Thursday, September 21, 2023

Hormones For Male To-female Transition

How Do I Prepare For Facial Feminization Surgery

*NEW* Male to Female Transition Timeline (4 years on female hormones)

Before facial feminization surgery, your healthcare provider will perform a thorough personal assessment. They will ask you about your goals for surgery and explain what you can expect during your recovery after the procedure. It’s important that you and your surgeon have goals that are aligned and realistic.

Your provider also makes sure youre in good physical health by:

  • Assessing your lifestyle, including smoking or drinking habits.
  • Doing a physical exam, including lab tests.
  • Identifying risks for potential complications.
  • Reviewing your current medications and any allergies you may have.

You might also have imaging scans before facial feminization surgery. X-rays or CT scans take pictures of the bones and soft tissues of your face and skull. Your surgeon may also measure your face, take photographs and assess your skin quality. All of this information helps your surgeon plan your treatment.

Hormonal Treatment In Adolescents

GAHT introduction is generally recommended around the age of 16, although it can be considered around the ages of 14-16, even though there are very few published studies of being administered between the ages of 13.5 and 14 . There are two treatment regimens. In the case that GnRHa was introduced early in pubertal development, the puberty of the desired gender is induced by slow increasing doses of testosterone or estradiol, that are modified every six months. In the case that GnRHa began late in puberty, the suppression lasts about 3-6 months and GAHT begins at higher doses, with a faster increase to achieve maintenance dose .

Since the long-term effects of both suppressive and GAHT treatment are uncertain, adolescents must be encouraged to adopt a healthy lifestyle, increase exercise, avoid tobacco, and keep regular check-ups with the endocrinologist for the monitorization of liver and renal function, lipids, and glucose.

What To Know About Transgender Medical Transitioning: Male To Female

Samantha Newman, National Center for Health Research

The focus of this article is medical transitioning from male to female, the process by which transgender individuals change the way they look so that their physical characteristics match the gender they feel. Transgender is defined as individuals whose social or psychological gender identity is different than their sex assigned at birth.

Transitioning isnt necessarily medical. It can involve changing ones name or ones pronouns. It can involve changing the way one dresses. Medical transitioning can involve medical treatments and can involve surgery. Experts agree that there is not one right way to transition. Transitioning can involve any combination of these changes or it can be any change that allows someone to more comfortably present to the world. What is most important is that someones transition process reflects their needs and what works best for them and their body. While there are many social ways to transition, such as coming out to friends, using different pronouns, or using a different name, this article will specifically examine the medical treatment options in the male to female transition process.

Each medical intervention has its own unique recommendations and risks.

For trans women, medical transitioning may include any of the following :

· hormone therapy

· laser hair removal

· tracheal shave

· facial feminization surgery

· breast augmentation

· orchiectomy

· penile inversion vaginoplasty

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While phytoestrogens aren’t a substitute for transgender hormone replacement therapy, these foods can help give you a feminine boost. As an added bonus, they’re also super healthy and can help maintain an ideal weight. Here are 5 phytoestrogen-rich foods worth including in your MTF diet.

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Informed consent must be obtained from the patient. 2 Standard treatment in adults is based on a gender-affirming hormone. This is testosterone for femaletomaletransition and estrogen, supplemented by an anti-androgen, for maletofemaletransition. Treatment of transwomen produces variable changes including: breast growth.

Always Going To Be A Man

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Around the time Garcia began transitioning to a female, he joined an LGBT support group in California. He told The Daily Signal that the group initially showered him with affection.

Now, Garcia says, he believes the group was using love-bombing tacticsa recruitment technique used by cult-like groups to lure new members through praise and affection.

Shortly after his surgery to create breasts, Garcia says, he had a falling out with a member of the group. The groups love-bombing suddenly vanished, he recalls, and some members began dragging his name through the mud.

Then he hit rock bottom, he told The Daily Signal.

I realized that I was always going to be a man. I was just a man who mutilated his body to make what I believe was a woman just a caricature of a woman.

Just three to four months after receiving breast implants, he says, I admitted defeat and tried my best to reverse everything.

He sought guidance from the same therapist who first signed off on top and bottom surgery for him. The therapist said that Garcia hadnt made a mistake. Rather, it was just childhood trauma returning while he was still recovering from surgery.

Garcia went to see a different therapist, who said he shouldnt be too cavalier with his detransition, since he didnt know the full extent of the damages reversing his transition would cause.

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What Are Commonly Used Medications For Transition

In transgender men, or trans masculine people , the most common medication used for transition is testosterone. Administration of testosterone lowers serum estradiol levels, raises serum testosterone levels, and results in the development of typical male secondary sex characteristics. Irreversible changes include: deepening of the voice, increase in facial and body hair growth, clitoral enlargement , and thickened facial bone structure. Reversible changes include amenorrhea, male-pattern fat distribution, increased muscle mass, vaginal atrophy, and male-pattern baldness. Some trans men also describe changes in emotions as well as increased libido. Adverse effects can include elevations in blood pressure, polycythemia, worsening of lipid profile, elevations in glucose, elevations in transaminases, acne, and effects on fertility .

