Hormone replacement therapy (male-to-female) – Susan’s Place …

Editor's Note: While discussion of hormone replacement therapy (HRT) and its medications is permitted, discussing the means to acquire them without a prescription, and self medication without a doctors care is prohibited. We cannot in good conscience condone the self administering of these medications. Not only may self medication be illegal there can also be serious health consequences resulting from the taking of these medicines. See a qualified medical professional before taking any prescription drugs.

Hormone replacement therapy (HRT) for transgender and transsexual people replaces the hormones naturally occurring in their bodies with those of the other sex. Some intersex people also receive HRT, either starting in childhood to confirm the gender they were assigned, or later, if this assignment has proven to be incorrect. Some cisgendered men may use HRT to have a hair-free body, as a result of less testosterone in their body.

Its purpose is to cause the development of the secondary sex characteristics of the desired gender. It can not undo the changes produced by the first natural occurring puberty, which necessitates sexual reassignment surgery and epilation by either electrolysis and/or laser hair removal. This is due to being easier to produce secondary male sexual characteristics with androgens than it is to rid trans women of established characteristics.

While some argue that hormonal therapy does not truly masculinize or feminize, the question is one of definitions. If by masculinize and feminize one means to completely reproduce the male or female biological state, that cannot be done with current medical or surgical therapy. However, the goal of HRT, and indeed all somatic treatments, is to provide patients with a more satisfying body that is more congruent with their true psychological gender identity.

The requirements for hormone replacement therapy vary immensely by country to country and often state by state. In the past, the Standards of Care for Gender Identity Disorders demanded a certain amount of psychological counseling or a similar amount of time in so-called Real life experience (RLE). While the SOC recommended 3 months, often practitioners would extend or sometimes shorten the time demanded from the client. While there is good faith in the guidelines to reduce the chances of the patient regretting their transition, many trans people see them as a way to limit their autonomy which is where so-called informed consent guidelines have sprung up from.

In these circumstances, the individual may self-administer hormone therapy until they can get these authorizations, feeling that they shouldn't have to wait for a medical professional to be convinced of their situation. In addition, as many individuals must pay for evaluation and care out-of-pocket, expense can also be prohibitive to pursuing such therapy. In addition, some individuals choose to self-administer their medication ("do-it-yourself"), because available doctors either have too little experience in this matter, or refuse to accept him or her as a patient.

Because of the dangers in self-administration of hormones, individuals seeking physicians who are knowledgeable and willing to treat transgender patients may wish to consult local transgender support groups. Many of them maintain lists of LGBT-friendly doctors and other services such as legal aid. In the United States the Gay and Lesbian Medical Association maintains a referral service.

A number of skeletal and cartilaginous changes take place after the onset of puberty at various rates and times. Sometime in the late teen years epiphyseal clusure (in other words, the ends of bones are fused closed) takes place and the length of bones is fixed for life. Consequently total height and the length of arms, legs, hands, and feet are not affected by HRT. However, details of bone shape change throughout life, bones becoming heavier and more deeply sculptured under the influence of testosterone. Many of these differences are described in the Desmond Morris book Manwatching.

Facial changes develop gradually over time, and sexual dimorphism (physical difference between the sexes) tends to increase with age. Within a population of similar body size and ethnicity:

For trans women, taking estrogens causes among other changes:

For male-to-female transgendered people, HRT often includes antiandrogens in addition to the estrogens and progestagens mentioned above.

HRT does not usually cause facial hair growth to be impeded; or the voice to change.

The psychological changes are harder to define, since HRT is usually the first physical action that takes place when transitioning. This fact alone has a significant psychological impact, which is hard to distinguish from hormonally induced changes. Many also report feeling more confident.

Main article: Antiandrogen

*Some information provided in whole or in part by http://en.wikipedia.org/

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