Tranny Hormones
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Tranny Hormones
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Queer
Trans
HRT
Hormones
Hormone Replacement Therapy
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Before starting hormone-replacement therapy , Simon Moore, 27, thought hard about what effects they wanted to get from testosterone.
While they had always wanted a deeper voice, they didn't want all the added muscle and hair growth that sometimes comes with a full, longer-term dose of testosterone-based HRT. Like a growing number of nonbinary people , they decided a microdose would offer a slower transition.
"There is less emotional roller coaster. The vocal cords thicken slower and more gradually," Moore said.
Moore, who is nonbinary and trans, grew up in Moscow and moved to the US with their partner in 2019. They were able to access HRT for the first time in January through Plume , an online transgender-health service, they said.
It's been seven months since Moore started testosterone (commonly referred to as "T"), and they have decided to wean off it.
"I'm not really a 'trans man.' I never really wanted to be full-on masc, like go to the gym, get ripped, and get the whole beard," Moore told Insider. "I wanted something in between. I wanted to be comfortable."
Transition is often portrayed as a linear journey that has a clear beginning and end .
But many trans people go on and off hormones for a number of reasons, such as access to care, a desire to get pregnant, medical complications, or contentment with the results of HRT they already received.
Insider spoke with three trans people who have gone on and off HRT at various points for medical or personal reasons.
A popular misconception perpetuated by TV shows, films, and general misinformation is that being trans means someone needs to " medically transition ," or get gender-affirming medical procedures , to be seen as valid.
The idea that gender-affirming care is one size fits all and people stop HRT only because they regret their decision is often used as a political argument to justify anti-trans medical bills that suppress access to medical care for trans people.
There is a small and vocal group of people who have " detransitioned " and actively say they are no longer trans. But research suggests a majority of people who stop HRT do so for other reasons . Some trans people never take hormones at all.
"Nobody needs to be on hormone therapy. Nobody needs to undergo any medical, surgical, or other procedure, or even therapy — despite what people have told us for many years — to be trans," Dr. Jerrica Kirkley, the medical director for Plume , told Insider.
Stopping treatment doesn't make a person not trans, Kirkley said.
Like many young trans people who grew up with little trans visibility, Moore as a teen relied on YouTube videos on female-to-male transition to get information about gender-affirming care.
But Moore decided they wanted their care to look a little different.
On their YouTube channel, Moore blogged their personal HRT journey.
Rather than taking the standard 0.5 milligrams of testosterone every week indefinitely, Moore decided to microdose 0.3 mG of testosterone a week for just seven months.
Moore then stopped microdosing once they got a deeper voice. (Certain effects of testosterone, like facial hair and a deeper voice , are permanent, while others, like building more muscle, are not and require consistent doses of T over time.)
Moore is happy with their results. They told Insider that while they were stopping, they were open to the idea that what their future desires could differ.
"I think a lot of people kind of want you to pick a label, stick to it, pick a journey, stick to it," Moore said. "I don't need to."
Tuck Woodstock, a 29-year-old journalist, host of the " Gender Reveal" podcast , and cofounder of Sylveon Consulting , started testosterone in July 2020, four years after he came out as nonbinary to close friends and family.
As a gender educator, Woodstock knew testosterone was a resource for years before they made the decision to go on it.
"The reason that it took four years for me to start testosterone is because it took four years for me to want to start testosterone," Woodstock said. "It was very much, for me, an incremental journey where the way that I thought about my own gender inched very slowly away from womanhood."
Woodstock added: "Because that process was gradual, it took several years before I was interested in physical or medical transition, which I recognize is very different than most people I know who came out as trans nonbinary, trans men, and immediately started testosterone. That was not my experience at all."
In the past year and a half, Woodstock has stopped and restarted testosterone three times. This is partially because of being a podcaster and musician who relies on their voice heavily.
"When I hit a certain level of testosterone in me personally, it changes my voice so rapidly that it becomes harder to sing at all," Woodstock said.
In addition to giving their voice a break, Woodstock also wants to take time to relish the changes his body is going through while on testosterone and likes to take breaks.
"I think it's nice to take a moment and regroup because these changes often are at least semipermanent," Woodstock said. "And I like to make sure that I have a moment to spend in this version of my body before I progress on to a later version. It's not so much that I don't want them to actualize but that I want to enjoy every single moment of this journey individually."
Kayden Coleman , a 35-year-old trans medical advocate and educator, started taking testosterone in 2009.
