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What Hormone Therapy Means For Transgender People
Video by ACS
How do hormones affect the appearance of gender?
Many transgender people find themselves facing questions from others about what it means to transition. After the public transition of Caitlyn Jenner, a new video from the American Chemical Society explains the role that estrogen and testosterone can play in this process.
The video explains the basics of how hormone therapy works for those transitioning from male to female and from female to male . Taking certain amounts of estrogen, testosterone and antiandrogens can cause a person to begin to develop the secondary sex characteristics of the gender with which they identify. For MTF people, this can mean breast development and a shrink in muscle mass and body hair for FTM people, this could result in deepening voice, more facial hair, and broadening shoulders, among other changes.
These changes take several years to fully take effect, and the effects of hormones vary from person to person. Not everyone who is transgender transitions, and for some people, transitioning does not involve hormones at all. But for others, hormone treatment makes a big difference by helping their body to align with their gender identity.
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.
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Hormones For Transgender Youth
I have a page on hormones, but this page is about getting hormones and blockers as a minor. This can be a big help, so choose what is right for you.
Even if you do not think you can start hormones yet, you should think about taking a hormone blocker to make your puberty stop. This is one of the most important things you can do at your age. Try to find a way if you can.
What Are The Side Effects Of Puberty Blockers
While puberty blockers are generally considered safe, they have some side effects. Not everyone experiences the following, but some people do.
Possible long-term side effects of puberty blockers
- Lower bone density. To protect against this, we work to make sure every patient gets enough exercise, calcium and vitamin D, which can help keep bones healthy and strong. We also closely monitor patients bone density.
- Delayed growth plate closure, leading to slightly taller adult height.
- Less development of genital tissue, which may limit options for later in life.
- Other possible long-term side effects that are not yet known.
Possible short-term side effects of puberty blockers
- Headache, fatigue, insomnia and muscle aches.
- Changes in weight, mood or breast tissue.
- Spotting or irregular periods .
For children who want to delay or prevent unwanted physical changes, the mental health benefits of puberty blockers may outweigh these risks.
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Treatment For Children And Young People
If your child is under 18 and may have gender dysphoria, they’ll usually be referred to the Gender Identity Development Service at the Tavistock and Portman NHS Foundation Trust.
GIDS has 2 main clinics in London and Leeds.
Your child or teenager will be seen by a multidisciplinary team at GIDS including a:
- clinical psychologist
- family therapist
- social worker
The team will carry out a detailed assessment, usually over 3 to 6 appointments over a period of several months.
Depending on the results of the assessment, options for children and teenagers include:
- family therapy
- group work for young people and their parents
- regular reviews to monitor gender identity development
- referral to a local Children and Young People’s Mental Health Service for more serious emotional issues
- a referral to a specialist hormone clinic for hormone blockers for children who meet strict criteria
Most treatments offered at this stage are psychological rather than medical. This is because in many cases gender variant behaviour or feelings disappear as children reach puberty.
Are Puberty Blockers Permanent
No, puberty blockers are temporary:
- Injectable blockers can last one, three or six months. Patients can continue getting injections until they decide what to do next.
- Implants , which are placed just under the skin in the arm, can last 12 to 24 months before they need to be replaced.
Both types are meant to give patients more time to consider their options:
- If your child decides to continue , they will likely want to consider and possibly .
- If your child decides that they want to develop characteristics of the sex they were assigned at birth, they can simply stop taking puberty blockers. Once the puberty blockers are out of their system, theyll go through the puberty of the sex assigned at birth. Puberty blockers alone should not affect your childs fertility, but hormone therapy can.
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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:
How To Make Voice Deeper For Ftm
Wondering how to make your voice deeper? Go here and learn more on voice exercises, hormones, voice modification surgery, and voice therapy for FTM.
Voice is a significant part of ones personality and gender affirmation process. Many trans guys feel insecure about their voices being too feminine. Even though thats normal, you should be able to feel completely comfortable with yourself. So, if youre wondering how to make your voice deeper, youve come to the right place. In this article, well discuss how to lower your voice FTM, FTM testosterone voice change, voice modification surgery, and other relevant topics related to FTM voice change.
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Transgender Hormone Therapy In Las Vegas Nv
Transitioning to your preferred gender is certainly a thrilling, life-changing decision. For more on the effects of transgender hormone therapy, contact HEALOR Primary Care in Las Vegas, NV and schedule your visit today. Double board-certified physician Dr. Raj Singh and our team have advanced expertise in guiding trans men and trans women through the transition process and are excited to help you achieve your treatment goals.
