Hormones

This page is intended to give you general information about options for hormone therapy. If you choose to begin hormone therapy, your primary care provider will provide you with more detailed information that is specific to your needs.

Many trans and gender diverse people are happy with their bodies, or find comfort with their bodies without hormone therapy. Only you can decide whether hormone therapy is right for you.

What is hormone therapy?

Hormone therapyHormone Therapy (HT): administration of sex hormones for the purpose of bringing one’s secondary sex characteristics more in line with one’s gender identity; hormone replacement therapy; HRT; transhormonal therapy. is the use of sex hormones to alter secondary sex characteristics. The hormone estrogen (often combined with other medications) can be used to feminize the body. The hormone testosterone can be used to masculinize the body. Either can be used in lower doses to achieve a more androgynous effect.

Why hormone therapy?

If you experience discomfort or distress because your gender identity (internal sense of being male, female, or an alternate gender) and the sex you were assigned at birth are different, hormone therapy may provide significant comfort.

Hormone therapy may help you to feel more at ease in your body. This may have positive effects on your emotional and sexual wellbeing. It may also improve your ability to be read by others as your gender identity.

Who decides?

The decision to start hormone therapy is yours. Your primary care provider’s (PCP) role is to encourage, guide and assist you in making fully informed decisions and becoming adequately prepared.

Any PCP can assess hormone readiness and prescribe hormone therapy. Please note that Nurse Practitioners cannot prescribe testosterone. Not all PCPs feel comfortable initiating hormone therapy, and may require a letter from a mental health professional before writing you a prescription. We hope that as more PCPs receive basic hormone therapy education, this will occur less frequently.

Youth under 18 years of age, typically first receive a hormone readiness assessmentHormone Readiness Assessment: evaluation conducted by a healthcare professional to determine if a patient is ready to begin hormone therapy. with a qualified mental health professional and are then referred to an endocrinologistEndocrinologist: a doctor specially trained in the study of hormones and their actions and disorders in the body. who prescribes and monitors hormone therapy. Treatment decisions are ideally to be made among you, your family, and your health care providers. The consent of your guardian(s) is preferred, but not absolutely necessary under the BC Infants Act.

Who monitors hormone therapy?

For adults, your primary care provider (PCP) can monitor your medications. Just as a patient with diabetes can expect their primary health care provider to monitor their medications, you have a right to the same support with hormone therapy. If your PCP does not have the knowledge to monitor your hormone therapy, they can:

  • Educate themselves by referring to the WPATHWorld Professional Association for Transgender Health (WPATH): professional organization devoted to transgender health, whose mission as an international multidisciplinary professional association is to promote evidence based care, education, research, advocacy, public policy and respect in transgender health. Standards of CareStandards of Care (for the Health of Transsexual, Transgender and Gender Non-Conforming People): guidelines containing the recommended course of care for people seeking medical transition to their self-determined gender, published by the World Professional Association for Transgender Health (WPATH). Version 7.
  • Contact the Rapid Access to Consultative Expertise (R.A.C.E.) Line to receive support from a doctor with experience in this field

Children and youth typically have their medications overseen by an endocrinologist, due to changing needs during adolescence. However the endocrinologist can work with your local PCP for routine monitoring.

I’m a youth – how is hormone therapy different for me?

There are two stages of hormone therapy for youth.

  1. When your body begins puberty, you can start taking a medication called a puberty blocker. This delays the changes that happen during puberty. Using puberty blockers does not mean that you have to start hormone therapy later on. For more information, check out our Puberty Blocker page.

  2. When you’re around age 16, you can decide if you want to start hormone therapy. Hormone therapy is used to make you either more masculine or more feminine. Medications used by youth are generally the same ones used by adults.

What are the risks associated with black market hormone use?

When you buy hormone medications illicitly, you cannot be sure about the quality of the product. Unlike medications from a pharmacy, they may be diluted or mixed with unknown substances. It is also important to have your hormone therapy monitored by a health care provider in order to manage risks (see the Feminizing Hormones and Masculinizing Hormones sections for information about risks.) The dosage required for optimal effects varies from person to person and is best determined through blood work.

Hormone readiness assessment

hormone readiness assessment is an evaluation conducted by a healthcare professional to determine if a patient is ready to begin hormone therapy.

Feminizing hormones

Feminizing hormones are medications (e.g. estrogen, anti-androgens, progestins) to develop physical characteristics that are in line with one’s gender identity or gender expression.

Masculinizing hormones

Masculinizing hormones include the use of testosterone to develop physical characteristics that are in line with one’s gender identity or gender expression.

Puberty blockers

The changes to your body that happen during puberty can be distressing if they are not in line with your gender identity. Puberty blockers can help relieve this distress. Delaying puberty gives you more time to explore your gender identity before changes happen to your body that can’t be reversed.

Hormone therapy funding

You may have a benefit plan that provides hormone therapy funding which would cover the cost of hormone therapy medications.

A note about the information in this section

The medical information on our website has been reviewed by medical professionals, and is current as of May 2014. This information is not intended to replace consultation with your primary care provider.