Puberty is an awkward time for everyone, but for many trans people, every change their body goes through is a horrifying reminder that their body does not align with their gender. Luckily for those decide to transition, Hormone Replacement Therapy (HRT) can make it a little easier.
With the help of their doctors, people assigned female at birth might use a form of testosterone which can be injected, applied with a patch, as a topical cream or gel, as a subcutaneous pellet (six to 12 placed under the skin every three months), or use progestin injections as another option.
For people assigned male at birth, they might start with some form of antiandrogen (commonly referred to as a “T-Blocker,” or testosterone blocker) like spironolactone or cyproterone acetate, and some form of estrogen and progesterone.
Every body is different, but here are some things you probably never knew about taking hormones.
1. HRT is not a magical cure-all that will change your body overnight. If you’re baking a cake and the instructions say, “Bake at 425 degrees for 20 minutes,” and you bake that cake for 10 minutes at 550 degrees, that will not bake the cake faster and bad things will happen. This is also true when taking any kind of hormone. You don’t always need the maximum dose and you certainly should not up your doses unless your doctor tells you to.
2. Get ready for the return of your teenage acne … with a vengeance! Most people remember that teenage moment when their face basically exploded. Going on HRT is like that, times 10. You might find you have acne that’s just as bad (if not worse) than the first time you went through puberty and may even develop body acne. One trans person wrote in to say they found acne in their inner thigh and other places they never expected to find it.
3. Your breasts might leak. Your chest area may experience tenderness and you may develop breasts from your cocktail of antiandrogen, estrogen, progesterone. You may also experience lactation from the nipples. This is totally common, but it’s still a pretty startling sensation.
4. Weird things get hairy. On testosterone, your breasts (and cleavage in particular) might get hairy. You may also develop more hair on your legs, in your ears and nose, and on your butt. If there is a history of baldness in your family, your hairline may start to recede as well. Just a lot of hair changes in general.
5. Your emotions might go totally haywire … or not. Some trans men I’ve talked to said that after being on some form of testosterone, they became angrier (one person specifically said, “Think Hulk-like anger … but out of nowhere”). Others have said being on testosterone leveled them out. If you’re taking testosterone blockers and estrogen, you may experience severe mood swings, but it’s really hard to know what will happen until you go through it.
6. You might get confusingly horny a lot. A lot of people I’ve spoken to say that when they got horny on HRT, it was like a “different kind of horny” than they were used to. This is most common among trans men going on some form of testosterone. One person wrote to me, “I wish I would have known about the ‘constant hard-on’ problem you seem to get, almost immediately after starting (1-2 weeks in).”
7. Stopping hormones once you’ve started them doesn’t necessarily mean you regret transitioning. One myth many trans people want to dispel is the myth that you can’t detransition. Detransitioning is different from what is known as “transition regret.” One trans person who wrote to me said they stopped taking hormones for a period of time to allow them and their partner to conceive more easily. There are also health risks of taking hormones, including blood clots and potential liver damage, which can cause a person to stop taking hormones (which are all good reasons why you should absolutely not self-medicate with HRT).
8. Going on HRT may not solve all the problems in your life, but it can help. People who transition do so in order to cement the gender identity they have. Some trans people think all their life’s difficulties only stem from the fact that their body does not align with their gender, but HRT is not the end-all and be-all solution to a person’s life problems. Like everyone else, transgender people don’t only deal with gender issues, but also racism, sexism, classism, ageism, ableism, etc. In the end, a person’s gender is more than just pronouns and preference, it is a process.
If you’re interested in Hormone Replacement Therapy, please consult a trusted medical professional for more information.
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We do transgender hormones. A letter of therapy clearance from a therapist with a doctoral degree is required. If you are a minor consent is needed from both parents as well, similarly if you are living with your parents.
Dr. Harold Reed | The Reed Centre for Transgender Surgery