Feminizing GAHT Effect Overview
The effects of combined estrogen and antiandrogen hormone therapy (does not include potential effects of progesterone). Keep in mind that effect strength and onset can vary greatly between individuals, consider this table as an approximate guide only.
| Effect | Expected Onset | Expected Maximum Onset |
|---|---|---|
| Redistribution of body fat | 3–6 months | 2–5 years |
| Decrease in muscle mass and strength | 3-6 months | 1-2 years |
| Softening of skin/decreased oiliness | 3-6 months* | Unknown |
| Decreased sexual desire | 1-3 months | Unknown |
| Decreased spontaneous erections | 1-3 months | 3-6 months |
| Decreased sperm production | Unknown | 2 years |
| Breast growth | 3-6 months | 2-5 years |
| Decreased testicular volume | 3-6 months | Variable |
| Thinning and slowed growth of body and facial hair* | 6-12 months | >3 years |
| Increased scalp hair** | Variable | Variable |
| Voice changes*** | None | None |
| *Complete removal of hair requires laser treatment [1]. | ||
| **Familial scalp hair loss may occur if estrogen is stopped [1]. | ||
| ***Voice and speech therapy may be available [1]. | ||
Table adapted from Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 [2].
Permanent Effects
- Gradual increase in breast size over 2–3 years (can cause breasts to feel tender).
- It is unknown if taking estrogen can increase the risk of breast cancer, generally it is best to follow breast screening guidelines.
List adapted from Guidelines for gender affirming healthcare for gender diverse and transgender children, young people and adults in Aotearoa New Zealand [1].
Likely Reversible Effects
- Softer skin.
- Decreased muscle mass.
- Reduced body hair.
- More fat on bum, hips and thighs.
List adapted from Guidelines for gender affirming healthcare for gender diverse and transgender children, young people and adults in Aotearoa New Zealand [1].
Minor Or No Effect
- Facial hair growth slows but does not completely stop.
- Voice is unaffected, although speech therapy may be available.
- Facial bone structure and Adam's apple does not change.
List adapted from Guidelines for gender affirming healthcare for gender diverse and transgender children, young people and adults in Aotearoa New Zealand [1].
Effects On Fertility
GAHT stops the testicles producing testosterone, possibly causing them to shrink up to 50% and halt sperm production, possibly leading to infertility.
In order to combat this it is possible to preserve fertility by freezing sperm at a fertility clinic prior to starting GAHT [3].
Effect On Sexual Intercourse
GAHT can lower libido to a point were people can develop a lack of interest in sexual activity, erections may become less firm and frequent. [1].
Citations
- [1] Oliphant J, Veale J, Macdonald J, Carroll R, Johnson R, Harte M, Stephenson C, Bullock J. 2018. Guidelines for gender affirming healthcare for gender diverse and transgender children, young people and adults in Aotearoa New Zealand. researchcommonswaikatoacnz. https://hdl.handle.net/10289/12160.
- [2] Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, Ettner R, Fraser L, Goodman M, Green J, et al. 2022. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. International Journal of Transgender Health. 23(S1):S1–S259. doi:https://doi.org/10.1080/26895269.2022.2100644. https://www.tandfonline.com/doi/full/10.1080/26895269.2022.2100644.
- [3] Neblett MF, Hipp HS. 2019. Fertility Considerations in Transgender Persons. Endocrinology and Metabolism Clinics of North America. 48(2):391–402. doi:https://doi.org/10.1016/j.ecl.2019.02.003.