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Is masculinizing or feminizing hormone replacement therapy right for me?

Is masculinizing or feminizing hormone replacement therapy right for me?

Updated on:
February 16, 2022
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When it comes to hormone replacement therapy (HRT), there’s a lot to learn, explore and decide, which can be daunting for people new to it. With the proper knowledge and preparation, gender-affirming HRT can be life-changing for gender-diverse individuals.

This article will also discuss what the healthcare process looks like and everything you need to know before starting HRT.

How do I decide if I should be on gender-affirming HRT?

Deciding to start gender-affirming hormone replacement therapy is an important decision due to the many changes to your body and hormonal system.

When a person’s gender identity does not represent their social or physical experience in the world, dysphoria and stress can increase. 

If you experience significant distress related to your gender identity and/or body image, talk to your healthcare provider about exploring gender-affirmative care. Their job is to help you make these decisions with the necessary knowledge and informed consent!

What will a healthcare provider ask me before starting HRT?

The process of obtaining and beginning gender-affirming HRT is dependent on the healthcare program within which you are working. Providers will ask a number of questions to determine when the best time to begin hormone therapy is for you, based on your medical history, physical exam and transition plan.

Your first appointment will usually follow an informed consent model and will not often yield a hormone prescription. Your health provider will collect your medical history and other relevant information to determine your preparedness for beginning hormone replacement therapy.

Before beginning treatment, you will also need:

  • a blood test for overall health
  • a physical exam
  • signed consent forms
  • and answers to any questions you have about your transitional care 

Some providers may also ask about drug use, HIV and other sexually transmitted infections, discuss sperm freezing, as well as review your immunizations.

Your healthcare provider will be able to guide you through this process, making sure to tick all the boxes before getting your prescription. This preparation makes it easier for you to focus on your feelings surrounding starting hormone replacement therapy and feel cared for by a gender-affirming healthcare team!

What should I know before starting feminizing or masculinizing HRT?

Before starting hormone therapy, it’s important to learn about the short-term and long-term effects of gender-affirming hormone replacement therapy, as well as the risks associated with this kind of treatment.

Someone may choose to start HRT to ease gender dysphoria or emotional distress associated with societal transphobia. They may also select HRT to improve their social functioning or sexual satisfaction in relation to their gender identity. There are many reasons why people may choose to be on HRTs.

There are several benefits of HRT, including improved psychological and social functioning, sexual satisfaction and overall quality of life. However, there are risks and changes that you should consider before starting HRT. Be sure to think through impacts on fertility, sexual functioning and other health problems with your doctor.

Thus, HRT allows for these hormonal and physical changes to occur and, as a result, decrease gender dysphoria and psychological distress that stems from a transphobic society.

Feminizing HRT can impede the effects of testosterone via hormone blockers and the replacement of testosterone with estrogen. Feminizing treatment can also impact your fertility and sexual functioning.

Masculinizing HRT impedes the effects of estrogen on your system by replacing estrogen with testosterone and encouraging the development of masculine features. This replacement process can also impact your fertility.

While some of the effects of hormone replacement therapy are reversible, these are big decisions that should be made with care.

Reviewed by:
Emeline Mugisha

Emeline’s expertise stems from over a decade of community/public health practice among marginalized communities in the U.S. and abroad, with a clinical focus on HIV and infectious diseases.

Using a social justice lens, she is a fierce advocate for empowerment-based practice, trauma-informed care, and cultivating rest as tools for advancing towards whole-life wellness.

She holds a Master of Science in Nursing and a Master of Public Health from Johns Hopkins University.