Healthy Lifestyle

Hormonal therapy options for transgender community

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By Meghna Shah, MD, Nuvance Health Medical Practices – endocrinology


Transgender medicine is important to understand and be familiar with. These patients are often mistreated by the healthcare community so understanding the needs and therapies available is paramount to all healthcare. I’m pleased to bring these specialized services to Nuvance Health Medical Practices, as an endocrinologist based in western Connecticut.

As an endocrine specialist, we can offer gender affirming therapy to help match gender identity to the body. Both feminization therapy and masculinization therapy exist. Here are the differences:


Feminization therapy

Feminizing hormone therapy is used to induce physical changes in your body that are caused by female hormones. If feminizing hormone therapy is started before the changes of male puberty begin, male secondary sex characteristics, such as increased body hair and changes in voice pitch, can be avoided.


During feminizing hormone therapy, medication to block the action of testosterone is given. The hormone estrogen is also given to decrease testosterone production and induce feminine secondary sex characteristics. Those include decreased facial hair and increase in breast development.


Estrogen comes in different forms including patch, tablets and injections. The changes caused by these medications can be temporary or permanent. Feminizing hormone therapy can be done alone or in combination with feminizing surgery.


Feminizing hormone therapy isn't for all transgender women, however. It can affect fertility and sexual function, increase risk of blood clots and increase cholesterol levels.


Masculinization therapy

The goal of masculinizing hormone therapy is the development of male secondary sex characteristics and suppression or minimization of female secondary sex characteristics. Masculinization effects include the development of facial hair, changes in your voice, a redistribution of facial and body subcutaneous fat, increased muscle mass, increased body hair and the end of menstruation.


The therapy used to achieve these changes is testosterone. Testosterone comes in a variety of formulations including topical gel and injections. Changes caused by these medications can be temporary or permanent and will affect fertility. Testosterone therapy can be given alone or alongside masculinizing surgery.


Side effects of testosterone therapy include elevated risk of a clot, increased risk of stroke and heart attack. 


If you or a loved one is considering one of these therapies, I recommend speaking with your doctor to weigh risks, benefits, and create the best health care plan that’s ideal for you.


Dr. Shah is an endocrinologist with Nuvance Health Medical Practices, and she is a LGBTQ+ ally. She sees patients in Wilton, Conn. You can read her bio here or request an appointment at (203) 852-2270 / TTY 1-800-842-9710.

Meghna Shah, MD