Male to Female Transition: The Benefits and Risk of Feminizing Hormones among Transgenders

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Estrogen hormone therapy is a treatment that causes typically feminine physical traits while suppressing typically masculine ones. People undergoing estrogen hormone therapy usually receive the hormone estrogen, and other medication to reduce testosterone. This can result in the development of typically feminine secondary sexual characteristics, such as fat distribution and the development of breasts. It can also decrease the growth of facial and body hair. Other names for estrogen hormone therapy may include feminizing hormone therapy, gender-affirming hormone therapy, and cross-sex hormone therapy. People who undergo estrogen hormone therapy will receive medication to block the action of testosterone, a hormone responsible for traits that people may consider to be masculine. They will also receive estrogen, which is the hormone responsible for what people may see as typically female characteristics. There are several potential benefits and risks estrogen hormone therapy may have. The changes it causes may be temporary or permanent.

A person may undergo estrogen therapy if they have gender dysphoria. This is when a person experiences distress because their gender identity does not match the sex assigned at birth. Estrogen treatment is vital among people with gender dysphoria to alleviate emotional distress and improve their quality of life. It may also help promote the matching of a person’s gender identity and their body and allow them to experience gender congruence. Those who receive estrogen hormone therapy during adolescence (around the age of 16 years or older) may avoid the development of male secondary sexual characteristics, such as a deepening voice and the growth of body hair.

The Effects of Feminizing Hormones:

Estrogen

Estrogen is responsible for most feminine characteristics. An example of estrogen for treatment is estradiol, as it most closely resembles the estrogen that the ovaries produce. Estrogen hormone therapy is available as an injection into a muscle (intramuscular) or a pill. It is also available in transdermal form, as a patch that a person wears on their skin.

Anti-androgens

People can take anti-androgens as either injection under the skin (subcutaneous) or oral medication. Anti-androgens block the action of testosterone to reduce masculine characteristics.

What are the chances of Hormone Replacement Therapy:

Some people may consider estrogen hormone therapy a second puberty. While some changes may occur within weeks, it can take years for the full effect.

Physical changes

People using estrogen and anti-androgens as part of their hormone treatment may notice:
drier and thinner skin with smaller pores
changes in the odors of sweat and urine
a reduction in sweat production
the development of breast buds beneath the nipples that will develop into breasts as treatment progresses
a more feminine facial appearance
an increase in fat around the hips and thighs
a loss of muscle mass in the arms and legs
a reduction in strength
a reduction in body and facial hair

Sexual changes

Estrogen hormone therapy will typically change a person’s libido and genitals. Individuals may experience:

a reduction in the number, duration, and firmness of erections
shrinking of the testicles to less than half their original size
changes in orgasms
changes in arousal
changes in sexual interests and attractions

Emotional changes

During estrogen hormone therapy, a person’s emotional state may or may not change. A person is likely to experience a rollercoaster of emotions, but this will usually settle down after a while. People may experience a wider range of emotions, have different interests, or behave slightly differently.

When to start taking the hormones?

Before a person begins estrogen hormone therapy, a doctor will evaluate their health. They may:

take a complete medical and family history
perform a physical examination
order blood tests
request relevant age- and sex-related screenings

Doctors will also inform the person about the potential risks of the treatment and discuss contraception and future fertility, including the freezing of sperm. Some people may also undergo a mental health evaluation that explores their mental health, gender dysphoria, and use of alcohol and drugs. People under 18 years of age may also need to see doctors with expertise in pediatric transgender health. Some individuals may wish to further prepare by seeing a mental health professional before beginning treatment to explore their goals and expectations of hormone therapy, as well as its side effects and challenges and ways to deal with them.

Precautions before undergoing Hormone Replacement Therapy:

However, estrogen hormone therapy may not be suitable for everyone. Some people may experience potential complications or difficulties in receiving treatment. This may include those who:

are under 16 years of age
smoking
have serious mental health issues that require treatment
have or have had hormone-sensitive cancer, such as breast cancer, prostate cancer, or pituitary cancer
have a thromboembolic condition, such as deep vein thrombosis

People with gender dysphoria who undergo this treatment may experience an improvement in mood and quality of life. However, the treatment carries a number of risks, including a loss of fertility and an increased likelihood of blood clots and high blood pressure. It is very essential to visit your healthcare provider before taking such medications to avoid such unwanted effects and future complications.

Written by: Dude Arnel Flores Lopez, BSN, RN 15 June 2021

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