Medication
Read our disclaimer regarding medical advice.
Table of contents
If you are unable to find a doctor, DIY HRT is a widely trusted source of information regarding HRT regimens.
Feminizing Hormones
A feminizing hormone regimen is typically made up of two parts, a testosterone blocker and an estrogen supplement. Typically most results will be achieved within three years, though many report experiencing changes for a longer period of time. Common results include the thinning (though not the total removal) of facial and body hair, breast growth, and fat redistribution on the face and body. Hormones do not affect voice.
Estrogen Regimen
Estrogen is normally taken in one of the following forms:
- Pills - Taken either orally or sublingually - meaning it dissolves beneath the tongue or in the cheek. There is some evidence that suggests that some, but not all, oral forms of estrogen at high doses increase cardiovascular risk (source). If you are unable to find a doctor experienced in trans healthcare, ensure you and your doctor are educated on this risk.
- Patches - Placed on the skin and changed occasionally.
- Gel - A usually alcohol based solution of estrogen, applied to the skin daily. Hands must be washed after application and care taken not to transfer any of the gel to others.
- Injections - Administered through intramuscular injection - typically either weekly or fortnightly. Common in the United States and Canada, but rarely prescribed in the United Kingdom and Australia.
- Implants - A crytaline pellet is surgically implanted by a doctor. Pellets typically last between 6-24 months (likely on the lower end) and may require a second dose if your body is not responding appropriately. Pellets are not currently available on the commercial market by any manufacturer, meaning they must be sourced from a compounding pharmacy.
Testosterone Blockers
Common testosterone blockers include:
- Cyproterone - An extremely common androgen blocker prescribed in Australia and elsewhere. Not widely available in the United States due to FDA restrictions.
- Spironolactone - Another common blocker, popular in the US. Spiro is a diuretic, so it can result in a lot of bathroom visits.
Progesterone
Progesterone is an optional part of a feminizing hormone regimen, often described as assisting with breast growth and increasing sex drive.
Masculinizing Hormones
Unlike feminizing hormones, testosterone is not generally combined with any form of estrogen blocker. Most results are typically achieved within 3-5 years. Common results include greater muscle mass, redistribution of fat on the face and body, the development of masculine facial hair and increase in body hair generally, as well as the deepening of the voice. Breast size may reduce, but is unlikely to disappear.
Testosterone Regimen
Testosterone is normally taken in one of the following forms:
- Injections - Administered through intramuscular injection - typically by a doctor every three months or fortnightly.
- Gel - A usually alcohol based solution of testosterone, applied to the skin daily. Hands must be washed after application and care taken not to transfer any of the gel to others.
- Implants - A crytaline pellet is surgically implanted by a doctor. Pellets typically last several months. Pellets are not currently available on the commercial market by any manufacturer, meaning they must be sourced from a compounding pharmacy.
Under 18
Access to medical transition varies widely between countries and localities, minors should research the laws of their area and find an advocate if possible. A commonly available form of transition available to minors is puberty blockers.
TransHub/Puberty Blockers - Australia Specific Advice
MedPageToday - A list (from August 2024) detailing US state regulations