Effects of 9 Years on Hormone Replacement Therapy for Trans Women

Hormone replacement therapy (HRT) is an important part of the transition process for many transgender women. Mathilda Hogberg, a transgender YouTuber, recently made a video discussing her experiences and results after being on HRT for 9 years. 

This article summarizes and optimizes the effects of 9 years on hormone replacement therapy for transgender women. 


Starting HRT

Mathilda started HRT around age 18. Her initial regimen consisted of testosterone blockers and estrogen pills. After a year, she switched to estrogen gels, which doctors often recommend as easier for the body to absorb.

After undergoing gender confirmation surgery, she stopped taking testosterone blockers since her body was no longer naturally producing testosterone.

Many transgender women start to see subtle body changes around 3-4 months on HRT as fat redistributes to create more feminine contours. Mathilda first noticed facial changes around this time when a child commented that she looked like a girl. This affirmation gave her the confidence to fully socially transition to living as a woman.


Physical Changes on HRT

Some of the main physical effects of HRT include:

Breast Development

  • Mathilda first noticed breast bud formation and soreness around 2-3 months on HRT.
  • Significant breast growth occurred between 4-12 months.
  • Final breast development takes approximately 3 years. She got breast augmentation surgery at 1.5 years, which accelerated their growth.

Body Fat Redistribution

  • At 3-4 months, Mathilda noticed initial fat redistribution to hips/thighs and face.
  • After 1.5 years, her hips were significantly rounder and her waist narrower.

Muscle Mass & Strength Loss

  • Decreased testosterone causes loss of muscle mass and strength.
  • This gives transgender women a build and strength level more typical for cisgender women.

Body Hair Changes

  • With lower testosterone, body/facial hair gradually becomes finer and sparser.
  • Additional hair removal (laser, electrolysis) is sometimes needed to fully eliminate beard growth.
  • Mathilda has successfully used at-home IPL hair removal from KetchBeauty to remove body hair.

Voice Changes

  • HRT does not alter vocal pitch or resonance.
  • Voice training or surgery is required to feminize the voice.
  • Mathilda had voice lessons to develop a higher, more feminine voice.


Other Effects of HRT

Some other effects Mathilda reported after 9 years on HRT include:

  • Height does not change.
  • The bone structure remains the same (i.e. shoulder width).
  • Mood swings and more intense emotions due to estrogen's effects.
  • She must remain on HRT lifelong to maintain female hormone levels.



While individual responses vary, Mathilda's firsthand account provides helpful insights into the timeline and extent of feminizing changes from male to female HRT.

Under a doctor's supervision, HRT allows transgender women to develop many of the secondary sex characteristics associated with being female. This can greatly improve physical comfort and self-confidence.

The full effects unfold gradually over the years, requiring patience through the transition process.