Hormone replacement therapy (HRT) for individuals transitioning from female to male (FTM) primarily involves testosterone administration. The goal of this therapy is to induce masculinizing changes that align the individual’s physical appearance with their gender identity.

Here’s an overview of what FTM HRT typically involves and what can be expected:

  1. Types of Testosterone Administration:
    • Injections: Testosterone cypionate or enanthate are the most common forms used for intramuscular injections. The frequency of injections can range from weekly to bi-weekly or even every ten days, depending on the dose and individual response.
    • Gels and Patches: These are applied daily and provide a consistent release of testosterone. Brands include AndroGel, Testim, and Androderm (patch).
    • Pellets: Testosterone pellets can be implanted under the skin and provide a slow release over several months.
    • Oral Tablets: Less common due to concerns about liver toxicity with some formulations.
  2. Physical Changes:
    • Voice Deepening: One of the first and most noticeable changes. The voice starts to deepen and can continue to change for several months to years.
    • Facial/Body Hair Growth: Increased hair growth on the face, chest, abdomen, back, and legs. The extent and pattern of growth vary among individuals.
    • Body Fat Redistribution: Fat tends to redistribute from the hips, thighs, and buttocks to the abdomen area.
    • Muscle Development: Increased muscle mass and changes in muscle distribution, especially with exercise.
    • Menstrual Cessation: Periods usually stop within six months of starting testosterone. However, if they continue, it’s essential to consult a healthcare provider.
    • Clitoral Enlargement: The clitoris can grow in size, often becoming more sensitive.
    • Skin Changes: The skin can become oilier, leading to acne in some individuals.
    • Hairline Changes: Some individuals might experience male-pattern baldness or hair thinning.
    • Vaginal Atrophy: The vaginal tissues might become thinner and drier.
  3. Emotional and Mental Changes:
    • Some individuals report changes in their emotions, such as feeling more assertive or experiencing mood swings. These changes are individual and might not be experienced by everyone.
  4. Risks and Considerations:
    • As with any medical intervention, there are potential risks, including polycythemia (an increase in red blood cells), liver strain, cardiovascular issues, and changes in cholesterol levels.
    • Regular medical check-ups, including blood tests, are essential to monitor health and adjust dosages as necessary.
  5. Fertility:
    • Testosterone therapy can reduce fertility, but it’s not a guaranteed or permanent method of contraception. Individuals wishing to have biological children in the future should discuss fertility preservation options with a healthcare provider before starting HRT.
  6. Duration:
    • Most physical changes start within the first few months and can continue to develop for several years. The duration and extent of changes vary among individuals.
  7. Legal and Social Considerations:
    • In conjunction with medical transition, individuals might choose to change their legal name and gender markers on identification documents.
    • Navigating social transitions, including disclosure at workplaces or schools, is an individual journey, and many find support groups or therapists helpful during this time.

As with any medical decision, it’s crucial to work closely with a knowledgeable healthcare provider to ensure that HRT is safe and effective. They can provide guidance, monitor health, and adjust treatment as necessary.