HRT, or hormone replacement therapy (also referred to as gender-affirming hormone therapy), includes the introduction of a puberty blocker, feminizing hormones like estrogen/progesterone as well as testosterone blockers, or masculinizing hormones/testosterone.

HRT is a medically-supervised transition option, and may be obtained on an informed consent basis or through a provider that follows WPATH standards of care.

HRT can take the form of an implant that goes under the skin, a regular shot that can be done at home or in a clinic, as well as patches, gels, creams, and pills. Stopping HRT “cold turkey” is not advised–if you want to discontinue your treatment for any reason, speak to your doctor about a schedule for tapering down your doses. Sudden hormonal changes can lead to symptoms seen in menopausal cisgender women and cisgender men with low T, migraines, fatigue, depression, and more.

Everyone’s body is different–your HRT dose may not be the same as your friend’s dose, or the dose that your favorite Youtuber/TikToker started on. Some clinics start trans folks on a lower dose for the first 3-6 months to help their body gradually adjust before they raise it, and some clinics don’t Unless your doctor is intentionally keeping you at a low dose for a long period of time without reasonable justification, or refusing to adjust your dose when you report that you’re having issues with it, trusting the science is the best way to go. If you do have issues with your HRT provider, don’t be afraid to seek out other professionals who may be more informed or comfortable providing trans-related healthcare.

Hormones you may be able to obtain through non-medically supervised means (black market) are dangerous. You may not know if what you’re taking is the medication you think it is, and you don’t know if it’s been stored properly or contaminated. You may also be putting your health at risk by not getting the appropriate testing done on a regular basis to ensure that your body is handling the hormonal transition in a healthy way. Without a prescriber, you are taking your life in your hands and putting yourself at greater risk of fatal blood clots and kidney and liver damage. Someone might seek out black market medications if they’re having difficulties getting access to a prescription, but it is not a sustainable, safe, long term solution. The only safe, advisable option is to get medications from your doctor/pharmacy.

Resources:

UCSF–Approach to Genderqueer, Gender Non-conforming, and Gender Nonbinary People

UCSF–Transgender Care, Patient Information

UCSF–Guidelines for the Primary and Gender Affirming Care of Transgender and Gender Nonbinary People

Planned Parenthood–What Do I Need To Know About Trans and Nonbinary Healthcare?

Transfeminine Science–Puberty Blockers

Fenway Health–Self-Injection Guide

Callen Lorde–Testosterone (English and Spanish)

Callen Lorde–Estrogen (English and Spanish)

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