Transgender, gender diverse and gender non-binary (TGNB) people identify as a different gender than the one that was recorded for them at birth. Depending on your personal preferences, if you are transgender you may seek medical therapies to change your body so that it reflects your gender identity.
What hormone treatments are available for TGNB people?
Treatments are entirely dependent on the individual and can range from no treatment to hormone therapies or surgery to help align your body with your gender identity. Hormone therapy is effective at aligning physical characteristics with gender identity and improving mental health and wellbeing as part of your overall health care plan. Hormone treatments may include:
Masculinising hormone therapy – options include transdermal or intramuscular testosterone.
Feminising hormone therapy – options include anti-androgen medications and transdermal or oral estradiol.
Every person’s goals and circumstances are different. It’s important that you can talk honestly with your healthcare team about what is best for you.
When should I start taking gender-affirming medication?
In Australia we have a holistic, patient‐centred, informed consent model of care. The first step in the process is to obtain a comprehensive mental health review by an experienced clinician (GP, physician, psychiatrist or psychologist) with adequate time to assess and support individuals seeking transition.
Mental health professionals play an important role in affirming your capacity for informed consent. They also help ensure that transition‐related mood changes and stress is managed. As endocrinologists, we prefer not to prescribe any medications until a mental health review has taken place.
What changes should I expect?
Feminising hormone therapy will result in physical changes to your body. The rate and extent of these changes is different for everyone and depends on your body’s response to medication. Changes can include:
In one to three months – a decrease in libido (including erections) and a decrease or slight reversal in baldness
In three to six months – softer and less oily skin, breast development and tenderness, a decrease in testicular size, decreased muscle mass and changes in the distribution of body fat
In six to twelve months – decreased facial and body hair growth along with hair becoming softer and finer
Your voice, height and Adam’s Apple will not be affected by feminising hormone therapy
Masculinising hormone therapy can result in the following physical changes in the first year of hormone therapy:
Your skin may become oilier and prone to acne
Your periods will reduce or stop altogether
You may develop more facial and body hair
You may notice changes to the distribution of body fat and an increase in muscle
Your clitoris may get bigger
Your voice may lower
What are the side-effects of gender-affirming hormone therapies?
Everyone comes to us for treatment with their own personal family history, medical conditions, genetics and associated risks (for example, whether you smoke). Because of this, the risk of each medication will vary depending on the individual.
The main risks and side effects that may occur from feminising hormone therapy can include:
A blood clot in a deep vein (deep vein thrombosis) or in a lung (pulmonary embolism)
High blood triglycerides (cholesterol)
Weight changes
Decreased libido
Affected fertility and erectile dysfunction
High blood pressure (hypertension), type 2 diabetes and cardiovascular disease (depending on your risk factors)
The main risks and side effects that may occur from masculinising hormone therapy can include:
Oily skin and acne
Weight gain
An increase in red blood cell count (polycythemia)
Affected fertility
High blood pressure (hypertension), type 2 diabetes and cardiovascular disease (depending on your risk factors)
Thinning and dryness of the vagina, and occasionally pelvic pain
Every person’s journey and body is different. Our team is here to support you through your hormone therapy treatment and make decisions based on what’s best for your body and your gender identity.