Gender Affirming Hormone Therapy (GAHT)

Feminizing hormone therapy (FHT) is a gender affirming hormone treatment that helps transfeminine and non-binary people develop feminine physical traits. This process is often part of a gender-affirming journey for those looking to align their appearance with their gender identity. It’s important to know that FHT is highly personalized, meaning each person’s treatment plan can look different, depending on their individual goals.

How Feminizing Hormone Therapy Works

FHT typically involves two key types of medication: anti-androgens and estrogen. Anti-androgens reduce testosterone levels, which is the hormone responsible for more masculine traits like facial hair and muscle mass. Common anti-androgens include spironolactone and cyproterone. After testosterone is lowered, estrogen is introduced to promote feminine characteristics like breast growth and softer skin. Estrogen can be taken in various forms, such as pills, skin patches, or injections such as estradiol valerate.

What to Expect with FHT

The effects of FHT don’t happen overnight. It usually takes several months to start noticing changes, and full effects may take up to two or three years. Here are some of the changes you might expect:

• Softer skin
• Breast growth (though typically modest)
• Less body and facial hair growth
• Changes in body fat distribution (more fat in the hips and thighs)
• Reduced muscle mass

While most of these changes are reversible if treatment is stopped early, breast growth is permanent.

Monitoring and Safety

Safety is a top priority with FHT. Regular doctor visits and blood tests are needed to monitor hormone levels and make sure the treatment is safe and effective. Typically, patients have bloodwork done every few months in the first year and annually after that. These tests check things like hormone levels, kidney function, and overall health.

While FHT is generally safe, there are some risks to be aware of, such as blood clots, changes in sexual function, and potential infertility. This is why it’s crucial to work closely with a healthcare provider to discuss your goals and the potential risks before starting treatment.

A Collaborative Process

Feminizing hormone therapy is a personal decision and should be made with the help of a healthcare provider. It’s a collaborative process where the patient’s goals and preferences play a key role in designing the treatment plan. For many people, FHT is an important step in their gender-affirming journey, helping them feel more comfortable in their own skin.

Gender affirming hormone therapy offers a path for people to physically align with their gender identity, improving both mental and physical well-being. With regular monitoring and professional guidance, this therapy can be a safe and effective way to achieve one’s desired goals.

GAHT vs. hormone replacement therapy

Since GAHT and hormone replacement therapy (HRT) are often confused or used interchangeably, let’s take a moment to differentiate them.

The term HRT has often been used by the trans community to describe the process of GAHT. However, GAHT is a more accurate description of the use of hormones by trans people because nothing is technically being “replaced.” Medical professionals who treat transgender people are moving away from saying “HRT” as not to conflate the terms.