Feminizing hormone therapy helps achieve physical changes that align with a person’s gender identity by adjusting hormone levels in the body.
What is feminizing hormone therapy and how does it work?
This type of treatment relies on medications aimed at lowering testosterone levels in the body while simultaneously administering estrogen. Estrogen stimulates the development of secondary female sex characteristics, which helps reduce the psychological distress associated with gender dysphoria and improves overall quality of life and satisfaction.
This clinical path may be combined with feminizing surgeries or used as a standalone feminizing treatment.
Preparing for hormone therapy
Before starting, the medical team performs a comprehensive evaluation that includes:
- Medical Screenings: Reviewing medical history, conducting a physical exam, laboratory tests, and reviewing vaccination records.
- Behavioral Assessment: Discussing gender identity, the desired goals of the treatment, and the extent of available social support.
- Risk Management: Addressing any existing health conditions, such as substance use disorders or sexually transmitted infections.
Treatment path and expected changes
Feminizing hormone therapy typically begins with “spironolactone” to block androgen receptors. After a period of 4 to 8 weeks, estrogen is introduced, available in several forms (tablets, injections, creams, gels, sprays, or skin patches).
Physical changes appear gradually according to the following timeline:
- Within 1 to 3 months: Decrease in the frequency of erections, volume of ejaculate, and a slowing of hair loss from the scalp.
- Within 3 to 6 months: Beginning of breast growth; skin becomes softer and less oily, with a decrease in testicular size, loss of muscle mass, and an increase in body fat.
- Within 6 to 12 months: Noticeable reduction in the growth of facial and body hair.
- Long term: Breast growth is completed within 2 to 3 years, and the increase in body fat reaches its peak within 2 to 5 years.
Risks and side effects of feminizing hormones
Although effective under specialist supervision, the use of feminizing hormones may be associated with some complications:
- Blood and Heart Issues: Such as stroke, hypertension, deep vein thrombosis, or pulmonary embolism.
- Metabolic Disorders: Weight gain, type 2 diabetes, and elevated levels of triglycerides or potassium in the blood.
- Other Effects: Elevated prolactin levels and nipple discharge.
Regarding breast cancer, individuals undergoing this therapy may be more susceptible than cisgender men, but the risk does not exceed the incidence rate among cisgender women.
Fertility and reproductive capacity
Hormone therapy affects fertility and may lead to permanent infertility, especially when started before puberty. Since the testes may not fully recover after stopping the treatment, it is recommended to discuss “sperm cryopreservation” options before beginning the procedures.
Medical follow-up and results
This process requires regular visits to monitor hormone levels and adjust dosages, as well as periodic screenings including:
- Blood tests for liver function, glucose, and cholesterol.
- Preventive screenings for breast and prostate cancer according to age group.
- Bone density assessment, with the possibility of taking Vitamin D and calcium supplements.
FAQ
What is feminizing hormone therapy and what does it do?
It is a medical process that uses estrogen and testosterone blockers to develop female physical characteristics and reduce gender dysphoria.
Are all physical changes permanent?
Some changes are reversible upon stopping the treatment, but others are permanent and cannot be undone, such as breast growth.
Who is not advised to undergo this treatment?
Doctors may advise against treatment in cases of hormone-sensitive cancers (such as prostate cancer), a history of blood clots, or serious untreated health and behavioral conditions.
What is the best way to take estrogen if there is a history of clots?
It is preferable to avoid taking estrogen via tablets if there is a personal or family history of venous thrombosis.
When to visit a doctor immediately?
Urgent medical care should be sought if warning signs appear, such as:
- Symptoms of blood clots (swelling or pain in the leg).
- Sudden shortness of breath (which may indicate a pulmonary embolism).
- Symptoms of a stroke.
Disclaimer: This content is for informational purposes only and does not substitute for professional medical advice.
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Photo: brian.gratwicke, BY 2.0, via flickr.com
approved by: Medica Health team