Regression Outcome: Taking More Hormones Than Prescribed
Table shows the adjusted multivariable logistic regression models examining factors associated with taking more hormones than prescribed. In the final model, the odds of taking more hormones were lower among respondents who identified as transmasculine compared to transfeminine and among low-income respondents . The odds of taking more hormones than prescribed were higher among respondents who reported having the same provider for primary and gender-affirming care and those with an increased number of major gender-based discrimination experiences out of a possible 11 .
Table 2 Unadjusted and adjusted lasso-selected logistic regression results modeling hormone medicating behaviors among transgender adults in Massachusetts and Rhode Island .
Increased Scrutiny Of Trans Athletes
As the transgender community has become more visible, their place in athletic competitions has come under increased scrutiny.
In October, the World Rugby League became the first international sporting body to ban transgender women from playing in the womens division, citing player welfare risks. Two months later, a group of 200 elite female athletes including Billie Jean King, Megan Rapinoe and Candace Parker signed a friend-of-the-court brief supporting the rights of trans women and girls to participate in female sports.
The brief was filed with the 9th U.S. Circuit Court of Appeals in response to Idahos Fairness in Womens Sports Act, signed by Gov. Brad Little, a Republican, in March. The law prohibits transgender athletes from competing in school sports consistent with their gender identity, regardless of when they transitioned.
The case is currently before the 9th Circuit after a lower court blocked it from going into effect in August.
“There is no place in any sport for discrimination of any kind, King in a statement. I’m proud to support all transgender athletes who simply want the access and opportunity to compete in the sport they love.”
How Long Does It Take For Testosterone To Work For Transgender
After starting testosterone therapy, you may notice some changes as soon as one month after taking it, but it may take a little longer to reap the full benefits. You can expect your body to respond to the therapy within a few days, depending on your age and genetics. Even if you stop taking hormones, you will continue to experience these symptoms.
Men who are transmasculine or have transgender issues may be able to use testosterone to masculinize their bodies. When testosterone is taken, the body does not need to suppress estrogen production. Testosterone can be administered in a variety of ways. In addition, certain types of prescription drugs may be more difficult to obtain. Injections are the most common method of delivering testosterone to the body. Gels, creams, and patches, for example, can help to treat testosterone deficiency. Because of advances in therapy, a wide range of topical and oral formulations are available.
Jatenzo, a softgel oral capsule, is not intended for use as testosterone replacement therapy in transgender men. Some men may experience side effects while undergoing testosterone replacement therapy. Some are mild to severe. Other conditions may become intolerable, requiring treatment adjustment or even discontinuation. It is critical for transgender men and non-binary people considering testosterone to consider their fertility before starting testosterone.
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How Long Does Mtf Hormone Therapy Take
Changes in a person can take several months for noticeable results to show up, and they may take up to four years for noticeable changes to fully manifest. Even if you stop using HRT, there are some permanent effects.
The Many Benefits Of Estrogen
The authors of the study believe estrogen may influence both the health of womens faces and their hair, as well as their attractiveness and healthy hair. Despite the fact that we dont know how estrogen affects our face and hair, the research provides some evidence that it does. When youre experiencing hair loss, its critical that you consult with your doctor about treatments that may help you stop or regrow your hair.
What Does Feminizing Hormone Therapy Do
In order to achieve a gender identity that corresponds to your bodys natural gender expression, your hormones are adjusted. People who require feminizing hormone therapy frequently experience discomfort or distress because of their gender identity that differs from that assigned at birth or due to a physical characteristic associated with gender identity .
The Effects Of Estrogen On Male Breast Development And Sexual Function
After the start of cross-sex hormone therapy , the breasts develop in 3 to 6 months. Some women may have to wait up to a year for their breasts to grow in their desired size. According to the Endocrine Societys Clinical Practice Guidelines, breast development begins three to six months after CHT. It is possible that estrogen stimulates breast tissue growth. Gestational gynecomastia is caused by an excessive amount of estrogen, and it results in enlarged breasts. Erectile dysfunction is defined as the inability to achieve sexual desire. When there is high estrogen in a mans body, he may struggle to have an erection. Most men benefit from estrogen during their breast development. There are a few men who may suffer from gynecomastia as a result of estrogen-induced breast tissue growth. Ethrex, as well as estrogen, can affect a small number of men. A few men may be unable to maintain their erections or get an erection if they have high levels of estrogen.
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Study Sample And Procedures
This is a secondary cross-sectional analysis of survey data from Project VOICE , a needs assessment led by the Fenway Institute at Fenway Health and the Massachusetts Transgender Political Coalition . Between March and August 2019, trans residents of Massachusetts and Rhode Island were surveyed about their sociodemographics, healthcare experiences, and health. Respondents were purposively sampled and recruited via venues where trans people congregate, including online sites such as listservs and community-based social networking webpages, as well as in-person sites such as trans-specific community events and trans-friendly clinics. Participants were eligible for the study if they were 18 years or older, self-identified as transgender or nonbinary, resided in MA or RI, were willing to provide electronic written informed consent, and spoke either English or Spanish. Eligible respondents who completed the survey were invited to opt into a community raffle for one of 54 gift cards, with values ranging from $10 to $250. Additional details on the study procedures can be found elsewhere .
