Healthcare for transgender people used to use a “one size fits all” model. Now that better healthcare models are in place, your gender diverse identity and expression can be reflected in your medical options.
In the case of hormones, talk to your healthcare provider about your goals. You can start and stop hormones if you want to try them for a while. Some people try them for a few weeks or a few months to see how they feel. You can stop and restart anytime, but it’s a good idea to do it under a doctor’s care.
Some healthcare providers are not as familiar with sex and gender diversity as they should be. It may be easier to get hormones if you tell them you are transgender.
Many trans+ and gender+ people take hormones as part of their gender expression. You must think about you reproductive options before you start hormones. Hormones may change your body so you can not make children. It is important to know the other possible risks and side effects before starting.
Androgen reduction and blocking
Androgens are hormones that make the body more masculine. Some people take drugs to stop this. Androgen blockers have several names:
- androgen antagonists
- testosterone blockers
Human bodies produce a number of androgens. These cause masculinizing effects. The two key androgens are testosterone and DHT.
- androstenedione (A4)
- androstenediol (A5)
- dehydroepiandrosterone (DHEA)
- dihydrotestosterone (DHT)
Some people want to reduce androgens in their bodies for any number of reasons:
- reduce or prevent certain health issues
- precocious puberty
- some cancers
- some tumors
- adrenal gland function
- high cholesterol
- high blood pressure
- heart disease
- reduce or prevent masculine physical traits
- scalp hair loss
- facial hair growth
- body hair growth
- oily skin
- changes to hair and nails
- vocal deepening
- skeletal development
- pubertal development
- muscle mass increase
- body fat decrease
- change body odor
- reduce or prevent increase in sex drive
- unwanted spontaneous arousal
- unwanted sexual thoughts
- unwanted sexual behaviors
Estrogen reduction and blocking
Estrogen is a hormone that makes the body more feminine. Some people take drugs to stop this. Estrogen blockers have several technical names:
- estrogen antagonists
Some people want to reduce estrogens in their bodies for any number of reasons:
- delay or prevent precocious puberty
- reduce or prevent feminine physical traits
- fat redistribution to lower body
- fat redistribution in face
- body fat percentage
- hip widening
- breast growth
- brittle nails
- skin thinning and drying
- hair drying and breakage
Progesterone reduction and blocking
Progesterone is a hormone that makes the body more feminine. Some people take drugs to stop this. Progesterone blockers have several technical names:
- progesterone antagonists
Some people want to reduce progesterone in their bodies for any number of reasons:
- emergency contraceptives
- treatment of uterine fibroids
- treatment of some breast cancers
Adding hormones without blocking
Some gender diverse people do not want to block the hormones their bodies make. In some cases they add other hormones to look more masculine or feminine.
Where to get hormones
This information is for adults. For younger people, see how to get hormones as a minor.
From your doctor
- Most people get hormones from their healthcare provider. Tell them you want to start hormones. They will probably give you a physical exam that includes blood tests. In some cases, they may ask you to take other steps before prescribing them, like speak with a therapist.
From a clinic
- Many larger cities have clinics that serve our community. See the resources section for options near you.
- Planned Parenthood offers hormones and has locations throughout the US: (plannedparenthood.org/health-center)
Online (less recommended)
- Some people order hormones online from foreign pharmacies.
- This can be an option for those who do not want others to know about hormone use.
- Buying and importing prescription drugs without a prescription is probably against the law where you live.
- Because it is against the law, you might lose the money you paid:
- No delivery sent
- Fake drugs sent
- Drugs seized by police at the border
- Some people order hormones online from foreign pharmacies. This can be an option for those who do not want others to know, but there are a number of risks:
- Scams that don’t deliver
- Fake drugs
- Products seized by customs officials
- If you want to use this option, here is how to order hormones online.
From someone you know (not recommended)
- This used to be common, but there are cheaper and safer ways now. If you do not have insurance or can’t afford going to the doctor, it’s better to go to a clinic.
UCSF Transgender Care (transcare.ucsf.edu)
Gardner IH, Safer JD (2013). Progress on the road to better medical care for transgender patients. Current Opinion in Endocrinology, Diabetes and Obesity. 2013 Dec;20(6):553-8.https://doi.org/10.1097/01.med.0000436188.95351.4d