The process of taking hormones of the opposite physical sex for a transsexual to appear more like that of the other gender, mainly by development of the secondary genderic signs identified with that gender. The amount of effect depends on the person's genetics and age - the younger someone is when starting on the hormone therapy, the stronger the effect of the hormones.

Taking estrogen causes breast growth, softer skin, and makes a person more emotional and sensitive.

Taking testosterone causes facial hair growth, a deeper voice, and may make one more aggressive and competitive, though there is debate about the last part.

Hormone therapy in the United States is usually done in a manner closely resembling the HBIGDA Standards of Care for pre-operative transsexuals. Usually a person is required to be in a program of psychotherapy for a minimum of three months, with a letter of approval from the therapist for starting hormones.

The method of administering the hormones varies from doctor to doctor. Some rely solely on injections, others use orally administered hormones in pill form, and some combine the two.

Hormone therapy is not a temporary thing. Because the body of a transsexual will never have proper hormone levels for their chosen gender, the person must continue their hormone regimen for the rest of their life. After Sex Reassignment Surgery, the dosage can usually be lowered, and the drugs for blocking the undesired hormones can be discontinued, but at least something will continue to need to be administered regularly.

Hormones should never be taken without a doctor's care. They have serious effects, and if not properly monitored, can cause serious physical harm and have significant effects on the mental state. Also, taking too much of a hormone, because of how the body processes the hormones, can actually result in decreasing the effects of that hormone.

In the past, doctors used to cycle the hormone dosage for male-to-female transsexuals, to attempt to give them the monthly cycle that occurs naturally in the bodies of genetic women. However, this practice has ceased, as there is no real need to create the cycle. Interestingly, even with consistent dosage of hormones throughout the month, some transsexual women do still seem to have a monthly cycle. On a schedule as regular as a genetic women, there may be a period of moodiness that can be quite noticable. Some even have "cramps" occasionally. How? While the reproductive organs are not present, the muscles that are involved are present (though aligned slighly differently), and as the body adjusts to the estrogen, the body may start triggering them at that point.

(I can vouch for all this last part - I do have a monthly cycle that is identifiable by my other half, and the past few months I've had some unusual muscle tightness at that time that I've never experienced before, but appears to be of the same type.)

No studies show conclusive evidence that testosterone makes one more aggressive or competitive (and, as far as I know, researchers haven't even attempted to connect androgens to competitiveness; women are often very competative, too, just often in different ways and about different things.) Some FTMs report increased aggression, but many do not; it's possible that they only feel more comfortable expressing aggression because it is expected or because they simply feel more comfortable with themselves, thus not too shy to be aggressive/assertive. It seems reliable that estrogen causes what might be described as being "emotional" (since when are "masculine emotions" not emotions?) but that is generally believed to be due to the cyclic nature of female hormone production, which may not apply to MTFs, depending on their regimen. Increases in sensitivity may be due to the psychological factors mentioned above.

Transsexual hormone therapy is also known as Hormone Reassignment Therapy (with the sometimes confusingly identical acronym as for Hormone Replacement Therapy for menopausal women).

Other physical changes that often occur with HRT for female-to-male transsexuals (I'll be onesided since this is my area of knowledge) include...

  • Changes in smell in sweat, urine and sexual fluids (many report more of a musky scent)
  • Roughening of the skin (complimentarily to what Saige mentions above, softening of skin in MTFs)
  • Increased body hair as well as facial hair
  • Creation of a more masculine hairline, possible thinning of hair or balding (though usually not until after several years)
  • Cessation of menses
  • Thinning of vaginal wall/lessening of vaginal lubrication
  • Clitoral growth
  • Increased sex drive
  • Increased risk of heart disease (only to the "male level", as males are considered to have a higher risk of heart disease)
  • Decreased risk of osteoporosis
  • Softening of breast tissue (some also report a slight decrease in breast size, though I have never heard of it being enough to actually make a difference with regard to hiding or removing them)
  • Increased risk of reproductive organ cancer (uterine and ovarian) if they are not removed. This increased risk is caused by the organs lying dormant for a long period of time and is similar to the way that post-menopausal women have an increased risk for this very reason.

The most common "full dose" of testosterone for FTMs is 200mg every two weeks (or the equivalent... some do 100mg every week to provide hormonal consistency) if one is using injections. Almost no FTMs take their hormones orally as it's quite hard on the liver; the most common method is injections, and secondary options include gel (applied to the skin) or a patch (much like a nicotine patch), though the alternatives to injection are considerably more expensive and some people find they irritate the skin.

I'd like to supplement eliserh's excellent write-up on this subject, over at hormone replacement therapy, if I may.

Since I started taking oestrogen a few years ago, I've noticed some changes in my mind, and probably missed a bunch more besides. For what it's worth, here are ways in which I think differently to how I used to, that I speculate might be caused by this hormone.

Noticing aesthetic beauty in things

I distinctly remember when I was many years younger and my mother bought a yellow CD player just because it was yellow and would therefore look good in the kitchen next to a lot of other yellow appliances. At the time, I couldn't believe she would rather buy something for how it looked rather than how well it functioned at its task (in this case, playing CDs in a non-tinny way, at which it failed miserably).

Recently, though, I've been looking at a certain modular synthesizer over others, mainly because it's an all-in-one unit with a built-in keyboard, in a beautiful wooden case. I've also been looking at Mac OS X, despite my political inclination towards free software, because it looks like it has the most slick GUI I've ever seen. I'm sure that, to some extent, my values have changed in terms of why I desire certain products over others. Now I care about aesthetics as well as functionality.

Empathising with fictional characters

Although I occasionally watched romantic films before, it was nothing compared to the experience it is now. I finally understand why they're so popular: even when I'm watching a kid's film, or a badly written film, even while I'm actually thinking about how badly written it is, I can't help but cry involuntarily when the two good characters get back together at the end, reunited at last. This still applies even if I've seen the film many times before. I even cried when Data talked about how he missed Geordi in Star Trek, when he thought he was dead. If an episode of Star Trek can make someone cry, imagine what a well-written, emotionally charged romantic film can do for that person.

Empathising with living creatures

Shortly after I started taking oestrogen, I became a vegetarian, a few years later going all the way and becoming a vegan. While this seems rare amongst the transwomen I know, it's worth noting that there appear to be more vegetarian women than vegetarian men1. (Of course, it's possible that the reason I wasn't a vegetarian before was simply that I was too depressed to think about such things).

Never being alone thanks to stuffed toys

When I was a teenager, I dismissed stuffed toys as being for kids. Since then, my partner and I have immersed ourselves in countless stuffed toy animals. We hug them all the time, we sleep hugging them, and sometimes I can even see how they're lonely when they're in a room all by themselves, but happier after I hug them, just from their inanimate facial expressions.

Feeling right

In short, if you're a transwoman about to take this hormone, the benefits of finally being able to think like you always should have done can be every bit as good as growing breasts and developing attractive curves.

Of course, it'll probably help that you won't be constantly depressed any more, but that's just as true of transmen taking testosterone. It's not specific to any particular hormone, just the wonderful effect of taking the right hormone for your own particular mind.

These are just my personal experiences. It's impossible to tell which changes were caused by oestrogen, which were caused by not being depressed since admitting to myself who I was and changing my body to more accurately reflect that, and which were simply caused by me growing up.

1. - Out of a poll of 1051 university and college students conducted in 2002, 11% of women claimed to be vegetarian, whereas only 4% of men claimed to be such.

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