While he was really excited about the changes that happened in his first year on T, he said the weekly shot became more of a hassle, especially once certain changes, like hair growth and voice deepening, plateaued.
A post shared by Kayden X Coleman (He/Him) (@kaydenxofficial)
Coleman stopped taking testosterone twice. The first time was after a surgeon told him to before he underwent top surgery in 2013, though he has since learned that may not have been medically necessary . The second time was in 2019, when he moved states, briefly lost medical coverage, and became pregnant.
"With testosterone, that first year is like, you cannot wait to take your shot because all these changes. Then, you kind of get to where you are, and you're like, 'OK, I'll take it next week,'" Coleman said. "Or like me, you'll get needle anxiety and really put it off."
When he stopped taking testosterone, he said he didn't experience many negative effects. Because Coleman already had a full beard and low voice, which are permanent effects of testosterone, he said going off it didn't change many things physically.
But he said he felt a lot more emotional going off T.
"When I'm not on testosterone, I'm like all over the place," Coleman said. "Testosterone kind of keeps me at a more level headspace."
The way gender-affirming care is framed as a journey with a clear beginning and end point, Coleman said, harms trans people because it makes it seem like care needs to look the same for everyone.
"Trans people should feel free enough to start and stop hormones as a form of self-care," Coleman said.
"If I want to try for a baby, I should be able to," he added. "If I just don't feel like sticking myself in the thigh or butt cheek or arm or stomach with a needle for the next few weeks, I should just be able to not."
Important
Disclaimer: The first version of this page was written in 2001 when I
was collating a mass of information and trying to decide whether to
finally make a life changing decision. I'm not a medical
professional and the content does NOT constitute Medical
Advice. I disclaim any responsibility for extracts that have appeared
elsewhere that might imply that it does. Also, I cannot accept any
responsibility for any medication that a reader may take. Such treatment should
always be done done under the supervision of a qualified medical
professional.
For
male-to-female transsexual women, taking hormones becomes part of their
daily routine. Although the amounts taken can be reduced after sex
re-assignment surgery, it will still be necessary for them to take
hormones every day for the rest of their lives in order to remain
healthy. It must be emphasised that some of the effects of long
term hormone use are irreversible, at least without surgery; hormones
are not something that can be experimented with. The widely
followed HBIGDA
Standards of Care of Gender Identity Disorders Version 6, warns
that:
" Social
Side Effects [of Hormones]. There are often important social
effects from taking hormones which the patient must consider.
These include relationship changes with family members, friends, and
employers. Hormone use may be an important factor in job
discrimination, loss of employment, divorce and marriage decisions,
and the restriction or loss of visitation rights for children."
Before taking
female hormones it is also necessary to carefully consider several other
important points:
Firstly, why do
you really want to start taking them? The results of prolonged use of hormones
such as oestrogens at medicinal levels are obvious and
permanent . Taking female hormones makes no sense unless you
are seeking permanent and irreversible body feminisation. In
particular breast development can soon become a source of embarrassment
for some one still living as a man, it will not shrink significantly when the hormones
are stopped, and may eventually require surgical removal (gynecomastia).
Secondly, there
are serious medical risks associated with long term hormone use, although
admittedly recent studies seem to show that these risks are much less
than previously thought, for example post-operative MTF women seem to be
no more at risk of getting breast cancer than genetic women on HRT.
Thirdly, there
are considerable costs associated with hormone treatment,
particularly if "natural" hormones are preferred over much
cheaper "synthetic" hormones which are thought to have higher
risks of side effects and complications. The cost of hormones
varies hugely from country to country, but if you are paying yourself
then $100/ €1 00 a month is about
the minimum budget for hormones and antiandrogens when pre-SRS, perhaps
halving after surgery. This may not sound too much, but it must be maintained
month after the month, and the total annual
expenditure can be a significant burden, particularly for young women on
low salaries and pensioners.
The crazy monthly hormone cycle of a fertile woman.
Finally it is
necessary to be realistic about what feminising hormones can do,
they are not some magic potion. Also the effects take a long time
to realise - it's at least two to three years before maximum effects are
achieved.
Types of
Hormone
Oestrogens
Oestrogen (or 'Estrogen' in American English) is the most important female hormone taken by transsexual
male-to-female women.
Many transwomen try to emulate the oestrogen and progesterone
cycle of women, but most eventually give up -
thus avoiding the associated mood swings, hot flushes and
physiological effects.
