What You Should Know About Hormone Replacement Therapy

Hormone replacement therapy (HRT) plays a crucial role in gender transition for many transgender and nonbinary people. It affects the mind and body in significant ways. 

In this article, we analyze some key information for those considering or starting Hormone replacement therapy (HRT).


HRT Impacts Emotions and Thinking

The first year of HRT tends to have the most intense psychological effects.

For trans women taking estrogen, many report feeling more in touch with their emotions, able to cry more easily, and more aware of others' feelings. There can be a softening of aggressiveness and frustration.

Trans men starting testosterone often experience increased irritability and aggression as testosterone builds up. There is often a strong sense of frustration and impatience during the first year.

Either way, HRT reconfigures brain chemistry and neurological patterns. The mental impact is like going through a second puberty. It can feel like completely rearranging the furniture in your mind. Confusion, disorientation, and inner chaos are common.


Physical Changes on HRT

In addition to mental impacts, HRT also brings considerable physical changes.

For trans women, these include breast growth, softer skin, decreased muscle mass, thinning of body hair, and redistribution of fat to hips/thighs.

For trans men, facial and body hair thickens, the voice deepens, muscles grow, and fat redistributes to a more masculine pattern.

These physical changes affect how one passes in their affirmed gender identity. This can bring up complex feelings around transition.


Timeline of HRT Effects

The intensity of mental and physical changes is most pronounced in the first year of HRT. This can feel like a rollercoaster.

After 12-18 months, the effects tend to stabilize. However, changes often continue long-term over years, especially physical ones. HRT results are somewhat unpredictable.

At a certain point, the bulk of the transition is complete. However new effects can still emerge years later as the body continues to transform. Patience and trust in the process are helpful.


HRT is an Exploration, Not a Commitment

Importantly, starting HRT does not have to be a permanent, lifelong commitment or identity. It can be framed as an exploration.

If HRT does not feel right after some time, it's possible to simply stop or adjust the dosage. However, there can be some irreversible effects if taken over 6 months, such as potential sterility.

Viewing HRT as a reversible experiment rather than absolute commitment can reduce the fear and pressure many feel when considering it. Give it time, pay attention, and make adjustments if needed.


An Intense But Rewarding Process

Overall, the first year of HRT and transition is often intense yet rewarding. It sets in motion deep personal transformation on mental, emotional, and physical levels.

Being open and allowing this process to unfold at its own pace appears to be helpful. With the right knowledge and support, HRT can be a profoundly beneficial step for those who need it to actualize their gender identity.


What You Should Know About Hormone Replacement Therapy: Summary

Hormone replacement therapy (HRT) is a treatment that can help transgender and nonbinary people achieve their desired gender identity. It works by changing the levels of hormones in the body, which can lead to a variety of physical and mental changes.

The first year of HRT is often the most intense, with both mental and physical changes happening rapidly. It is important to be patient and allow this process to unfold at its own pace. 

HRT can be a life-changing experience, and it is important to have the right knowledge and support in place.

Here are some key points to keep in mind if you are considering or starting HRT:

  • HRT can have a significant impact on your emotions and thinking. Be prepared for changes in your mood, sensitivity, and ability to deal with stress.
  • HRT will also cause physical changes, such as breast growth, hair loss, and voice changes. The timeline of these changes varies from person to person.
  • HRT is not a permanent commitment. If you decide that HRT is not right for you, you can stop taking it at any time. However, there may be some irreversible effects, such as sterility, if you take HRT for more than 6 months.
  • It is important to have a supportive team around you while you are going through HRT. This may include friends, family, a therapist, or a support group for transgender and nonbinary people.

HRT can be a challenging but rewarding experience. If you are considering HRT, it is important to do your research and talk to a doctor who specializes in transgender care.