Feminizing hormone therapy
Feminizing hormone therapy is a medical treatment designed to help transgender individuals align their physical characteristics with their gender identity. By adjusting hormone levels, specifically decreasing testosterone and increasing estrogen, the therapy induces physical changes similar to those experienced during female puberty, such as breast development, fat redistribution, softer skin, and reduced body hair. While many individuals find that this therapy significantly improves their quality of life and emotional well-being, it is essential for patients to undergo the treatment under the supervision of a qualified healthcare provider due to potential risks and side effects, which may include high blood pressure and increased chances of certain health conditions. The process typically begins with a thorough health screening, followed by the administration of medications like spironolactone and estrogen. Changes can begin within weeks but may continue for up to three years. Importantly, feminizing hormone therapy does not affect vocal pitch, which requires separate training for individuals seeking to alter their voice. Furthermore, access to healthcare and reliable medications can be significant barriers for some transgender people, leading to unsafe practices like self-administering hormones. Overall, feminizing hormone therapy is a crucial component of gender-affirming care, promoting better mental health and self-acceptance among transgender individuals.
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Subject Terms
Feminizing hormone therapy
Feminizing hormone therapy is a medical practice that helps transgender people treat the symptoms of their gender dysphoria. By carefully altering the body’s hormone levels, doctors can induce many of the changes that women undergo during puberty. These changes include the growth of breast tissue and a redistribution of the body’s fat deposits. Patients may also experience testicular atrophy, softer skin, and a reduction in body hair.
Though feminizing hormone therapy is often effective, it has the potential for negative side effects. It also must be continued for the rest of the patient’s life to maintain the results. For these reasons, feminizing hormone therapy should not be practiced without the supervision of a medical doctor.
Background
Transgender individuals are those whose gender identity does not match the identity they were assigned at birth. Gender identity refers to how a person views themself. It is commonly confused with biological sex, which refers to the physical characteristics that are often associated with different gender identities.
When someone’s gender identity does not match their outward appearance, they may experience gender dysphoria. This is characterized by feelings of anxiety, depression, a strong dislike of signs associated with someone’s biological sex, and the desire to commit self-harm. To treat gender dysphoria, many transgender people undergo gender-affirming practices and therapies.
One of the most common methods for treating the symptoms of gender dysphoria involves transitioning to a new gender, which refers to living outwardly as a gender that matches an individual’s personal gender identity. They may adopt clothing styles, manners of speaking, and hairstyles culturally associated with their gender identity. They may also seek legal affirmation by changing their name and gender on government identification. In some cases, transgender individuals will transition through surgical procedures that change their bodies. However, these procedures are sometimes expensive, painful, and dangerous, limiting the number of people who undergo them.
Transgender hormone therapy is a non-surgical medical process used to change transgender people’s bodies to better match their gender identities. Bodies naturally produce hormones, encouraging the development of certain secondary sexual characteristics. Male bodies typically produce more testosterone than estrogen, while female bodies typically produce more estrogen than testosterone. By manipulating the balance of those hormones in the body, doctors can encourage the body to display more traits associated with a certain gender.
Overview
Feminizing hormone therapy involves manipulating the levels of testosterone and estrogen in the body to emulate the changes that female hormones cause during puberty. In doing so, they encourage the body to undergo some of the physical changes that many women experience during puberty. When used properly to treat gender dysphoria, feminizing hormone therapy can improve quality of life, reduce emotional distress, and improve psychological health.
When physicians believe that someone is a candidate for feminizing hormone therapy, they will carry out a thorough health screening. This health screening will check the patient’s family history for any traits that might increases the risks of feminizing hormone therapy. It will also include lab tests measuring blood sugar, hormone levels, liver enzymes, and blood count. Because the treatment may make it more difficult to conceive children, doctors may discuss freezing sperm before beginning feminizing hormone therapy.
If doctors are satisfied with the results of these tests, the patient may begin undergoing hormone therapy. Most doctors begin feminizing hormone therapy by prescribing a daily dose of 100 to 200 milligrams of diuretic spironolactone. This drug lowers the amount of testosterone produced by the body and blocks androgen receptors. After four to eight weeks of diuretic spironolactone treatments, doctors prescribe estrogen, which begins the feminizations process. Estrogen may be prescribed in an oral form, as a patch, or as injections.
Some individuals begin experiencing significant changes just weeks after beginning feminizing hormone therapy, while others may take months. However, most people who undergo feminizing hormone therapy will experience changes according to a particular timeline. Some of the quickest changes that typically occur include significantly reduced libido, the slowing of scalp hair loss, and decreased instances of spontaneous erections. Several months into the treatment, most patients experience a redistribution of body fat, softer skin, the development of breasts, and testicular atrophy. After six months, many patients experience a marked reduction in facial and body hair. Bodily changes may continue for up to three years. Patients must continue monitoring their bodies and ingesting estrogen to maintain these changes.
Feminizing hormone therapy does not alter the patient’s voice. This is sometimes contrasted with masculinizing hormone therapy, which does lower the register of the patient’s voice. If a transgender person wants to speak in a higher register, better matching the vocal styles traditionally associated with women, they will have to modify their own voice or hire a vocal coach.
Though feminizing hormone therapy is beneficial for many transgender people, doctors encourage patients to carefully consider the risks associated with the treatment. Feminizing hormone therapy increases the risk of high blood pressure, type 2 diabetes, stroke, breast cancer, infertility, deep vein thrombosis, pulmonary embolism, and hyperprolactinemia. The risk of these complications may remain elevated even if a patient later stops undergoing feminizing hormone therapy.
In some cases, transgender individuals may seek to undergo feminizing hormone therapy but may lack access to quality health care. They may be unwilling to visit a doctor for fear of being discriminated against. They may also lack the funds necessary to visit a medical professional. For these reasons, many transgender people seek black market drugs to begin or continue hormonal therapy. Self-administering feminizing hormone therapy is more dangerous than carefully following a doctor’s prescription. Additionally, it can be difficult or impossible for individuals to verify the integrity of illegally purchased medications. To avoid unnecessary complications, doctors do not recommend self-administering any type of hormone therapy.
Bibliography
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