Oestrogens are
steroid "female hormones" produced in large quantities by the
ovaries of women, however they are also produced in small quantities by
the testes of men. During a girl's puberty it's a flood of oestrogens that
are responsible for the development of female secondary sexual
characteristics such as breast enlargement, broadening of the pelvis and
fat deposition around the hips. In a sexually mature woman
with female reproductive organs, oestrogens participate in the monthly
menstrual cycle that prepares the body for a possible pregnancy, and
they also participate in the pregnancy if it occurs.
Oestrogens also
have several non-reproductive effects: they are mental tonics and
have anti-depressive effects; they antagonize the effects of the
parathyroid hormone, minimizing the loss of calcium from bones and thus
helping to keep bones strong; and they promote blood clotting and
may lower the risk of heart disease (although a recent study has
questioned this) .
In terms of the specific
biochemicals contained in oestrogen-based hormone preparations, there
are three main categories of interest to transsexual women:
For hormone
therapy both synthetic and natural oestrogens are commercially
available. Synthetic oestrogens are generally cheaper but more
prone to side effects than are natural oestrogens. Products based
on phyto-oestrogens are available in health food shops but are not
subject to licensing or standardisation of their active constituents,
and are usually of very low , and possibly ineffective dose - the
sweeping claims made by manufacturers of such products should treated
with great scepticism.
Most of the preparations
that are licensed for use as female hormone therapy (these may be
conjugated oestrogens, but are usually based on oestradiol valerates)
are only available by doctor’s prescription. Oestradiol valerate is
the only form of hormone therapy that can be measured in blood, so blood
oestrogen measurements are meaningless in someone taking, say, Premarin .
Progesterone
Progesterone is another steroid "female
hormone". It is secreted by the corpus luteum and by
the placenta, is responsible for preparing the body for pregnancy
and if pregnancy occurs, maintaining it until birth.
Progesterone is very important during pregnancy and pregnant women have
lots of progesterone, which helps their bodies support the developing
baby. It is also known that progesterone has an effect on the
brain, where it acts as a mild anaesthetic.
In the
transsexual woman progesterone administered with oestrogen appears to
help promote breast growth: oestrogen stimulates cell mitosis and growth
of the ductal system, while lobular development and differentiation
seems to be dependent on progesterone (breast fat accretion seems to
require both). Progesterone consistently administered with
oestrogen also seems to reduce the risk of fibrosis, cysts, and cancer
from administration of oestrogen alone.
There are some
prescription HRTs available that are based on synthetic progestogens
(chemicals that have progesterone-like actions), e.g. Provera and
Duphaston .
True, non-synthetic, progesterone (as opposed to a progestin) is very
rarely reported to have any adverse effect, and seems to provide a
healthier balance for an aggressive oestrogen dosage in pre-op TS women,
as well as improving libido and overall energy level.
Gia and Allanah posing as sisters after after many years on
hormones plus lots of surgery!
Androgens
The principal androgen (male sex hormone) is testosterone .
This steroid hormone is mostly manufactured by the interstitial
(Leydig) cells of the testes and therefore men have much more
testosterone than women. Testosterone is one of the hormones that
make men look different from women, secretion of testosterone increases
sharply at the start of a boy's puberty and this is responsible for the
development of the male secondary sexual characteristics such as beards
and deeper voices. Testosterone is also essential for the
production of sperm by men.
One of the
well-known effects of testosterone is that it stimulates muscle
growth. For this reason, some athletes and body builders (both
male and female) take testosterone or similar drugs - called
"anabolic steroids" - to help them build bigger, bulkier
muscles. Conversely in pre-SRS transsexual women it is highly desirable to
block the muscle building and other masculinising effects of androgens
such as testosterone which are produced by the testes, and to a lesser
extent the adrenal cortex. This can be most safely and
effectively fought by taking an "anti-androgen" drug, rather than by
trying to overwhelm the effects of androgens by mega-dosing with oestrogen.
The Spironolactone and Finasteride anti-androgens are
very commonly prescribed and taken by pre-SRS transwomen, transsexual
women older than 25 or so seem to find taking an anti-androgen to be much more
effective and important than those who are younger. Most post-SRS
transwomen don't need an anti-androgen, but a few find Finasteride to
still be useful.
Gonads
The gonads ( ovaries in women and testes in men)
are the reproductive organs which produce eggs and sperm, the cells that
join to form an embryo that develops in to a baby. Gonads also
make most of the reproductive or sex hormones produced by a body.
Testes produce testosterone while ovaries produce a mixture of
oestrogens of which estradiol is the most abu
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