Embarking on Your Journey: A Guide to Masculinizing Hormone Therapy for Trans and Nonbinary Individuals

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A warm welcome to all our transgender and gender-nonconforming readers who are considering or curious about masculinizing hormone therapy. This blog post is written with you in mind, focusing on the unique needs and concerns of those in the early stages of transition or still questioning their gender identity.

Masculinizing hormone therapy plays a significant role in the transition process for many transgender and gender-nonconforming individuals. The primary goal of hormone therapy is to help align one’s physical appearance with their gender identity, which can have a profound impact on mental health and well-being (Deutsch, 2016). However, the decision to begin hormone therapy can be complex, and it’s essential to gather accurate information to make an informed choice.

Our goal is to provide you with reliable information about masculinizing hormone therapy, addressing common apprehensions and debunking myths that may cause unnecessary worry. We will offer an overview of the process, discuss potential risks, and share the hopeful possibilities that hormone therapy can bring to your journey of self-discovery and affirmation. By the end of this blog post, we hope to empower you with the knowledge and resources you need to make the best decision for your unique journey (Deutsch, 2016; Ziegler, 2021).

Addressing Apprehension and Dispelling Myths

Common fears about starting HRT

  1. Hormone therapy is irreversible: One of the most common fears about starting hormone therapy is that the changes it brings are irreversible (Ziegler, 2021).
  2. Health risks are too high: Some individuals may worry about the potential health risks associated with hormone therapy (Ziegler, 2021).
  3. Hormone therapy will change one’s identity: Another concern is that hormone therapy may fundamentally alter one’s sense of self or identity (Ziegler, 2021).

Debunking myths

  1. The gradual nature of HRT: In reality, many of the changes brought about by hormone therapy occur gradually, giving individuals time to adjust and make decisions about their treatment (Deutsch, 2016).
  2. Managing health risks with medical supervision: With proper medical supervision and regular check-ups, most health risks associated with hormone therapy can be managed, making it a safe option for many people (Hembree et al., 2017).
  3. Hormone therapy as a tool for self-expression: Rather than changing one’s identity, hormone therapy can serve as a powerful tool to help individuals express and align with their authentic selves (Deutsch, 2016).

Overview of Masculinizing Hormone Therapy

What is masculinizing hormone therapy?

Masculinizing hormone therapy is a medical intervention designed to help transgender men and gender-nonconforming individuals (often AFAB) achieve a physical appearance that aligns more closely with their gender identity. By administering testosterone, the primary male sex hormone, masculinizing hormone therapy promotes the development of male secondary sexual characteristics and helps to suppress female characteristics (Mayo Clinic, n.d.).

The role of testosterone

The role of testosterone in masculinizing hormone therapy is vital, as it is responsible for driving the physical changes that occur during the treatment. These changes can include:

  1. Body hair growth: Testosterone stimulates the growth of facial and body hair, such as chest hair and hair on the abdomen, arms, and legs (Mayo Clinic, n.d.).
  2. Voice deepening: Testosterone affects the vocal cords, causing them to thicken and resulting in a deeper voice (Mayo Clinic, n.d.).
  3. Muscle development: Testosterone promotes an increase in muscle mass and strength, leading to a more masculine body shape and contour (Mayo Clinic, n.d.).
  4. Clitoral enlargement: Testosterone can cause the clitoris to enlarge, which is a permanent change (Mayo Clinic, n.d.).
  5. Menstrual cessation: The administration of testosterone can lead to the cessation of menstruation in most individuals, usually within several months of starting therapy (Mayo Clinic, n.d.).
  6. Redistribution of body fat: Testosterone influences the distribution of body fat, which may shift from a typically female pattern (such as in the hips and thighs) to a more male pattern (such as around the waist) (Mayo Clinic, n.d.).
  7. Skin changes: Testosterone can cause the skin to become thicker and more oily, which may result in acne (Mayo Clinic, n.d.).

It is essential to note that the effects of masculinizing hormone therapy can vary from person to person, and not all individuals will experience the same changes or to the same degree. The timeline for these changes can also vary, with some effects appearing within a few months and others taking several years to fully manifest (Mayo Clinic, n.d.).

Different methods of administration

  1. Injections: Testosterone can be administered through intramuscular or subcutaneous injections, which are typically given every one to two weeks (PHSA Trans Care BC, n.d.).
  2. Gels: Topical gels are applied daily to the skin, allowing for a steady release of testosterone (Mayo Clinic, n.d.).
  3. Patches: Transdermal patches are another option, which are applied to the skin and replaced every one to two days (Mayo Clinic, n.d.).

How to start hormone therapy

  1. Consultation with a healthcare provider: Individuals interested in hormone therapy should first consult with a qualified healthcare provider to discuss their options and assess their overall health. The healthcare provider will typically ask about medical history, conduct a physical examination, and may order blood tests to ensure that hormone therapy is a safe and appropriate option for the individual (Deutsch, 2016; Mayo Clinic, n.d.).
  2. Informed consent process: Before beginning hormone therapy, individuals will go through an informed consent process. This process ensures that they understand the potential benefits, risks, and limitations of hormone therapy and can make an informed decision about whether to proceed. The healthcare provider will provide detailed information about the treatment and answer any questions the individual may have (Deutsch, 2016).
  3. Monitoring and adjusting dosage: Once hormone therapy is initiated, individuals will work closely with their healthcare provider to monitor their progress and adjust the dosage as needed. Regular follow-up appointments and blood tests will be necessary to track the effects of hormone therapy on the individual’s body and health. The healthcare provider will make adjustments to the treatment plan as needed to optimize the therapeutic effects while minimizing any potential side effects or risks (Deutsch, 2016; Hembree et al., 2017).

