Gender-affirming hormone therapy helpstransgenderand othergender-nonconformingpeople align their bodies with theirgender identity.
Not all transgender (trans) people are interested in hormone therapy.
However, many transgender people, particularly binary transgender people, turn to hormones to affirm their gender.
Verywell / Brianna Gilmartin
It also explains what to expect when undergoing gender-affirming hormone therapy and the possible risks.
The word confirm suggests proof, while affirm means to assert strongly.
Who Is Gender-Affirming Hormone Therapy For?
Gender-affirming hormone therapy is the primary medical treatment sought by transgender people.
It allows their secondary sex characteristics to be more aligned with their individual gender identity.
They are considered to be a distinct but complementary component of gender-affirmation therapy.
How to Get Started
Gender affirmation is a process in which hormones only play a part.
Hormone therapy is typically overseen by a specialist in theendocrine (hormonal) systemcalled anendocrinologist.
Other healthcare providers trained in gender-affirming medical care may be equally qualified to administer treatment.
No letter from a mental health provider may be needed.
Call Planned Parenthood or your local LGBTI organization to learn about the laws in your state.
To receive authorization for insurance coverage, many insurers require a diagnosis ofgender dysphoria.
How to Choose the Right Provider
Not every endocrinologist is equally well-suited to administer gender-affirming hormone therapy.
Those who have undergone a comprehensive, multidisciplinary gender-affirmation training program are generally preferred.
Do not hesitate to ask about a healthcare providers experience and qualifications in administering gender-affirming care.
Testosterone is most often given as an injection, but other formations are available, including pills and creams.
However, they are not always available or covered by insurance.
Testosterone will also not significantly increase height unless it is started reasonably early.
Finally, testosterone should not be considered an effective form of contraception, even if menses have stopped.
Feminizing Hormone Therapy
Feminizing hormone therapy uses a combination ofestrogenand atestosterone blocker.
The testosterone blocker is needed because testosterone has stronger effects on the body than estrogen.
The blocker most commonly used in the United States isspironolactone, a medication also used for heart disease.
Various forms of estrogen can be used for feminizing hormone therapy.
Many of these can be addressed with aesthetic or surgical treatments.
Others need to be administered by a healthcare provider.
Thereafter, regular follow-ups are needed to evaluate the effects of treatment and possible side effects.
Most healthcare providers recommend visiting every 3 months for the first year and every 6 to 12 months thereafter.
Some changes can occur within the first six months, such as the development of larger breasts.
Others, like changes in facial structure, can take years.
In addition to physical changes, hormone therapy can cause emotional changes.
If you are sexually active, it may improve sexual satisfaction as well as your overall sense of well-being.
Hormone therapy can also help to ease the stress associated with gender dysphoria.
If you discontinue therapy, some changes may be reversible.
Others, like changes in bone structure, may be permanent.
Summary
Gender-affirming hormone therapy is the primary form of treatment for transgender people.
Masculizing hormone therapy involving testosterone is used to develop secondary male sex characteristics like larger muscles.
Feminizing hormone therapy involving estrogen and a testosterone blocker is used to develop secondary female sex characteristics like breasts.
Some masculinizing and feminizing effects can occur within months, while others may take years.
If you stop treatment, many of the effects will reverse, while some will be permanent.
Regular follow-up care is needed to avoid potential side effects and long-term complications.
Gardner IH, Safer JD.Progress on the road to better medical care for transgender patients.Curr Opin Endocrinol Diabetes Obes.
Washington, DC: National Center for Transgender Equality.
Planned Parenthood.Gender-affirming hormone therapy: what to expect on your first visit and beyond.
2022;23(Suppl 1):S1-S259.
