The Effects of Hormone Replacement Therapy for Transgender Individuals

Hormone replacement therapy (HRT) is an important part of the transition process for many transgender individuals. HRT involves taking hormones of the gender one is transitioning to, in order to develop the secondary sex characteristics of that gender.

This allows transgender individuals to align their physical appearance with their gender identity. HRT results in both physical and emotional changes.

In this article, we take a look at the effects of hormone replacement therapy for transgender individuals.


When Changes Start Happening

For transgender women transitioning from male to female, HRT consists of taking estrogen and testosterone blockers. Changes from HRT start becoming noticeable around 3 months.

One of the first changes is that muscle mass starts decreasing while body fat increases, especially around the hips and face resulting in a more feminine shape.

Breast growth also starts around 3 months. The redistribution of fat and breast growth continues for 2-3 years.


Other Physical Changes

A few other physical changes that occur on HRT for transgender women:

  • Skin becomes softer and smoother
  • Body hair decreases
  • The face takes on a more rounded, feminine shape
  • Reduced libido and erectile function

Around 6 months, transgender women experience PMS symptoms like mood swings and irritability. Menstruation does not occur.

The voice does not get higher with HRT, so voice training is required. Any height changes also do not occur from HRT if male puberty has already been experienced.


Emotional Changes

In addition to the physical changes, HRT causes emotional changes as estrogen increases emotional sensitivity.

Transgender women describe crying more easily and having more intense emotions on estrogen. Moods fluctuate more.


Importance of Maintaining HRT

It is vital for transgender individuals to maintain a consistent hormone regimen. Stopping HRT abruptly can cause intense menopausal symptoms along with a return of dysphoria.

Doctors emphasize the importance of monitoring hormone levels and never abruptly stopping HRT.



HRT enables transgender individuals to align their bodies with their gender identity for a happier life. While the process takes time, the emotional and physical changes from feminizing HRT allow transgender women to live authentically.

Maintaining treatment is essential. HRT dramatically improves mental health and quality of life.