Skip to content

Transgender hormone side effects

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

For over a century, these drugs 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 talk about 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 chance of these changes increases the longer you use them, especially for minors before puberty. 

Hormones and blockers can also change your sex drive. They can make you want more sex or less sex. They can make it easier or harder to have sex.

Other risks and possible side effects

While rare, some of these side effects are serious. Some of them can kill you, but that does not happen much. If you already have any of these issues, or if you are at risk for these, you should talk about hormones and hormone blockers with your healthcare provider before starting.

Hormone blockers may carry these possible risks:

  • Bone development issues
  • Cognitive development issues

If you are absolutely certain you want to transition, it is better to minimize the time you are on blockers only. Adding hormones will allow you to go through your desired puberty and reduce these risks.

Feminizing hormones carry these possible risks:

  • Blood clots
    • in a deep vein (deep vein thrombosis)
    • in a lung (pulmonary embolism)
  • Stroke
  • Higher 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 possible risks:

  • Making too many red blood cells (polycythemia)
  • Weight gain
  • Acne
  • Male-pattern baldness
  • Sleep apnea
  • Developing high cholesterol and other lipids, which can cause heart and vein problems (dyslipidemia)
  • High blood pressure (hypertension)
  • Type 2 diabetes
  • Blood clots
    • in a deep vein (deep vein thrombosis)
    • in the lungs or brain (venous/pulmonary thromboembolism)
  • Drier and thinner vaginal lining (atrophic vaginitis)
  • Pain in the clitoris
  • Pelvic pain