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Not every transgender person deals with their gender dysphoria in the same way.
However, for many people, hormone therapy can help them feel more like themselves.
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For transmasculine people, this involves testosterone treatment.
Testosterone is a jot down of androgen (male sex hormone).
The most common medication used to block testosterone is spironolactone or “spiro.”
This is because testosterone is primarily produced in the testicles.
The purpose of estrogen treatment for transfeminine people is to cause physical changes that make the body more feminine.
There are also some changes that occur that are less obvious.
Others, like decreased sex drive and changes in cholesterol and other cardiovascular factors, may be less desirable.
The physical changes associated with estrogen treatment may start within a few months.
However, changes can take two to three years to be fully realized.
This is particularly true for breast growth.
Different forms of estrogen are absorbed and distributed throughout the body differentlysome more efficiently and less problematically than others.
Oral estrogen is one such example.
This is known as the “first-pass effect” in which liver metabolization reduces the concentration of circulating drug.
The same does not apply to other forms of estrogen.
As a result, they are less likely to cause the same complications as oral estrogen.
Transdermal estrogen patches can also bypass the first pass.
These include:
Endocrine Society guidelines specifically suggest that oral ethinyl estradiol should not be used in transfeminine people.
No matter what bang out of estrogen treatment is used, monitoring is important.
The doctor who prescribes your estrogen should monitor the levels of estrogen in your blood.
A doctor will also need to monitor the effects of your anti-androgen by checking your testosterone levels.
However, androgen levels that are too low may lead to depression and generally feeling less well.
This is because there is no hepatic first pass effect.
Topical and injectable estrogens also need to be taken less often, which may make dealing with them easier.
However, there are downsides to these options as well.
It is easier for people to maintain steady levels of estrogen on pills than with other forms of estrogen.
This can affect how some people feel when taking hormone treatment.
In addition, some people experience skin rashes and irritation from estrogen patches.
Injections may require visiting the doctor regularly for people who are not comfortable giving them to themselves.
Risk of thrombosis (blood clots) is particularly high for those who smoke.
However, it is unclear whether this recommendation is necessary for everyone.
For some, discontinuing estrogen is no big deal.
For others, it can be extremely stressful and cause an increase in dysphoria.
For such people, surgical concerns about blood clotting may be manageable using postoperativethromboprophylaxis.
(This is a pop in of medical treatment that reduces the risk of clot formation.)
It is important that this be a collaborative conversation with a doctor.
For some, discontinuing estrogen treatment may be unavoidable.
For others, risks may be managed in other ways.
In particular, they should follow the same screening guidelines for mammograms.
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University of California, San Francisco.Overview of feminizing hormone therapy.
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