Balancing The Risks And Benefits
Transgender women and transfeminine people are people whose assigned sex at birth is male, yet they exist as women. Transgender people represent a group that includes not just transgender women but also non- people who have a more feminine gender identity than the one that is expected for their recorded sex at birth. The term “transfeminine” is an umbrella term that encompasses both transgender women and feminine people of nonbinary identity. Many transgender people experience what is known as gender dysphoriathis is discomfort caused by people’s bodies not matching their sense of identity.
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Not every transgender person deals with their gender dysphoria in the same way. However, for many people, hormone therapy can help them feel more like themselves. For transmasculine people, this involves testosterone treatment. For transfeminine people, this usually involves a combination of testosterone blockers and estrogen treatment.
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Feminizing Hormone Therapy And Fertility
Gender-affirming hormone replacement therapy may affect your fertility, as it impacts sperm production. While some transgender women can produce sperm again after stopping hormone treatment, research indicates that this may not be the case universally, and there is a risk of permanent infertility with long-term use of hormones. If you would like to have biological children, ask your doctor about your options with freezing your sperm before starting hormones.
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What Does Hormone Therapy Do To A Man
Hormone therapy lowers the amount of testosterone in the body and this affects your ability to have and maintain an erection. This may get better within 3 to 12 months after the treatment ends. For some men, erection problems are permanent. It depends on the drug you are having and how long you have been taking it.
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Physical Effects Of Masculine Or Female To Male Transitioning Hormone Therapy On Transgender People
Effects On The Body: The effects of testosterone are completed over several years and a lot of factors can influence the degree of change one experiences, including the number of hormone receptors in your body, your age, the dose. Testosterone affects the entire body and it is impossible to pick some changes and not others.
Effects On Voice: Your voice may get deepen during female to male transitioning hormone therapy. In most people, some change can be noticeable after 3 months and there is no further change after one year. This change is permanent. One more way to change your voice is via voice therapy.
Effects On Hair: The effect of testosterone hormone on transgender people can cause hair loss and perhaps baldness. For some individual, this is a desired effect. If this is not your case, then you may consider a range of options like medication for preventing hair loss such as Finasteride, wigs or implants.
Effects On Body Fat/Muscles: Your body fat will be redistributed from the more typically female pattern to a more typically male pattern . Apart from this, your muscular mass may increase. These changes will be gradual, possibly beginning around 3 months after the therapy. Fat may redistribute towards its original pattern and muscle mass may decrease gradually in transgender people if they stop taking the testosterone hormone
Reasons For Taking More Hormones
As shown in Table , the most endorsed reasons for taking more hormones than prescribed were believing that it is not the right prescribed dose , taking it to feel good , to speed up transition or the gender-affirmation process , and making up for missed doses .
Table 3 Reasons for taking more or less hormones than prescribed.
Emergent themes from the write-in responses included the following reasons for taking more hormones: making up for missed doses, having concerns about reproductive health, and having an imprecise practice of dose administration.
Many respondents reported making up for missed hormone doses as a reason for taking more hormones than prescribed, with some respondents indicating doubling or taking a little extra dose if missed. These respondents noted:
If I miss a week because my pharmacy took forever to get my T in, Ill sometimes go to 0.45 on the 1mL syringe instead of 0.4.
Accidentally doubling my dose because I forgot that I took the first.
I miss my shot day I accidentally pull a little extra when getting the shot ready.
Reproductive health concerns regarding menstruation also emerged as one of the reasons transmasculine people reported taking more hormones than prescribed. Specifically, many transmasculine respondents reported taking higher doses of their hormones to mitigate ones gender dysphoria and physical discomfort related to menstruation. Participants noted:
Experience menstrual cramping.
If I start bleeding.
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Is Hormone Therapy Safe
Most experts, including our team, believe that hormone therapy is a safe choice for transgender older teenagers and young adults, but it can have some side effects. Because research in this area is just beginning, its possible that there are other long-term risks we dont yet know.
To monitor for possible side effects, we do frequent blood tests to monitor health and check for:
Possible side effects of feminizing hormone therapy
Possible side effects of masculinizing hormone therapy
- Headaches or migraines
- Higher risk of heart attack, heart disease and stroke
Medical Care For Transgender And Non
Transgender and non-binary people often seek to change their bodies to better align with their gender identities. The Center for Transgender Medicine and Surgery can help. We offer hormone therapy and other gender-affirming medical care. CTMS also provides primary care to meet all of your health needs. We maintain a sensitive and supportive environment.
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Surgery For Trans Men
Common chest procedures for trans men include:
- removal of both breasts and associated chest reconstruction
- nipple repositioning
Gender surgery for trans men includes:
- construction of a scrotum and testicular implants
- a penile implant
Removal of the womb and the ovaries and fallopian tubes may also be considered.
Treatment And Gender Surgery
Currently, most surgeons recommend that transgender women and transfeminine people stop taking estrogen before they undergo gender affirmation surgery. This is because of the potentially increased risk for blood clots that is caused both by estrogen and by being inactive after surgery. However, it is unclear whether this recommendation is necessary for everyone.
