Hormone Replacement Therapy (HRT) is the medical process of blocking the body's naturally produced sex hormones and/or replacing or supplementing these with a different sex hormone or set of sex hormones. Sex hormones include estrogen, progesterone, and testosterone. Many transgender individuals undergo hormone therapy as part of their transition. Non-binary and genderqueer individuals may also choose to undergo HRT as well. Not all trans folks choose to undergo HRT, either for medical reason or because they are already comfortable with their appearance.
Some cisgender individuals also undergo HRT. It is usually to replace the hormones that their body naturally used to make. This is most common for older individuals, whose bodies no longer produce sex hormones at a healthy amount. However, there are also cis individuals who undergo HRT for the "opposite" sex, usually due to being transsex/altersex. One example of this would be cis butch lesbians that take testosterone to appear more masculine.
Many intersex people with irregular hormonal output also go on HRT, as to balance their hormone levels.
Transmasculine HRT
Female-to-male HRT or transmasculine HRT typically has the goal of increasing testosterone levels until the levels of an average wolffian body is reached. Testosterone is most commonly taken through injection (either intramuscular or subcutaneous) but can also be taken through gels, however with gel results typically occur slower. Although testosterone pills do exist, these are typically not used as they can cause dangerous amounts of liver damage.
Permanent Effects
These are the effects seen when taking testosterone that are not easily reversible.
- Voice becomes deeper.
- Adam's apple may develop.
- Increased body hair and facial hair.
- Male-pattern baldness in some individuals.
- Enlargement of the clitoris.
- Increase in height and in relative size of hands and feet (if taken before the end of one's natural puberty).
- Possible shrinking of breasts.
- Possible decease in fertility.
Temporary Effects
These effects will only last for as long as one continuously takes testosterone.
- Increased sex drive.
- Redistribution of body fat to a more masculine figure.
- Changes in fat distribution on face for a more masculine appearance.
- Increased ability to gain muscle.
- Increased sweat and changes in body odor.
- Acne (especially in the first few years of HRT).
- Possible changes in mood.
- Menstrual cycle stops.
Transfeminine HRT
Male-to-female HRT or transfeminine HRT typically has the goal of decreasing testosterone levels and increasing estrogen levels until the levels of an average mullerian body is reached. This is done through the administration of estrogens, and possibly progesterone as well. Many individuals also require antiandrogens, to decrease testosterone, in order to see desired effects. These are commonly taken through pills or through injection (either intramuscular or subcutaneous) but it can also be taken through gels, however with gel results are typically occur slower.
Permanent Effects
These are the effects seen when taking estrogen that are not easily reversible.
- Development of breasts.
- Widening of pelvis (if taken before the end of one's natural puberty).
- Possible decease in fertility.
Temporary Effects
These effects will only last for as long as one continuously takes estrogens.
- Thinning/slowed growth of facial hair and body hair.
- Cessation of male-pattern hair loss.
- Decreased skin oiliness and acne.
- Redistribution of body fat to a feminine body shape.
- Changes in fat distribution on face for a more feminine appearance.
- Decreased ability to gain muscle.
- Possible changes in mood.
- Decreased sex drive.
Non-Binary HRT
Some non-binary and genderqueer individuals may choose to undergo HRT for the "opposite" sex of their assigned gender at birth. Some are fine with undergoing a "full" hormone transition. However some may choose to go on a lower dose, possibly combined with a hormone blocker. This may allow them experience changes very gradually. They may also stop and start HRT as needed in order to maintain a more androgynous appearance. For others they may take the hormone blockers along with a minimum possible 'maintenance dose' designed to be the minimum required for healthy body functions. Some will opt to take hormones until permanent effects (such as voice deepening or the growth of breast tissue or facial hair) are achieved and then stop so the non-permanent effects are reversed.