Hormone Replacement Therapy
Hormone Therapy, in its broadest sense, refers to a range of hormone-related treatments, such as Menopausal Hormone Therapy, Testosterone Therapy, or Growth Hormone Therapy. “Hormone Replacement Therapy (HRT)” conventionally refers to a form of hormone therapy for transgender patients who wish to align their secondary sexual characteristics with their gender.
Conventionally, HRT is offered in two broad categories: “masculinizing (testosterone HRT)” and “feminizing (estrogen HRT).” For transgender youth that are still going through puberty, puberty blockers may be offered as a way to delay development of secondary sexual characteristics.
For transgender men, transmasculine people, and nonbinary people, exogenous testosterone is used to “masculinize” their features, in line with male secondary sexual characteristics. Testosterone HRT provides the following changes over time:
-Stops menstruation. Starts in 2 to 6 months.
-Deepens your voice. Starts in 3 to 12 months, continues for up to 2 years.
-Grows facial and body hair. Starts in 3 to 6 months, continues for up to 3 ~ 5 years.
-Redistributes body fat. Starts in 3 to 6 months, continues for up to 2 ~ 5 years.
-Increases muscle mass and strength. Starts in 6 to 12 months, continues for up to 1 ~ 2 years.
-Enlarges the clitoris and thins vaginal lining. Starts in 3 to 12 months, continues for up to 2 ~ 5 years.
For transgender women, transfeminine people, and nonbinary people, exogenous estrogen is used to “feminize” their features, in line with female secondary sexual characteristics. Additional medicine is taken to suppress their body’s production of testosterone. Estrogen HRT provides the following changes over time:
-Decreases erections and ejaculation. Starts in 1 to 3 months, continues for up to 6 months.
-Decreases libido. Starts in 1 to 3 months, continues for up to 1 ~ 2 years.
-Breast development. Starts in 3 to 6 months, continues for up to 2 ~ 3 years.
-Decreases muscle mass and testicle size. Starts in 3 to 6 months, continues for up to 2 ~ 3 years.
-Increases body fat. Starts in 3 to 6 months, continues for up to 2 ~ 5 years.
Puberty blockers, most often a class of drugs called gonadotropin-releasing hormone (GnRH) analogues, are used to delay the onset of secondary sexual characteristics for transgender children. For people assigned male at birth, GnRH analogues delay the development of their testicles, penis, and scrotum, while also preventing the deepening of their voice and growth of facial and body hair. For people assigned female at birth, puberty blockers will limit breast development and stop menstruation.
