I do not endorse any of these ads. They are the price of a free website.

From Dimensions at the Castro-Mission Health Center in San Francisco
reprinted with permission



HORMONAL Therapy: Estrogen

What estrogen will do:

  • Estrogen will cause your breasts to grow. How large your breasts will get depends on what you’ve inherited from your family. Your breasts will probably not be as large those of your female relatives.
  • It may cause fat to migrate away from the waist and toward the hips and buttocks.
  • It may cause your skin to become softer.
  • It may change the way your body smells.

What estrogen won’t do:

  • Estrogen will not make your facial or body hair disappear. You will need to get electrolysis if you wish to remove this hair. If you have male pattern baldness it will not cause your hair to grow back. It may slow down how fast you are losing your hair.
  • Estrogen won’t make your penis go away. It can cause your testicles (and your prostate) to shrink.

It will not change your voice. You may wish to take voice lessons to change the tone and speech patterns you use.

  • Will not make your Adam’s apple or the bones in your face any smaller.
  • Don’t expect to change overnight. Hormones will take a while to take effect and the changes will come slowly. If you take more estrogen than your health care provider recommends, your body may convert it into testosterone, which could slow the feminizing effects you maybe trying to achieve.

The possible side effects and health risks of taking estrogen:

  • If you experience hives swelling, vomiting, call your health care provider
  • Taking hormones can cause problems with your liver.
  • Estrogen can increase your risk of getting blood clots. This can cause serious or fatal conditions such as stroke. Your risk of blood clots is much worse if you smoke or are over 35 years old.
  • Taking estrogen can increase your risk of getting breast cancer. You should examine your breasts regularly. Your health care provider can show you how to perform self-examinations.
  • Taking estrogen can cause nausea and vomiting. This is like morning sickness.
  • Taking estrogen can cause a skin condition that looks like vericose veins. These can appear on your face and other places on your body.
  • It may decrease your sex drive. You may not be able to get or maintain erections. If you get erections, they may not be hard enough for sexual intercourse.
  • The amount and quality of your ejaculate (cum ) may decrease. Keep in mind that your ejaculate may still contain sperm! If you are having unprotected sex with someone who can become pregnant, you may be able to cause pregnancy. You should also know that taking estrogen may make it impossible to get someone pregnant in the future even if you have stopped taking the hormone
  • It can cause depression and mood swings. If you already are depressed it can make your depression worse. Let your health care provider know if you have had any problems with depression to explore what treatments are available
  • If you have migraines, estrogen can cause these to happen more often.


Whether or not you want to take hormones is your choice. We want to help you figure out for yourself which decision is right for you.

Whom can I talk to if I have problems or questions?

The clinic staff can refer you to ……?

You may also want to check out some of the groups listed on the transgender resource sheet.

How will the effects and side effects of hormones affect my emotional state?

The way hormones effect people can be very different. Some people feel that they become depressed and moody when taking estrogen, while other people feel that it makes them very happy.

Changing your schedule of hormones may cause mood swings and irritability (crankiness). Try to be consistent in taking your hormones.

Why do some TG youth prefer not to take hormones?

There are many reasons to decide not to take hormones, if you are not sure you want to change your body, if you’re happy with what your body is like now, if you have health concerns or if you want to have children. There are many transgendererd people who decide to on the "NoHO, NoOp" option (no hormones no operation).

Hormones will not make you any more or less of a "real" transsexual or man or woman.

Some TG youth should not receive hormonal treatment.

You should not use hormones if:

  • You are still exploring
  • You smoke cigarettes
  • You have certain blood clotting conditions

Informed Consent to Continue Hormones
Informed Consent for Testosterone Therapy
Informed Consent for Estrogen Therapy
New Patient Flow Chart for Transgender Hormonal Treatment version 1?
New Patient Flow Chart for Transgender Hormonal Treatment version 2?
Flow Chart for New Patient Continuing Transgender Hormonal Treatment
Treatment Guidelines for MTF Transition
Treatment Guidelines for FTM Transition
FTM Handout
MTF Handout
Back to Critique