Risks and Side Effects

Potential side effects

  1. Acne: One potential side effect of masculinizing hormone therapy is the development of acne, which can be attributed to increased oil production in the skin (Mayo Clinic, n.d.).
  2. Changes in mood: Some individuals may experience mood changes, including increased irritability or emotional fluctuations, while undergoing hormone therapy (Mayo Clinic, n.d.).
  3. Increased red blood cell count: Testosterone can cause an increase in red blood cell count, which may increase the risk of blood clots or other health issues if left unmanaged (Hembree et al., 2017).

Managing risks

  1. Regular check-ups: To minimize potential risks and monitor side effects, it is essential to attend regular check-ups with a healthcare provider (Deutsch, 2016).
  2. Blood tests: Blood tests help monitor hormone levels, liver function, and other indicators of health throughout hormone therapy (Deutsch, 2016; Hembree et al., 2017).
  3. Open communication with healthcare providers: Maintaining open communication with healthcare providers is crucial for addressing concerns, managing side effects, and ensuring the best possible outcomes from hormone therapy (Deutsch, 2016).

The Impact of Masculinizing Hormones: What to Expect

Physical changes

  1. Body hair growth: Increased body hair growth, including facial hair, is a common result of masculinizing hormone therapy (Mayo Clinic, n.d.).
  2. Deepening of the voice: The voice often deepens as a result of testosterone-induced changes to the vocal cords (Mayo Clinic, n.d.).
  3. Redistribution of body fat: Hormone therapy can lead to a redistribution of body fat, resulting in a more masculine body shape (Mayo Clinic, n.d.).

Emotional changes

  1. Improved self-confidence: As physical appearance begins to align more closely with gender identity, many individuals experience improved self-confidence and overall well-being (Deutsch, 2016).
  2. Alignment of body and identity: Masculinizing hormone therapy can help individuals feel more comfortable in their bodies, promoting a greater sense of alignment between their physical selves and their gender identity (Deutsch, 2016).

Social changes

  1. Navigating relationships: Hormone therapy and the accompanying physical and emotional changes can have a significant impact on one’s relationships. It is essential to communicate openly and honestly with friends, family, and romantic partners about the transition process and the potential changes they may observe. Some relationships may evolve or shift as individuals grow into their authentic selves, and it’s crucial to maintain patience and understanding throughout this process (Deutsch, 2016).
  2. Building a supportive community: As individuals undergo hormone therapy and transition, building a supportive community becomes increasingly important. This community can consist of healthcare providers, therapists, support groups, and other transgender or gender-nonconforming individuals who can offer understanding, empathy, and shared experiences. Connecting with others who have navigated similar paths can provide invaluable guidance, encouragement, and camaraderie during the transition journey. Additionally, social media platforms and online forums can be helpful resources to connect with others in the transgender and gender-nonconforming community, providing a sense of belonging and support (Deutsch, 2016).


As we conclude this blog post, we want to emphasize the importance of informed decision-making when it comes to masculinizing hormone therapy. Gathering accurate information, consulting with healthcare providers, and considering both the benefits and risks of hormone therapy are crucial steps in making the best decision for your unique journey.

We hope that the information provided in this post has been helpful and encouraging for those considering masculinizing hormone therapy. Remember that transitioning is a deeply personal and individual experience, and there is no “one size fits all” approach. Trust in your journey, and know that with the right support and resources, you can achieve a greater sense of alignment with your authentic self.

For additional information and support, we encourage you to explore the resources provided in the reference list. Furthermore, if you are seeking psychotherapy, or guidance during the decision-making process, or require an assessment, please feel free to reach out to me. I am here to support you throughout your transition journey and help you navigate the various stages and challenges you may face. Remember, you are not alone in this journey, and there are many professionals and community members ready to offer their support and expertise.


Deutsch, M. B. (Ed.). (2016). Guidelines for the primary and gender-affirming care of transgender and gender nonbinary people. Center of Excellence for Transgender Health, University of California, San Francisco. https://transcare.ucsf.edu/guidelines/masculinizing-therapy

Hembree, W. C., Cohen-Kettenis, P. T., Gooren, L., Hannema, S. E., Meyer, W. J., Murad, M. H., … & T’Sjoen, G. G. (2017). Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 102(11), 3869-3903. https://doi.org/10.1210/jc.2017-01658

Mayo Clinic. (n.d.). Masculinizing hormone therapy. https://www.mayoclinic.org/tests-procedures/masculinizing-hormone-therapy/about/pac-20385099

PHSA Trans Care BC. (n.d.). Testosterone hormone therapy. Provincial Health Services Authority. http://www.phsa.ca/transcarebc/hormones/testosterone

World Professional Association for Transgender Health. (2011). Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People (Version 8). WPATH. https://www.wpath.org/soc8

Ziegler, S. (2021, August 30). The 3 biggest lies of starting masculinizing HRT. Dr. Z PhD. https://drzphd.com/trans-masculine-blog/the-3-biggest-lies-of-starting-masculinizing-hrt-dx3wf

Disclaimer: This blog shares general information only, not professional advice or recommendations. Consult healthcare providers for personal guidance. Decisions based on content are the reader's responsibility. Thank you.

Clayre runs a group practice of three queer and trans therapists, including youth therapist Audrey Wolfe, RCC, LGBT therapist Camber Giberson, RCC, CCC, and gender-affirming therapist Clayre Sessoms, RP, RCT, RCC, CCC, ATR-P. Work with us: book a session.

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