Transgender women and nonbinary feminine people who are considering surgery should discuss the risks and benefits of discontinuing their estrogen treatment with their surgeon. For some, discontinuing estrogen is no big deal. For others, it can be extremely stressful and cause an increase in dysphoria. For such people, surgical concerns about blood clotting may be manageable using postoperative thromboprophylaxis.
However, individual risks depend on a number of factors including the type of estrogen, smoking status, type of surgery, and other health concerns. It is important that this be a collaborative conversation with a doctor. For some, discontinuing estrogen treatment may be unavoidable. For others, risks may be managed in other ways.
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How Long Does Transgender Hormone Therapy Take To Work
There is no one answer to this question as transgender hormone therapy can produce different results for different people. For some, the effects of hormone therapy may be felt within a few weeks, while for others it may take months or even years to see the full effects. Ultimately, it depends on a variety of factors, including the individuals physiology and the dosage of hormones being taken.
Hormone Replacement Therapy For Transgender Women
Estrogen and testosterone-blocking medications help transgender women develop a more feminized appearance in line with their gender identity while transitioning. It reduces the discomfort of gender dysphoria, the distress caused by having a gender identity that differs from the sex you were assigned at birth. Many transgender women experience less emotional distress, improved personal relationships, and a better overall quality of life as a result of hormone replacement therapy.
Feminizing hormone replacement therapy causes a variety of physical changes like breast development and facial and body hair reduction. You may also experience a loss of muscle tone and changes in your body shape as the body redistributes fat cells.
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The Importance Of Patient
NYU Langone Health has been certified for 7 consecutive yearswith a score of 100 percentby the Human Rights Campaign Foundation Healthcare Equality Index Report, which evaluates the work of medical facilities in providing equal healthcare access to LGBTQ+ Americans. One factor in that success is the centers patient-centered approach to transgender care.
In some practices, patients can walk into the office and have someone use the wrong pronoun, Dr. Glodowski says. The doctor might see them briefly, write a prescription, and thats basically it. At NYU Langone, everyone from the receptionists to the medical assistants to the physicians have been trained to be sensitive to gender identity. I spend 40 minutes with each new patient, and 20 minutes with any follow-ups. In addition, we have one clinic a week specifically dedicated to gender-affirming hormone therapy.
Differences In Prevalence According To Gender
There are some discrepancies as to whether mental health diagnoses are more common among transgender men or among transgender women. Some studies have found that mental health diagnoses were not related to assigned or identified gender , whereas other studies have demonstrated higher rates of mood disorders , anxiety disorders , adjustment disorders , and substance abuse among transgender women than among transgender men. Most of those studies are biased by not controlling for factors known to influence mental health diagnoses, particularly hormone treatment. This means that people have been recruited for studies independently as to whether they are on hormone treatment or not, although research has confirmed that such treatment reduces mental health problems. Interestingly, more recent large controlled studies involving only transgender people not on treatment have found that anxiety disorders were more prevalent among transgender men than among transgender women . A similar study also found levels of self-harm were also higher among the same group .
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Specialized Training Enhances Clinical Precision
Although many medical centers offer gender-affirming hormone therapy, NYU Langone does so under the direction of an endocrinologist who specializes in transgender care. For these patients, the clinicians expertise can be crucial to optimizing outcomes, explains Michele B. Glodowski, MD, clinical instructor in the Department of Medicine, whose fellowship training included extensive clinical rotations at the University of Colorados Integrated Transgender Program.
Gender-affirming hormone therapy typically uses different doses and modalities from hormone replacement therapy for postmenopausal cisgender women or cisgender men with low testosterone. The risk of complications, including certain types of cancer, may be heightened as well. With testosterone, we often see weight gain, changes in LDL and HDL cholesterol, elevations in hematocrit, and increases in insulin resistance and blood pressure, Dr. Glodowski notes. Feminizing regimens, such as estradiol, can also trigger weight gain, raise the risk of cardiovascular disease, and often affect liver enzymes and triglycerides.
Nbc Outworld Rugby’s Transgender Ban A ‘dangerous Precedent’ Critics Say
Joanna Harper, a medical physicist in Portland, Oregon, has conducted research into the effect of testosterone blockers on transgender women runners like herself.
In 2015, she published the first study of transgender women and athletic performance and found that trans women ran at least 10 percent slower after beginning hormones. And, relatively speaking, they did no better against cisgender female runners than they had previously done against cisgender men.
Harper said Roberts methodology is solid, but she sees some limitations in the study. In an assessment shared with NBC News, she questioned the lack of data on participants individual training habits. She also noted there was no coordination between when subjects started hormones and when they took their annual fitness test.
The tests were placed into three bins, Harper said. One bin of tests that took place in the first year after the start of hormone therapy, one bin of tests that took place between one to two years of hormone therapy, and a third bin that took place between two and two and a half years after the initiation of hormone therapy.
Lumping the data together could blur out changes that occurred within a 12-month period and might distort the results notably, she theorized.
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