Understanding Testosterone Transition in Women: Key Facts to Consider
Testosterone therapy, also known as masculinizing hormone therapy, cross-sex hormone therapy, testosterone-based hormone therapy, and gender affirming hormone therapy, is a treatment that reduces estrogen production and induces physical changes associated with masculinity. This therapy is often sought by transgender men who experience distress due to gender dysphoria, a condition where a person's gender identity does not match their sex assigned at birth.
The therapy can bring about numerous physical changes, some of which are desirable, while others may require careful monitoring. These changes may be temporary or permanent and include physical transformations such as male-pattern hair growth, a deepening voice, and reproductive changes like menstrual cycle suppression. However, it's important to note that some effects, such as clitoral growth, facial hair growth, male-pattern baldness, and voice changes, are unlikely to be reversible.
One common side effect of testosterone therapy is acne. Additionally, the therapy may cause changes in a person's emotional state, leading to emotional shifts or fewer emotions. It's also worth mentioning that the therapy can reduce the ability to become pregnant.
Long-term use of testosterone therapy in transgender men leads to a mix of reversible and irreversible physical changes. Irreversible effects include deepening of the voice, facial and body hair growth, male-pattern baldness in some, clitoral enlargement, breast atrophy, and changes in growth if started before puberty ends. Reversible effects include increased libido, cessation of menstruation, increased musculature and body fat redistribution, acne, changes in body odor, prominence of veins, alterations in blood lipids, and increased red blood cell count.
Potential complications associated with long-term testosterone use include erythrocytosis (increased red blood cell count), which may elevate blood pressure and risk of heart attack if not monitored properly. Cardiovascular risks are still being studied, but testosterone use has been linked with changes in cardiac repolarization, including shortening of QT intervals, which may have implications for arrhythmia risk, particularly when combined with other medications affecting heart rhythm. Some observational data also suggest possible increased risks of myocardial infarction, venous thrombosis, or other cardiovascular risk factors, but findings are not fully conclusive.
Mental health outcomes generally improve with testosterone therapy in transgender men, including reductions in depression, gender dysphoria, and suicidal ideation. Hormone therapy aligns physiological traits with gender identity, which improves overall quality of life and mental health benefits. However, irreversible physical changes should be considered in treatment planning.
It's crucial to note that before starting testosterone therapy, a doctor will evaluate the person's health, take blood tests, and possibly perform a pregnancy test and other age- and sex-related screenings. In the U.S., testosterone therapy is typically prescribed by doctors and administered as injections, either intramuscular or subcutaneous, or orally, or through transdermal gels or patches. People undergoing the therapy should use birth control with any sexual partners who can produce sperm to prevent unintended pregnancy.
Some people who wish to undergo testosterone therapy may face difficulties receiving treatment or experience potential complications, including those who are under 16 years of age, have significant mental health complications, are pregnant or planning to become pregnant, have hormone-sensitive cancers, or have thromboembolic conditions.
In conclusion, while many physical changes on testosterone therapy are beneficial and desired, long-term use requires careful monitoring for cardiovascular markers, blood counts, and managing risks like erythrocytosis and metabolic changes. Mental health benefits are substantial, but irreversible physical changes should be considered in treatment planning.
- Testosterone therapy can affect mental health, potentially leading to improved mental health outcomes such as reduced depression, gender dysphoria, and suicidal ideation.
- Some physical changes from testosterone therapy, such as male-pattern baldness, clitoral growth, facial hair growth, and voice changes, are unlikely to be reversible.
- It is important to consider irreversible physical changes in the treatment planning for transgender men undergoing testosterone therapy.
- Potential complications associated with long-term use of testosterone therapy include erythrocytosis, changes in cardiac repolarization, and increased risks of myocardial infarction, venous thrombosis, or other cardiovascular risk factors.
- People undergoing testosterone therapy should use birth control with any sexual partners who can produce sperm to prevent unintended pregnancy.
- before starting the therapy, a doctor will evaluate the person's health, take blood tests, and possibly perform a pregnancy test and other age- and sex-related screenings.
- Long-term use of testosterone therapy can lead to a mix of reversible and irreversible physical changes, such as increased musculature, body fat redistribution, and breast atrophy.
- Some people may face difficulties receiving testosterone therapy or experience complications, including those who are under 16 years of age, have significant mental health complications, are pregnant or planning to become pregnant, have hormone-sensitive cancers, or have thromboembolic conditions.
- Science and health-and-wellness professionals continue to study and monitor the long-term effects of testosterone therapy on sexual-health, mental-health, and overall well-being, as well as the potential risks for conditions such as HIV, cancer, MDD, depression, diabetes, obesity, bipolar, multiple sclerosis, asthma, and predictive health markers.
