Hormone replacement therapy is usually the first step taken by transgender people who decide to medically transition, though this is not always the case. Their bodies will begin to change as they acquire the secondary sexual characteristics of their desired gender appearance by taking supplements and hormonal replacements, which will ultimately lessen their gender dysphoria.
An essential component of gender-affirming care is endocrinological intervention. Since transgender endocrinology is more complicated than trans men needing testosterone and trans women needing oestrogen, endocrinologists who specialize in transgender care manage the hormonal transition of transgender patients. Instead, hormone prescriptions must be carefully planned based on the patient’s body, health conditions, ideal timeline, and goal. Primary care teams in the UK won’t start hormone therapy unless gender-approved.
Does a transgender patient need to see a skilled endocrinologist before starting hormone therapy?
Their system may be severely disrupted by gender-affirming hormone therapy (GAHT), which may have long-term effects.Endocrinologists with expertise in transgender care can help patients with their GAHT by advising, guiding, and planning it according to their needs while carefully managing risks and taking into account any physical health concerns they may have.
In order for the endocrinologist to create a safe treatment plan that the patient can accept, a patient should have a psychosocial assessment, mental health evaluation, a thorough review of their medical history, a physical examination if necessary, and blood testing before starting GAHT.
Hormone therapy can help some transgender and nonbinary people who are experiencing distress and gender dysphoria. It can enhance their social and mental health.
What impact do hormones have on gender-affirming care?
There are numerous ways to administer hormones, including:
- Pills
- Shots
- Topical creams and gels
- Adhesive patches
Feminising hormone therapy
The goal of feminine hormone therapy is to increase the amount of oestrogen and decrease the amount of testosterone in the body. This is usually accomplished by giving anti-androgen prescriptions and the medication oestradiol. Feminizing traits like breast development and reduced facial hair growth will become noticeable when there is an adequate amount of oestrogen and testosterone suppression. Before receiving feminizing hormone therapy, patients who hope to have biological children in the future might want to think about freezing their sperm because this will cause the male sexual organs, like
- Fewer erections and a decreased libido
- Slower loss of scalp hair
- Softer and less oily skin
- Less muscle mass and more body fat
- Body fat redistribution
Masculinising hormone therapy
The goal of masculinizing hormone therapy is to raise the body’s testosterone levels. Similar to feminizing hormones, this will stop the menstrual cycle and prevent the ovaries from producing oestrogen, which may also result in infertility. Therefore, patients who want to have biological children in the future might want to think about freezing their eggs before undergoing masculinizing hormone therapy. Additional modifications will include:
- Voice deepening
- Hair growth on the face and body
- Elongation of the clitoris and vaginal dryness
- More muscle mass
The patient and their endocrinologist should have a full discussion before deciding to undergo a hormonal transition. Some of the changes, like breast development, are permanent, but the hormones can be stopped at any time, and some of the changes will return to their pre-hormone therapy states.