Hormonal Therapy
Gender-affirming hormone therapy can be part of care for some transgender and gender-diverse people, but it is not required for everyone and should be planned individually. Feminising hormone therapy commonly uses estrogen-based treatment, sometimes with medication to reduce androgen effects, while masculinising therapy commonly uses testosterone. The choice of treatment depends on a person’s goals, medical history, current medicines and clinical assessment.
Hormone therapy should be prescribed and monitored by a clinician experienced in gender-affirming care. Before treatment, patients should discuss expected changes, possible risks, fertility preservation, relevant medical conditions and the need for ongoing laboratory and clinical monitoring.
Important Safety Considerations
Physical and emotional experiences with hormone therapy vary from person to person. Factors can include age, genetics, baseline hormone levels, the medicines used, dose adjustments, other health conditions and how the body responds over time.
Regular follow-up helps the treating clinician assess desired changes, side effects and laboratory results, and adjust treatment when needed. Patients should not change doses or add hormone-related medicines without medical guidance.
Fertility may be affected by gender-affirming hormone therapy, so people who may want biological children in the future should discuss fertility-preservation options before starting treatment.
Possible effects of feminising hormone therapy can include changes in skin oiliness and texture, body-fat distribution, muscle mass, breast development, libido and spontaneous erections. Body and facial hair may grow more slowly or become less coarse, but hormone therapy does not reliably remove existing facial hair; some people use laser or electrolysis for additional hair reduction.
The timing and extent of changes differ widely. Some changes develop gradually over months or years, and not every person experiences the same degree of change.
For broader clinical guidance, see the Endocrine Society guideline resources and WPATH Standards of Care Version 8.
Breast development with feminising hormone therapy
Breast development is gradual and highly variable. Genetics, age, body composition, hormone levels and individual response can all influence the amount and pace of development. Fixed week-by-week or month-by-month results cannot be guaranteed, and development may continue over an extended period.
If a patient has concerns about breast development or is considering breast augmentation, these should be discussed with the treating clinician after an appropriate period of assessment.
Body and facial hair: Feminising hormone therapy may reduce the rate or coarseness of some body hair over time, but existing facial hair often requires additional hair-reduction methods such as laser treatment or electrolysis if that is a patient’s goal.
Cost Factors for Gender-Affirming Hormone Therapy
The cost of gender-affirming hormone therapy varies according to the medicines prescribed, consultation requirements, laboratory monitoring, follow-up frequency and the person’s medical needs. It should not be presented as the cost of surgery or as one fixed package. A personalised estimate can be discussed after clinical evaluation.
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Hormone therapy is one part of gender-affirming healthcare and does not determine whether someone must or must not have surgery. Treatment goals, benefits, risks and monitoring should be discussed with an appropriately trained clinician. Seek urgent medical care for severe or unexpected symptoms rather than adjusting medication on your own.
Related information: MTF gender-affirming surgery, FTM gender-affirming surgery and contact the clinic.
