Much like Dr. Jekyll and Mr. Hyde, hormone "replacement" therapy (HRT) has two major identities.
The best-known form of HRT is the increasingly controversial use of Premarin and such to alleviate menopause symptoms and the potential health risks (like osteoporosis associated with menopause. However, in the transgendered community, HRT is used to refer to doses of either estrogen or testosterone (depending on one's birth sex and desired gender presentation) which are used in transitioning.
There are many ways in which HRT used this way is different:
As is noted in transsexual hormone therapy, this "HRT" is sometimes alternatively known as Hormone Reassignment Therapy, or as Hormonal Sex Reassignment. Ironically, however, the term "hormone replacement therapy" is sometimes appropriate in this case, since from the transsexual perspective the purpose of undergoing HRT is to as nearly as possible replace the body's usual hormone balance with that of another sex - and FTMs at least get to take hormones which are not derived from horse urine.
Regardless, it is so often referred to as just HRT that the two acronyms have essentially become synonymous.
While there are many risks now associated with taking HRT as a menopausal woman, there are far fewer associated with the trans form of HRT. Unfortunately, this may be for the same reason that it took so long to understand the risks of menopausal HRT: the medical community does not study us.
Even in these presumably feminist times, many studies are conducted solely on men. This does decrease the number of variables in a study, but it means that the findings from many medical studies conducted on men are just assumed to be true for women. On top of that, issues that are specific to women's health get less funding and fewer grants than more obviously commercial studies. And many women still find that their medical complaints are written off as stress - the modern-day version of "It's all in your head, dear." Thus, it took a long time for the risks of HRT to be noticed in post-menopausal women.
The same factors are present in the transgender community. Doctors are, if possible, even less respectful of transgendered patients/consumers, particularly since they are placed in a position of so much power over us that they are actually allowed to decide what our physical sex should be and what we would have to do to change it. Medical researchers generally have a very difficult time getting grants to study anything related to this relatively small community, at least in the United States.
Fortunately, there are countries where this is less true. For example, researchers in the Netherlands completed a study on "Mortality and morbidity in transsexual subjects treated with cross-sex hormones" in 1997. They studied both transmen and transwomen and found that "total mortality was not higher than in the general population and, largely, the observed mortality could not be related to hormone treatment." We can only hope that this finding is duplicated by future studies.
Resources
- http://dmoz.org/Society/Transgendered/Health_and_Wellness/ has genderal... I mean general... links about this and other trans health issues.
- http://www.transgendercare.com/medical/library.htm has good information on HRT for transwomen, although they make the common mistake of using "transsexual" to refer solely to MTFs;
- http://library.ftmaustralia.org/ provides FTMs with health information including HRT and SRS info, as well as articles on personal and social issues; they have an abstract of the above-mentioned study on mortality and morbidity at http://health.ftmaustralia.org/library/97/0901.html;