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What Are The Risks Of Hormone Treatment
Ideally, medical treatment should be based on scientific evidence, but there is little research about the use of cross-sex hormones. Guidance is therefore provided, which may be used flexibly, taking account of your particular needs and keeping the risk to your health as low as possible.
Hormone treatment for trans people at reasonable dosages is remarkably safe. The hormone products that you will be prescribed are very like the natural hormones produced by the body. Most people taking hormones do not experience any major problems.
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 serious risks when taking oestrogens are:
Thrombosis Pulmonary embolism Altered liver function.
The most serious risk when taking testosterone is:
Polycythaemia .The risk of developing complications from hormone treatment is relatively small and is less common if your general health is good.Thrombosis in trans women is more likely to occur within the first year of treatment, particularly if you are taking a hormone called ethinylestradiol.There are far fewer risks of thrombosis with oestradiol, which is the product most widely prescribed for trans women now.
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Surgery For Trans Women
Gender surgery for trans women includes:
- removal of the testes
- removal of the penis
- construction of a vagina
- construction of a vulva
- construction of a clitoris
Breast implants for trans women are not routinely available on the NHS.
Facial feminisation surgery and hair transplants are not routinely available on the NHS.
As with all surgical procedures there can be complications. Your surgeon should discuss the risks and limitations of surgery with you before you consent to the procedure.
What Are The Emotional And Intellectual Effects Of Estrogen
People are very different so their emotional and intellectual changes vary widely. People taking estrogen have reported:
- Feeling more emotional and more in touch with their feelings
- Crying more easily
- Depression or sadness
- Thinking differently, having different ways of looking at things
- Feeling more like myself when taking a hormone that aligns with gender identity feeling more comfortable in ones body
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Who Is Feminizing Hormone Therapy For
Feminizing hormone therapy is an option for transwomen people who were assigned male at birth but identify as women. This therapy is a common treatment for gender dysphoria .
Nonbinary or intersex people may also choose to undergo feminizing hormone therapy. Nonbinary people have gender identities that dont fit inside traditional male or female categories. Intersex people are born with reproductive or sexual characteristics that dont fit traditional perceptions of male and female bodies. They may have conditions affecting their gonads, external genitals or chromosome patterns.
Stated simply, feminizing hormone therapy is for anyone who feels that theres a mismatch between their external appearance and their authentic sense of gender and self.
Puberty Blockers And Cross
Puberty blockers pause the physical changes of puberty, such as breast development or facial hair.
Little is known about the long-term side effects of hormone or puberty blockers in children with gender dysphoria.
Although GIDS advises this is a physically reversible treatment if stopped, it is not known what the psychological effects may be.
It’s also not known whether hormone blockers affect the development of the teenage brain or children’s bones. Side effects may also include hot flushes, fatigue and mood alterations.
From the age of 16, teenagers who’ve been on hormone blockers for at least 12 months may be given cross-sex hormones, also known as gender-affirming hormones.
These hormones cause some irreversible changes, such as:
- breast development
- breaking or deepening of the voice
Long-term cross-sex hormone treatment may cause temporary or even permanent infertility.
However, as cross-sex hormones affect people differently, they should not be considered a reliable form of contraception.
There is some uncertainty about the risks of long-term cross-sex hormone treatment.
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Effects Of Testosterone And Estrogen
Many trans men seek maximum virilization, while others desire suppression of their natal secondary sex characteristics only. As a result, hormone therapy can be tailored to a patients transition goals, but must also take into account their medical comorbidities and the risks associated with hormone use.
The following changes are expected after estrogen is initiated: breast growth, increased body fat, slowed growth of body and facial hair, decreased testicular size and erectile function. The extent of these changes and the time interval for maximum change varies across patients and may take up to 18 to 24 months to occur. Use of anti-androgenic therapy as an adjunct helps to achieve maximum change.
Hormone therapy improves transgender patients quality of life . Longitudinal studies also show positive effects on sexual function and mood . There is biologic evidence that may explain this. Kranz et al. have looked at the acute and chronic effects of estrogen and testosterone on serotonin reuptake transporter binding in trans men and women. SERT expression has been shown to be reduced in individuals with major depression . Kranz et al. found that androgen treatment in transmen increased SERT binding in several places in the brain and anti-androgen and estrogen therapy led to decreases in regional SERT binding in trans women. These types of data are preliminary, but do point to the important role of hormone therapy in patients who suffer from gender dysphoria.
