Currently, there are many individuals interested in transforming themselves to align with their gender identity, making “hormone therapy” a popular method. However, many people are unaware of how to take hormones correctly and may resort to self-prescribing, which can pose health risks. Many have heard the term “gender hormone therapy” and understand it as taking birth control pills among individuals assigned male at birth but identifying as female, to change certain physical characteristics without undergoing gender reassignment surgery.

In reality, hormone therapy can also be used by those assigned female at birth but identifying as male, to alter their physique to appear more masculine. Many transgender men, even when fully embodying a male identity mentally, may still have physical characteristics that do not reflect their gender identity. Thus, using male hormones plays a significant role in the lives of transgender men, as it helps define masculine traits and facilitates physical changes that align their appearance with their desired male identity.

Therefore, before starting hormone therapy, we will provide you with detailed information about hormone therapy, addressing common questions many have in this article.

What is Hormone Therapy?

Hormone therapy involves the administration of desired sex hormones into the body to induce physical changes aligned with one’s gender identity or desired characteristics. For transgender individuals, hormone therapy is categorized into two types:

1. Hormone Therapy for Male to Female (Feminizing Hormone Therapy): Also known as for transgender women, this therapy involves administering medications to suppress male hormones and reduce testosterone levels. It supplements female hormones, specifically estrogen, to eliminate masculine characteristics and promote changes that enhance femininity. These changes may include reducing facial hair, softening the voice, and altering facial features to appear more feminine.
2. Hormone Therapy for Female to Male (Masculinizing Hormone Therapy): Also referred to as for transgender men, this therapy involves the supplementation of male hormones, particularly androgens or testosterone. It aims to reduce or eliminate existing female hormones gradually and enhance male hormone levels instead. This process leads to physical changes associated with masculinity, such as increased body and facial hair, a deeper voice, enhanced muscle growth, and the cessation of menstruation.

Types of Hormone Therapy

Hormone therapy can be administered in various ways, depending on the suitability for each individual’s health and according to medical advice. These methods include:

1. Oral Tablets: This method involves taking hormone medication in pill form.
2. Injectable Hormones: This method acts more quickly than oral forms and has a longer duration of action, as it enters the bloodstream directly, resulting in a relatively stable hormone level in the blood.
3. Transdermal Hormone Application: This involves applying hormone medication to the skin, allowing it to absorb through the skin into the bloodstream for direct action.

Which Type of Testosterone Should You Choose?

Most doctors recommend short-acting injectable testosterone because it provides quick and noticeable physical changes, and the dosage can be easily adjusted. Generally, after using testosterone for about 3 to 6 months, changes will start to become apparent.

However, for individuals who find it inconvenient or have limitations regarding injections—such as a fear of needles or the need to travel abroad without the ability to carry injectable medications—doctors may consider prescribing other forms of testosterone. For instance, oral medications are available, but they come with drawbacks such as affecting the liver and providing slower results. Alternatively, transdermal options may also be offered based on individual suitability.

Criteria for Taking Hormones

• Age Requirement: You must be over 20 years old and first meet with two psychiatrists to assess your desire to transition to a transgender male. Sometimes, patients may not be confident about wanting to change their bodies or may simply have an attraction to women.
• For Ages 18-20: If you are 18 years old but not yet 20, you must have a guardian’s consent and also meet with two psychiatrists.
• Health Assessment: Before receiving testosterone, you must undergo a health examination to ensure your body is ready.

Changes in the Body When Taking Hormones

Once you begin hormone therapy with a doctor, you can typically expect to see results within approximately 3 to 6 months. The changes that occur are as follows:

Changes for Transgender Women (Female to Male)

• Overall physique appears smaller
• Decreased muscle mass
• Reduced body hair
• Higher-pitched voice
• Increased breast size
• Increased subcutaneous fat
• Decreased size of the penis and testicles, leading to difficulty in achieving an erection
• Reduced libido
• Less hair loss, thinning, or baldness caused by lower hormone levels

Changes for Transgender Men (Male to Female)

• Deeper voice
• Increased muscle strength
• Increased body hair
• Oily skin, with a tendency for acne
• Reduced ovulation and menstrual flow, gradually leading to the cessation of menstruation
• Potential increase in libido, with more frequent sexual arousal
• Possible issues with hair loss, thinning, or baldness due to testosterone levels

Summary of Hormone Therapy

It is not advisable to self-administer hormones due to safety concerns. Instead, it is important to receive hormones as scheduled by your doctor consistently. For those interested in hormone therapy, it is recommended to research and prepare for the changes, and to seek advice from a specialist. You can consult Dr. Suphong Engchuan, known as “Doctor Beer,” an expert in sexual health at Eternity Clinic, a comprehensive center for the care and treatment of sexual dysfunction and urological issues for both men and women. You can click to consult at a nearby branch or inquire through the clinic’s Line OA.

MD. Suebphong Angchoun

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