Finasteride can also be used to prevent male-pattern baldness in transgender men, as it only blocks dihydrotestosterone , not testosterone itself however this will likely slow or decrease secondary hair growth, and may slow or decrease clitoromegaly as well.

GnRH Agonists could also be used instead of Anti-Androgens to block endogenous testosterone production. Lupron is typically given intramuscularly every couple months and is very effective at blocking total testosterone levels. However, it can be difficult to obtain insurance coverage for it, and is otherwise fairly expensive out of pocket.

Lower Doses And Temporary Use

For some trans people, being on a lower dose of feminising hormones, or using them occasionally or temporarily is a part of how they seek to hormonally affirm their gender.

It can be difficult to try and implement one feminising change and not another, as once a hormonal threshold is reached, a range of secondary sex characteristics will begin to change.

This is especially the case for breast growth, which may occur even at lower estrogen levels .

Consultation with a specialist Endocrinologist may be helpful.

The use of hormonal suppression without gender affirming hormonal therapy can lead to adverse health effects, and so is to be undertaken carefully, and with regular oversight.

It is possible to achieve testosterone and estrogen hormone levels that are between the male and female ranges. However, at this point, there is little evidence for this practice as most research only considers binary gender options.

A Guide To Transgender Health, Heath R, Wynne K 4

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Where To Get Hormones

This information is for adults. For younger people, see how to get hormones as a minor.

From your doctor

  • Most people get hormones from their healthcare provider. Tell them you want to start hormones. They will probably give you a physical exam that includes blood tests. In some cases, they may ask you to take other steps before prescribing them, like speak with a therapist. You will have to sign something that says you give informed consent.

From a clinic

  • Many larger cities have clinics that serve our community. See the resources section for options near you.
  • Planned Parenthood offers hormones for our community at many locations and is throughout the US:


  • Some people order hormones online from foreign pharmacies.
  • This can be an option for those who do not want others to know about their hormone use.
  • Buying and importing prescription drugs without a prescription is probably against the law where you live.
  • Because it is against the law, you might lose the money you paid:
  • No delivery sent

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What Are The Risks Or Complications Of Gender Affirmation Surgery

Male to Female Transition Timeline – MTF

Different procedures carry different risks. For example, individuals who have bottom surgery may have changes to their sexual sensation, or trouble with bladder emptying. In general, significant complications are rare, as long as an experienced surgeon is performing the procedure.

With any surgery, there is a small risk of complications, including:

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A Note About Sex And Gender

Sex and gender exist on spectrums. This article will use the terms, male, female, or both to refer to sex assigned at birth. .

Estrogen hormone therapy involves an individual assigned male at birth taking the hormone estrogen to develop certain feminine characteristics.

Estrogen stops the pituitary gland from forming gonadotropin, which reduces androgen production. Androgens are a group of hormones that help with reproductive development, among other things. Reducing the number of androgens in the body helps a person transition by encouraging changes in fat distribution, breast development, and male pattern hair growth.

Doctors may also prescribe other anti-androgen drugs to help the transitioning process.

A person may not notice significant changes when starting estrogen hormone therapy. The timeline varies, and some people may see more significant changes than others.

People may notice more changes if they use anti-androgen therapy alongside estrogen therapy.

Estrogen hormone therapy can cause physical changes.

How To Transition From Male To Female

This article was co-authored by Inge Hansen, PsyD. Dr. Inge Hansen, PsyD, is the Director of Well-Being at Stanford University and the Weiland Health Initiative. Dr. Hansen has professional interests in social justice and gender and sexual diversity. She earned her PsyD from the California School of Professional Psychology with specialized training in the area of gender and sexual identity. She is the co-author of The Ethical Sellout: Maintaining Your Integrity in the Age of Compromise.There are 19 references cited in this article, which can be found at the bottom of the page.wikiHow marks an article as reader-approved once it receives enough positive feedback. This article received 72 testimonials and 91% of readers who voted found it helpful, earning it our reader-approved status. This article has been viewed 1,278,112 times.

Physically transitioning from male to female is a unique, individual, but hard process. There is no right or wrong way to physically transition. While some trans women may choose to undergo Sexual Reassignment Surgery , others may find that Hormone Replacement Therapy is sufficient. Transitioning, regardless of what it entails, is a long, expensive, and risky process that can lead to rewarding results! Be patient and surround yourself with supportive friends and family members.

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When Can People Take It

The age at which people can access gender affirming hormone therapy varies globally.