Ftm Testosterone Therapy Basics
DISCLAIMER The information contained herein is to be used for educational purposes only. The author is not a medical professional, and this information should not be considered medical advice. This information should NOT be used to replace consultation with or treatment by a trained medical professional. The listing of a medication herein does not imply endorsement by the author.
Also check out the page Myths and Misconceptions about Testosterone, Transition, and Trans Men for additional information.
Overview For trans men who have been born into typically female bodies , as well as trans men who were born into intersex bodies, the goal of testosterone therapy is to induce and maintain the presence of masculine secondary sex characteristics.
In FTM testosterone therapy, testosterone can be administered into the body in a number of ways. The most common method is injection with a syringe. Other delivery methods include transdermal application through gel, cream, or patch applied to the skin orally by swallowing tablets sublingually/buccally by dissolving a tablet under the tongue or against the gums or by a pellet inserted under the skin. The T-delivery method used will depend on the type of medication available in the country of treatment, the health risks/benefits for the patient, personal preference, and cost.
For more on T dosing, click here to go to the section Testosterone Types and Delivery.
Skin oils and acne may lessen.
Body scent may change.
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Indications For Bmd Screening
- All patients over 65 years old.
- Patients 50-64 years old at higher risk for osteoporosis .
- Consider before 50 years in:
- Certain high-risk conditions such as hyperparathyroidism or malabsorption syndrome.
- Patients who have undergone orchiectomy and have been on low-dose or no hormones for any significant length of time .
- Patients who have been on anti-androgens or a GnRH analogue for a significant length of time without co-administration of exogenous estrogen.
Keep in mind:
- There are no studies to guide the interpretation of BMD results and fracture risk in trans people, and whether to use sex assigned at birth or affirmed gender. One option is be to interpret results in comparison to both cis men and cis women.
- Frequency of BMD screening will depend on the results of the initial scan.
Breast/Chest health
- 1 Feldman J, Safer J. Hormone Therapy in Adults: Suggested Revisions to the Sixth Version of the Standards of Care. International Journal of Transgenderism 2009 11:146.
Keep in mind:
In Ontario, transfeminine patients who have changed their OHIP sex marker to ââ¬Åfemaleââ¬ï¿½ can be screened as part of the organized Ontario Breast Screening Program.
How To Get Access To Estrogen Hormone Therapy
If a person decides to transition, it is essential to receive estrogen hormone therapy from healthcare professionals.
Buying and taking hormones from other sources carries many risks, such as poor quality of drugs, improper doses, and possible harm.
In order to start the process, a person must discuss their options with a healthcare professional.
Transcaresite has a directory of trans-friendly medical professionals. If an individuals healthcare insurance covers the cost of transitioning, it is important to check that the healthcare professional a person chooses is in their insurance network.
The World Professional Association for Transgender Health recommends healthcare professionals and individuals undergo several steps before starting estrogen hormone therapy.
These include:
The GLMA is the national LGBTQI+ medical association that also has provider listings for trans-affirming care.
- psychiatric, including any mental health conditions
- social, such as social support and legal history
- family, such as a history of psychiatric illnesses, suicides, and substance use
- developmental, such as education level and any history of trauma
- any instances of substance use
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Are Transgender Men And Women Who Take Hormones At Risk For Heart Disease
The impact of hormone therapy on the heart health of transgender men and women has been the subject of several studies published within the last year. But medical experts and researchers arent ready to sound the alarm just yet.
We have to recognize that hormones can be lifesaving therapy for trans people, said Dr. Richard Greene, an associate professor at New York University School of Medicine. The answer is figuring out how to give them safely and how to modify some of these cardiovascular risk factors in the best way possible.
One study found that transgender women who take hormones were more than twice as likely to have a stroke and deep vein clots compared to cisgender men and women or people who identify as the sex they were assigned at birth. In addition, both trans women and trans men had a higher risk of heart attack than cisgender women.
Still, the findings arent enough reason for doctors to stop prescribing hormones primarily estrogen to transgender women and testosterone to transgender men. Greene said he found some of the science behind the more recent research problematic.
Many of the studies dont ask how long a person has identified as transgender or consider the kinds of hormones being used. Some older types of estrogen are associated with higher risk for stroke, he said. In addition, most studies did not ask whether the individuals taking hormones considered themselves non-binary, or not identifying as either man or woman.