factors being equal, there is no evidence to suggest that any medically approved type or method of administering hormones is more effective than any other in producing the desired physical changes.
The degree and rate of physical effects depend in part on the dose, route of administration, and medications used, which are selected in accordance with a patients specific medical goals and medical risk profile.
How Does Feminizing Hormone Therapy Work
You start by taking anti-androgens to block testosterone production. Then, after a few weeks, you take estrogen. This hormone comes in many forms, including:
People who choose feminizing hormone therapy start with a low dose of estrogen. The appropriate amount is different for each person. Your healthcare provider determines the type and dose thats right for you.
Starting with a low dose helps reduce the risk of complications and side effects. Then, as your body gets used to it, your provider will increase the dosage. After achieving the desired results, you take a lower dose for the rest of your life.
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How Does Masculinizing Hormone Therapy Work
You can take testosterone as injectables, pills, pellets, patches and gels. Your healthcare provider can recommend the type, dose and frequency thats right for you.
To lower the risk of complications and side effects, you may start with a low dose. As your body gets used to the therapy, your healthcare provider may increase your dosage. After achieving the desired results, youll take a lower dose for the rest of your life.
How Long Hrt Takes To Work: The Stages
In many ways, How long does HRT take to work?can be a difficult question to answer. There is likely no single moment oftransformation when you suddenly feel like your hormones are in balance. Thinkof it more like the lapping tide or the slow arrival of dawn it isgradualuntil it is everywhere.
But while the timeline can be somewhat nebulous,the process of recovering from the symptoms of hormonal imbalance andfluctuation is not. For the majority of patients, it can be broken down intothree distinct phases:
- Preparation, Testing, and Diagnosis
Lets start at the beginning.
Preparation, Testing, and Diagnosis
If you are feeling the symptoms of hormonal change or imbalance, whether from something predictable as menopause or for unknown reasons, you need to get checked out. The BodyLogicMD Hormone Balance Quiz can help you assess if your symptoms may be hormone related, but you should always seek the advice of an expert to ensure proper diagnosis and treatment.
By connecting with a practitioner who specializes in hormone health, you can discover the root cause of your symptoms and create a comprehensive plan for moving forward. When you become a patient of a BodyLogicMD-affiliated practitioner, this process begins with the following:
- An at-home hormone testing kit will be mailed to you. Complete the tests and mail them back.
- Visit a local lab for any recommended blood serum tests.
- Complete an online medical history.
- Attend your first consultation.
Ongoing Self-Care
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The Basics Of Hormone Therapy
Gender affirmation is a process that transgender and non-binary individuals can take to affirm their gender identity and live authentically in that identity. There are several dimensions of gender affirmation, including social, psychological, legal, and medical gender affirmation.
Hormone therapy is a subset of gender-affirming health care, along with things like puberty blockers, speech therapy, mental health counseling, and gender confirmation surgery.
As mentioned, not all transgender people need or want hormone therapy. However, for those who dont feel at ease or at home in their bodies, hormones can help lessen or even eliminate that dysphoria. For trans girls undergoing HRT, MTF hormones like estrogen, progestin, and androgen blockers can reduce their masculine characteristics and bring about more feminine features. Not only can this alleviate the symptoms of dysphoria, it can also reduce psychological distress, boost ones self-image and self-worth, and improve ones sex life.
Hormones For Male To Female Transition: How Do They Work?
Everyone has hormones. These chemical messengers send signals to different parts of the body, stimulating growth, digestion, fat burning, sex drive, and reproduction.
There are three kinds of sex hormones androgens, estrogen, and progesterone which all help develop and stimulate our reproductive organs, along with our secondary sex characteristics, like our body/facial hair, bone growth, etc.
Androgen Blockers
Estrogen
Preparation Before Taking Hormones
Before starting estrogen hormone therapy, it is important to gain as much information as possible. So always discuss the risks and side effects that hormone therapy may cause with a healthcare professional.
It is also essential that a person manages their expectations of when they will begin to see changes. Some people can take hormones for over a year before seeing any noticeable changes.
A persons healthcare provider may ask people to
The cost of estrogen hormone therapy can vary according to a range of factors. These include the type of hormones a person takes and how they use them.
A person wanting to transition must check that their health insurance covers the costs.
People must also check that the healthcare professional or medical center that their doctor has referred them to are in their insurance network.
There are several other gender-affirming procedures that people can opt for.
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What Is An Mtf Hormone Replacement Therapy Transition
A hormone replacement therapy transition is the use of hormone therapy to create a more feminine appearance.
The therapy involves the use of estrogen and anti-androgens to invoke physical, emotional, sexual, and reproductive changes.
These changes reduce gender dysphoria as the body realigns with the brain.
However, this transition requires patience and the extent of the change is not predictable.
Your breasts, for instance, may not get as big as your female relatives. Even after long-term use of the hormones, youre likely to remain a cup smaller than your closest female relatives.
The good news is that you can get a bigger cup size by combining HRT with safe and natural breast enhancement supplements.
Just as the natural breast enhancement supplement helps genetic females get firmer and bigger breasts, you can use it to accelerate your own bust development to make them fuller and perkier.
If you doubt itll work for you, Davids experience will change your mind.
As a transgender woman, she is excited about the noticeable increase in her breast size something that transgenders who rely on HRT alone rarely achieve.
What To Expect On Your First Visit And Beyond
Before you visit, please call to make an appointment and request gender affirming hormone therapy. We also have useful information about pharmacies, prescription refills, insurance, how to transfer your care, and much more.
We now offer gender affirming care at all 35 PPMM health centers! To book an appointment, you can call or book online. For online booking, please find the nearest health center, click BOOK ONLINE, and enter “Gender Affirming Hormone Therapy” as the reason for your visit.
- Feminizing Hormone Therapy including estrogen and spironolactone
- Masculinizing Hormone Therapy including testosterone
We may be able to start or continue hormone therapy and provide referrals for gender-qualified therapy and resources if needed. If you are on hormone therapy, you can utilize the health center for ongoing care and monitoring.
In order to receive gender affirming hormone therapy services you need to be over 18 and capable of providing consent for services. There are special consents for these services.
At PPMM, we strive to serve every patient to the best of our abilities. We are not currently able to prescribe puberty blockers or gender affirming hormones therapy to youth under 16. Transgender and gender diverse youth are welcome to access the rest of our services, including birth control, STI testing and treatment and more.
- UCLA Gender Health Program
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