Transgender hormone side effects

Many trans + people and gender diverse people take hormones as part of a gender transition. You do not need to take hormones, though. It is your choice.

Many transgender and gender diverse people have incorporated hormones and hormone blockers into their gender expression and healthcare. For over a century, these chemicals have been used safely and effectively by millions of people in our community.

Because this site is based on a harm reduction model, it is important to be fully informed before choosing this option. This page lists some side effects to discuss with your healthcare provider before starting.

Sexual and reproductive function

People who plan to take hormones must think about reproductive options before they start. Hormones may change their bodies so they can not make children.

The risk of permanent infertility increases with long-term use of hormones, especially when hormone therapy is initiated in minors before puberty. 

Other risks and possible side effects

While rare, some of these side effects are serious and potentially fatal. People who have experienced any of these or are at higher risk for these should discuss hormones with their healthcare provider before starting.

Feminizing hormones carry these risks:

  • Blood clots
    • in a deep vein (deep vein thrombosis)
    • in a lung (pulmonary embolism)
  • Stroke
  • Increased risk of breast cancer
  • High triglycerides, a type of fat (lipid) in your blood
  • Weight gain
  • High potassium (hyperkalemia)
  • High blood pressure (hypertension)
  • Type 2 diabetes
  • Cardiovascular disease
  • Excessive prolactin in your blood (hyperprolactinemia)
  • Nipple discharge

Masculinizing hormones carry these risks:

  • Producing too many red blood cells (polycythemia)
  • Weight gain
  • Acne
  • Developing male-pattern baldness
  • Sleep apnea
  • Developing an abnormal level of cholesterol and other lipids, which may increase cardiovascular risk (dyslipidemia)
  • High blood pressure (hypertension)
  • Type 2 diabetes
  • Deep vein thrombosis and/or pulmonary embolism (venous thromboembolism)
  • A condition where the lining of the vagina becomes drier and thinner (atrophic vaginitis)
  • Pelvic pain
  • Clitoral discomfort