I’m trans, and I want to use hormones. Are there any risks?

Yes, there are some risks. If you work with a physician, then you can minimize the risks. Do not believe everything you read on websites about hormones. The most accurate information can be gathered by talking to a trans-friendly health professional. The Gay and Lesbian Medical Association (GLMA) can help you find one. We recommend that you consider hormones when you can legally do so—that is, when you are 18 or with a parent’s permission if you are under 18. Some Planned Parenthoods also offer hormone replacement therapy, and for some teens, their pediatrician or family doctor might be willing to help.

Some transgender people decide to use hormones, or younger trans people might use puberty blockers to prevent them from going through puberty for the sex they were assigned at birth, to have their bodies more closely match their gender identities. Having supportive adults you can trust in your life definitely can make these decisions and accessing care much easier. Others choose not to take hormones and instead might change their name, pronouns, hairstyle and/or  clothing to express the gender they feel inside. Still others decide that a combination of these options will help them achieve the body that most closely matches how they feel inside. While many trans people are interested in hormones, surgery or both, they may not be able to access them for a variety of reasons.

People have to make the best choices for themselves, so it’s important to get good, accurate information. It is also useful to identify people in your life you can talk to. A trusted, supportive adult who cares about you—like a parent or guardian, family member, close adult friend, clergy person, counselor or medical provider—can be a great help in thinking things through.

Hormones cause big changes in a person’s body, so it’s important to know all of the facts.

Testosterone

People who were assigned the female sex at birth may choose to take testosterone to make their physical appearance look more “masculine.” Testosterone will cause some sex characteristics typical of males. Changes can include the following:

• A deeper voice
• Redistribution of fat and muscle tissue
• Growth of hair on the body and face
• Changes in skin texture
• Growth of the clitoris
• Acne
• Baldness, even for younger people
• Interruption of period
• Increased sex drive

Estrogen

People who were assigned the male sex at birth may choose to take estrogen to make their physical appearances look more “feminine.” Estrogen will cause some sex characteristics typical of females. These can include the following:

• Redistribution of fat and muscle tissue
• Widening hips
• Changes in skin texture
• Development of some breast tissue
• Decreased ability to achieve an erection
• Decreased testicle size
• Decreased sperm production
• Decreased sex drive

Estrogen will not raise your voice or shrink your Adam’s apple.

Because hormones are powerful drugs, they have to be prescribed by a physician. A family physician or endocrinologist may assist with preliminary exams and tests to make sure hormones will be safe for you to use. Again, having a trusted, supportive adult or adults help you figure out the medical system can be very important.

There are some things that hormones will not change. Estrogen will not make a person’s penis or facial hair disappear. Testosterone will not make someone’s breasts disappear. Testosterone won’t cause a person to grow testicles or produce sperm. Estrogen won’t cause a person to grow a uterus or ovaries or produce eggs. If you have any questions or worries about what hormones may do to your body, be sure to ask.

Some of these changes are permanent. This means that even if the person stops taking hormones, some of the changes that they caused may not ever go away. It’s important to think about this while deciding about hormones. Also, some side effects may be mild, while others might be life- threatening.

Some people may think about buying hormones on the street, sharing a friend’s hormones or using other drugs or substances not from a doctor to try to make their bodies change. This can be very dangerous. Using other substances or using more hormones than are prescribed can be deadly. Using a higher dose than your doctor prescribes will not make your body change any faster. Using too much can actually work against the changes you are waiting for and be bad for your health.

It is also important to use clean needles with injectable hormones since HIV and other viruses can be transmitted with shared needles.

Bottom line: Only hormones and treatments prescribed by a doctor and filled by a pharmacist can help your body more closely match your gender identity while balancing the potential risks.

Find a trans-friendly health care professional near you.