Transgender Transformations – Hormone Replacement Therapy For Men Who Want To Be Women

Over the years, our society has only recognized the binary male and female gender. But as we are coming to realize, gender is more than just black and white. Various gender identities apart from the traditional male and female gender include transgender, neutral, agender, genderqueer, third gender and so on. To ensure that a person’s anatomy aligns with his or her gender identity, it isn’t uncommon for individuals to undergo hormone replacement therapy. It’s an important phase of life as your body changes drastically and so it’s best if you are familiar with the procedure and risks involved in undergoing such therapy. Even as a cis-gender person interested in dating a transgender, getting as much knowledge about transgender issues (including hormone replacement therapy) is the best way to date a transgender. This will prepare you for the changes that will come.


What goes on in hormone replacement therapy?

In the body of a biological male, the hypothalamus and pituitary glands produce hormones which stimulate the production and release of testosterone from the testes located in the scrotum. The production of this hormone in the body begins earnestly at puberty. Consequently, characteristics that are typically found in biological males like deeper voice and more body hair begin to appear.

In cross-sex hormone therapy, specifically feminizing hormone therapy, various hormonal medications are administered to trigger physical changes that are more feminine and/or repress male physical characteristics. Starting hormone replacement therapy early enough, especially in teens can help avert going through puberty as the gender you do not identify with. This can help your outward physical appearance align more with your inward gender identity and improve your overall quality of life.

Just like in puberty, hormone replacement works differently on different people. How your body responds to feminizing hormones depends on a variety of factors from the age at which you commence this form of therapy, to your current health status and even your genes which determine a lot of how your body interacts with the drugs. So always keep in mind that it could work well on others and have dire consequences for the health of other people receiving the same treatment. With that in mind, it’s important to seek counseling and talk with your doctor before you begin using hormones and while using to them, to discuss whatever abnormal symptoms you might have. But what exactly should you be expecting in hormone replacement therapy?

The many changes you should expect to see

Changes to your Physical Appearance

The most obvious would, of course, be the physical changes that come with it. Your body will begin to go through puberty again which would involve changes like:

  • Breast development which might be painful and at times unequal.
  • Body fat redistribution as your body begins to redirect fat to your thighs and hips.
  • A decrease in muscle mass, especially in your arms which might lead to an indirect decrease in your muscle strength as well.
  • Shrinking of your testes, as they begin to atrophy due to the repression of the hormone testosterone.
  • Skin that is softer and less oily
  • Less facial and body hair

Click here to learn more about how male and female transitioning hormone therapy works.


Changes in your Sexuality 

The use of estrogen and progesterone is commonly employed to replace testosterone and seeing as they are typically sex hormones; you should expect changes to your reproductive system. While there would be an obvious reduction in your sex drive, you might also notice a decrease in the size of your testes as earlier stated. But it is not just the testes that will be affected. Your penis could also be affected, causing erectile dysfunction, but this can be countered with other oral medications like Viagra if you wish.

Your fertility could also be compromised, making it difficult to have biological children. So if this is important to you, you should consider options like getting your sperm frozen. While the effects of hormone replacement may be reversed by discontinuing using your drugs, they could also be permanent, so it’s safer not to risk it or at least have a backup plan should you change your mind in the future.

Despite undergoing hormone replacement therapy, it might still be possible to get a woman pregnant. Thus, hormone replacement therapy is not a substitute for birth control methods should you continue to be sexually active as a man, it is important to take the necessary precautions to avoid pregnancy.

Your mental health could be affected too

Of course, all these changes will occur gradually over weeks, months and at times even years. But these won’t be the only changes to expect. You might also find yourself feeling more emotional than usual as your hormonal levels begin to change. Your taste in food, clothing, and activities might also change as the therapy advances and undergoing counseling to help you cope with the changes could help.

As your body begins to take on a new form that is hopefully closer and closer to your true gender identity, the negative effects of hormone therapy cannot be ignored. Whilst you might reduce your chance of prostate cancer, your chances of breast cancer can significantly increase due to the switch in hormones, so prolonged use of feminizing hormones would require breast screening checks.

Other risks include the formation of clots in your blood (deep vein thrombosis), which might get dislodged and travel to the lungs (pulmonary embolism); Diabetes Mellitus, Weight gain and other health precautions. After carefully weighing the pros and cons of hormone replacement therapy, you can decide to go ahead.


Going through hormone replacement therapy or the more extreme gender reassignment surgery will help you align better to your true gender identity. However, the process can be a bit challenging both physically, emotionally and psychologically. Hence, it is best to go through this period of your life with as much knowledge of the subject as possible. Speak to your doctor to get further clarifications on hormone replacement therapy and how it will affect your body. If you have a friend in the process of transitioning, click here for some tips to help and support.