For example, in Europe, many countries allow people aged 1418 to access it. However, in some countries, such as the Netherlands, people can access it from the age of 12 years with parental consent.

In some other European countries, access depends on the maturity of the person who would like to receive the therapy.

In the U.S., most people can access estrogen hormone therapy at the age of 18 years, when they are capable of consent. At 17 years old, a person may have access, but they will require a parent or guardian to accompany them to appointments. At the age of 16 years or younger, additional paperwork is necessary to access such therapy.

People using estrogen and anti-androgens as part of their hormone treatment may notice:

  • drier and thinner skin with smaller pores
  • changes in the odors of sweat and urine
  • a reduction in sweat production
  • the development of breast buds beneath the nipples that will develop into breasts as treatment progresses
  • a more feminine facial appearance
  • an increase in fat around the hips and thighs
  • a loss of muscle mass in the arms and legs
  • a reduction in strength

Research also indicates that cross-sex hormone treatment changes the structure of the brain to bring trans people closer to their identified gender.

These changes could potentially affect a persons verbal and spatial abilities and the way they interact with others.

Hair Loss Or Androgenic Alopecia: How Does It Happen

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Androgenetic alopecia is the term used to call the hair loss phenomenon that occurs in both men and women. Individuals may also experience temporary hair loss or shedding due to telogen effluvium, a disorder that is caused by different triggers like stress or shock. To better understand how female pattern and male pattern hair loss happens, lets look at the three important phases of hair growth:

  • Anagen During this first phase, the follicles will push and grow hair from the roots until it reaches its maximum length. This phase may last between 2 to 7 years.
  • Catagen This is usually a transition period where the hair follicles begin to shrink and the growth of new hair slows down. This typically marks the end of the anagen phase.
  • Telogen The hair cycle begins its resting period and sometimes hair shedding is common in this phase as the hair falls from its roots. It is also during this stage that new hairs grow inside the follicle to prepare for the new cycle of hair growth.

The entire hair growth cycle and the composition of the hair follicle are influenced by hormones. There are two main types of hormones: androgen and estrogen hormones. In male pattern baldness, androgens like testosterone and dihydrotestosterone can affect the size of the hair follicle. Low testosterone and the presence of DHT may cause hair loss in men.

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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

What Hormones Are Used To Treat The Symptoms Of Menopause

The hormones most commonly used to treat symptoms of menopause are estrogen and progesterone. . Often, these 2 hormones are used together, but some women are given estrogen alone. Its important to know which hormones you are talking about when looking at the risks.

Common estrogen preparations used to treat menopausal symptoms include conjugated equine estrogens and estradiol, but several forms or types of estrogen are available.

There are also many progestins available, but medroxyprogesterone acetate , is often used with an estrogen to treat menopausal symptoms. Some preparations contain both an estrogen and a progestin.

Androgens are also sometimes used to treat menopausal symptoms. This is not common, though, and because only a few studies have looked at this practice, it isnt clear how safe it is in the long run.

Tibolone is a synthetic hormone drug that can act like estrogen, progesterone, and testosterone in different tissues of the body. Because this drug isnt available in the US, its not discussed here.

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What Is Male To Female Transition

A transgender woman is someone who was born with a male body but whose true gender identity is female. The discomfort and distress that come with this mismatch between a persons body and identity are often called gender dysphoria . Thankfully, there are many options now for male to female transitionthe process by which these individuals can change their appearance and social role to match their female gender identity.

MTF transition can involve wearing traditionally feminine clothing and hairstyles, changing their name and pronoun use to she/her/hers, and coming out to family, friends, and colleagues as female. It can also mean seeking medical treatment to acquire a more feminine body through hormones or surgery .

Estrogen Hormone Therapy Treatment

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The hormone, estrogen, influences most feminine characteristics. It can be given by pill, injection, or skin preparations like patches, sprays, gels, and creams. Pills are effective, cheap, and convenient, but if youre older than 35 or smoke, their safety can be compromised. Patches are also safe and effective, but you will need to wear them all the time. They can also irritate the skin. We generally start Estrogen at dose of 2 mg/day and titrate the dose to achieve the desired results while limiting negative side effects.

Most transwomen take in estrogen via injection. Injections can cause fluctuating or high estrogen levels, resulting in weight gain, mood swings, anxiety, migraines, or hot flashes. There isnt much information with regards to taking high levels of estrogen over a long time.

Contrary to popular belief, relatively small doses of estrogen can actually have the most effect on the transition. Taking higher doses dont necessarily make the changes happen quickly and may even harm your health. After going through orchiectomy or genital surgery, the estrogen dosage should be lowered by the doctor. Without testicles, you will need less estrogen for good health and feminine characteristics.

You will periodically need to get liver function, cholesterol, and diabetes screenings to check on your health while on estrogen.

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