Many of the effects of hormone therapy are reversible if you stop taking them. The degree to which they can be reversed depends on how long they have been in the body. The degree to which they can be reversed depends on how long it has been taking them. Some of the breast growth and, possibly, the decline or absence of fertility are not reversible. Some of the physical changes caused by feminizing hormone therapy can be reversed if you stop taking it.
Others, such as breast development, cannot be reversed. Some changes caused by hormones are permanent. For example, people who take feminizing hormones experience breast development, which won't go away if they later stop taking hormones. People who take masculinizing hormones experience several permanent changes (voice sharpening, facial and body hair growth, scalp hair loss, and clitoral enlargement), which will not go away if they later stop taking hormones.
The long-term effects of hormone therapy on a person's fertility are not fully understood. Below is a typical schedule of changes in feminizing and masculinizing hormone therapy. Patients who have non-binary physical goals may take lower doses of hormones. At lower doses, you can expect slower physical changes than indicated in the table.
Some changes caused by hormone replacement therapy are reversible, but others are not. Voice hardening, facial hair growth, body hair growth, clitoral growth, and pattern baldness are all permanent results of testosterone based hormone therapy. Some of the effects of hormone therapy are reversible if you stop taking them. The degree to which they can be reversed depends on how long you have been taking testosterone.
Clitoral growth, facial hair growth, voice changes, and male pattern baldness are not reversible. Some of the physical changes caused by masculinizing hormone therapy can be reversed if you stop taking testosterone. Others, such as a deeper voice, a larger clitoris, hair loss on the scalp, and more facial and body hair, cannot be reversed. Don't forget that it can take several months for the feminizing effects of hormone therapy to become apparent.
Research has shown that feminizing hormone therapy can be safe and effective when administered by a health professional experienced in caring for transgender people. The bottom line is that the main predictor of feminizing effects is probably a lack of testosterone rather than estrogen levels. The results will be similar to those of administering full doses of hormone therapy, but they may occur more slowly and appear more subtle, since some people may not want to enjoy all the effects of traditional hormone therapy. In addition to their many other uses, HRT treatments can be used in the transition to change which sex hormone is the dominant one.
Consider the effects of hormone therapy as if it were a second puberty, since puberty usually takes years to see all its effects. However, hormone replacement therapy for trans people can be especially useful and gender reasserting, in addition to alleviating sexual dysphoria, anxiety and depression. Starting hormone therapy at age 40, 50, or older may cause less dramatic changes than those seen at the beginning of the transition at a younger age, due to cumulative lifetime exposure to estrogen and decreased responsiveness to tailored hormonal effects that the age of menopause is approaching. Now that you've learned about the effects of feminizing hormone therapy, medication options, and risks, the next step will be to talk to your provider about what approach is best for you.
Many different types of people take estrogen-based hormone replacement therapy, including trans women, transfeminine people, non-binary people, gender people, and intersex people. Contrary to what many have heard, you can achieve the maximum effect of the transition with doses of estrogen that make your blood levels similar to those of a cisgender, premenopausal woman. There is no single way to not be binary, and hormone replacement therapy is not the definitive indicator of what makes a person transgender. Breast growth, decreased testicular volume, and (potentially) sperm production are permanent results of estrogen-based HRT.
Because bicalutamide carries a risk of liver injury and because spironolactone and GnRH analogs, such as leuprolide, are so safe and effective, the use of bicalutamide as part of a feminizing hormone regimen is not recommended. For example, some people may not want to risk losing the baldness that comes with testosterone based hormone replacement therapy, but some trans men may find this oddly comforting to encounter the same problem as their parents. While hormone replacement therapy is considered safe for people without underlying health problems, some complications may occur. Many other effects of hormonal hormone therapy, such as the redistribution of body fat, decreased or increased libido and muscle mass, can be reversed if treatment is discontinued.
