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Testosterone Hormone Replacement Therapy

The benefits and results of testosterone hormone replacement therapy (HRT) for transsexuals who are undergoing the gender reassignment transition process.

Depo-testosterone Vials

Depo-testosterone vials are available by prescription in a 10mL and a 1mL size.


For the FTM interesting in transitioning, testosterone hormone replacement therapy (HRT) is commonly the first step of the physical transition process. Testosterone HRT will commence a sort of ‘male puberty’ that promotes hair growth, deepens the voice, and changes body fat distribution.
Testosterone HRT is perhaps the largest physical step between passing as male verses appearing female. In a biological female, testosterone forces the body to form a sort of red-light green-light with the hormones already present, allowing the testosterone (aka “T”) to override the dominant female hormones, which in turn allows a biological female to develop more masculine physical characteristics. Many trans men are unable to pass as men without hormones. Trans men most commonly unable to pass without testosterone because their voice gives them away.
The doctor who prescribes hormones may be a general family practitioner or an endocrinologist (hormone doctor). Doctors who follow the Standards of Care will generally require two things so that you may begin taking hormones to transition from female to male. These are:

  • Letter from therapist to begin hormones
  • Blood work and testosterone levels

Blood work will be taken more frequently just after beginning hormone therapy. It is important to monitor your testosterone and CBC results after introducing the new hormone into the body. Testosterone intake may need to be increased if it is too low, or decreased if it is too high. Testosterone can increase red blood cell count, thereby increasing the probability of side effects.
Testosterone can be given as:

  • An intramuscular injection, usually the glutes or thigh;
  • A transdermal implant placed under the skin, usually the abdomen or buttocks; or
  • An oral tablet, not recommended because of liver toxicity

In biological men, testosterone is a hormone produced by the endocrine system though the testes. It is responsible for:

  • Libido (sex drive)
  • Energy
  • Development of male secondary sex characteristics, such as body hair growth, penile growth, and deepening of the voice
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Physical Effects of Testosterone Hormone Replacement

Testosterone hormone replacement initiates the development of secondary sex characteristics.

Irreversible changes

  • Deepening of the voice
  • Facial and body hair development
  • Enlargement of the clitoris
  • Male pattern baldness

Reversible changes

  • Muscle development
  • Increased libido
  • Redistribution of body fat
  • Cessation of ovulation and menstruation
  • Increased sweat
  • Changes in body odor
  • Prominence of veins
  • Coarse skin
  • Acne
  • Elevated blood lipids (cholesterol and triglycerides)
  • Increased red blood cell count
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Psychological Effects of Testosterone Hormone Replacement

The psychological effects of testosterone hormone replacement vary by individual. In transgender FTMs often report that they are happier.There may be a significant psychological impact, but its manifestation is different for everyone.  Trans men often experience increased energy and sex drive. They may feel more confident.  However, testosterone does not change ones personality at the root.
Some trans men may experience an increase in aggression.High levels of testosterone are associated with an increase in aggression, but the effects are associated more with testosterone used as a steroid rather than for HRT. Others may experience a decrease in aggression because they are more at home in their body.

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* The information contained is not a replacement for medical advice and should not be used for medical treatment or hormone replacement therapy without the supervision of a licensed physician. femaletomale.org seeks to provide relevant information about gender reassignment, but under no circumstances should the information provided challenge or take the place of the authority of a medical professional. Disclaimer


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