How Hormone Therapy Works for Transgender Individuals: Emily’s Story

How does hormone therapy work for transgender individuals?

There are many ways for a trans person to transition, from changing their name and pronouns to dressing differently. Hormone therapy is another way to help relieve gender dysphoria, which is a feeling of intense discomfort or unhappiness that your assigned sex at birth doesn’t match your gender identity.

“Just the hormones alone can cause very dramatic changes in your body and appearance,” says Jess Ting, MD, a Reconstructive Surgeon at the Mount Sinai Center for Transgender Medicine and Surgery in New York City. For example, estrogen hormone therapy may help a transgender woman develop breasts, and it may change their fat distribution. It may lead to more feminine facial features and reduced face and body hair.

The World Professional Association for Transgender Health (WPATH) says hormone therapy is medically necessary for many trans people. It can be helpful for those who don’t want or can’t afford gender affirmation surgery. Surgery can often be costly and may come with a long and challenging recovery period.

How might hormone therapy benefit mental health?

Taking hormones to suppress puberty in trans adolescents has been shown in some studies to decrease their symptoms of depression and gender dysphoria.  Studies have also shown that starting estrogen or testosterone therapy during your adolescence may improve your mental health.

WPATH recommends that you get a qualified mental health provider’s referral in order to start hormone therapy. This provider may have to show that you have lasting gender dysphoria and that you’re able to make the decision to consent to hormone therapy. You may then be prescribed hormones by a doctor, usually an endocrinologist.

“All of our patients that have gender affirmation surgery are [taking supplemental] hormones and have been for at least a couple of years prior to surgery. And our patients do stay on hormones after they have their surgeries,” explains Dr. Ting. “That's an important part of their self-care and their medical treatment, even after the surgery is completed.” 

If you are interested in hormone therapy, talk to your healthcare provider, and read more about it here.

Emily’s story

After Tressa came out as transgender and began socially transitioning, she started taking estrogen when she was 13. She had already been seeing a therapist, who diagnosed her with gender dysphoria. 

“It was so monumental for me,” she says. “I feel so much more myself, and comfortable. And it’s helped me emotionally feel more connected with myself.”

Tressa’s biggest complications on estrogen have been mood swings and hot flashes. “It took a little bit for that to even out and for me to get used to it,” she says. “That was all completely normal, and my doctor said that that was okay.”

Estrogen treatment can also come with potential side effects, including a slightly increased risk of blood clots and cardiovascular disease.

Tressa says that the side effects of her medication have been minimal for her, and she recommends hormone therapy to other trans individuals when medically appropriate. “I think it’s totally worth it,” she says. “The way that I feel now outweighs all of that completely [to me].”