Transgender hormones: men and transmasculine

Many transgender people take hormones as part of a gender transition. Trans people must think about their reproductive options before they start hormones. Hormones can change their bodies so they can’t ever make children.

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.

Below is a suggested hormone regimen for transgender men (aka female to male, FTM) and transmasculine people.

Androgen (testosterone)

Oral option:

  • Testosterone undecanoate*     160–240mg/day

Injected option:(aka parenterally, i.m., intramuscular, or subcutaneous)

  • Testosterone enanthate or cypionate     50–200mg/week or 100–200mg/2 weeks
  • Testosterone undecanoate     1000 mg/12 weeks

Transdermal option:

  • Testosterone 1% gel     2.5 – 10 g/day
  • Testosterone patch      2.5 – 7.5 mg/day 

*Not available in the USA.

Monitoring for transgender men (FTM) on hormone therapy:

  • Monitor for virilizing and adverse effects every 3 months for first year and then every 6 – 12 months.
  • Monitor serum testosterone at follow-up visits with a practical target in the male range (300 – 1000 ng/dl). Peak levels for patients taking parenteral testosterone can be measured 24 – 48 h after injection. Trough levels can be measured immediately before injection.
  • Monitor hematocrit and lipid profile before starting hormones and at follow-up visits.
  • Bone mineral density (BMD) screening before starting hormones for patients at risk for osteo- porosis. Otherwise, screening can start at age 60 or earlier if sex hormone levels are consistently low.
  • FTM patients with cervixes or breasts should be screened appropriately.

Source: Progress on the road to better medical care for transgender patients.