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Basic Hormone Effects Education and Cost Of Hormones

The vast majority of my patients come to me already very well read and self-educated regarding hormone therapy. Although, the type of research and/or education is wide and varied, as is the quality of the materials reviewed. The intent behind the quest for knowledge can color one’s vision when searching for information as well. For instance, if you are a typical excited young person ready to get started on your transition, you may initially seek out information from sources close to you, such as other transgender individuals who are already undergoing medical transitioning. This can be a good way to find out some experiential info, such as cost, good pharmacies, what to ask during an appointment, etc. It is usually not very deep into potential side effects and transitioning effects other than that one person’s experience. So talking to several people will attain a much better knowledge base with this method. Other people may dive straight into books and online searches for information. And depending on your medical background, some of the data located may be a bit above the your head. But still, knowledge is gained.

All knowledge is valuable (with the exception of blatant misinformation and rumors). So when people first present to me as a patient, one of the first things I try to do is gauge their understanding of the transition process, as well as their comfort and education level. As a requirement when one is signing up to be my patient, I have a couple of YouTube videos and readings I have created regarding masculinizing and feminizing hormone effects that need to be reviewed prior to meeting me. I believe this helps lay a basic foundation, though these items are certainly not exhaustible sources of information on hormones. They are more of a beginning, and by having my patients view these, I can at least know some of what they are informed about regarding hormone therapy. Then of course during the appointments, we talk about all kinds of other effects that are less common than the ones I had them learn about initially.

So, what do you need to know about the effects of hormone therapy? Below, I have copy/pasted my two informational papers on masculinizing and feminizing hormone therapy effects broken down by the body system being affected. Peruse whichever one fits your situation. Feel free to share; I don’t mind. Below those are an estimated price list of some of the most common hormone medications. I am including this because I have so many people who are not insured who are afraid of what the cost of hormones might be. Remember, it is only an estimated list of the average prices in Mississippi as reported back to me by my own patients. And cost can vary widely based on your dosage, state/city/region, which pharmacy you use, and the amount of medicine being dispensed. I tried to list approximate prices with how long they last as well. If you have information on cheaper medicines, please message me so I can share it with my patients.

And now……the effects of hormones!

Feminizing Therapy Effects

Feminizing treatment can include many things: estrogen, progesterone, and testosterone blockers are a few. Their routes can all vary as well (oral, rectal, injection, sublingual, etc). There are so many options, and we will find the one that works for you and your goals.

It should be noted before reading that everyone is different. Everyone will develop along a different timeline and with different results. Hormone dosages and route will vary between person to person because of age, metabolism, lifestyle habits, goals, etc. So don’t think that just because someone is on a higher/different dose that they are getting a better transition than you are.

This will be a second puberty, and it will take time. So be patient. The average puberty takes anywhere from 2-5 years.

Hair: Decreases in thickness all over the body. But likely, laser/electrolysis will be needed to remove it permanently, especially facial hair. Balding of the scalp usually slows or stops.

Breasts: Development is wide and varied. Begins with “buds” under the nipples and spreads out over time. Your breasts may be quite tender when touched while developing. Shape and size is different for everyone, including cisgender women.

Fat: Some people do gain weight on Estrogen, so be aware. Most certainly, though, the fat you have will “redistribute” itself to more feminine locations, such as hips, thighs, and breasts. The fat in your face will also shift, which usually softens features a bit.

Skin: Your skin will likely be drier and thinner over time. Less oily and softer.

Emotions/Personality: You will remain yourself. Your personality does not change, that is a myth. However, you may find yourself more moody and more open to the traditional female emotions, such as crying during Hallmark movies….

Sex: As in, intercourse and libido. Many people experience a decreased sex drive. And most become unable to sustain an erection capable of penetration, although sexual stimulation still can result in orgasm. There may be less semen (and sometimes none at all) during orgasm, though. This is a time to explore yourself and find out what feels good to you. It may stay the same, or you may discover new areas of pleasure.

Genitals: The testicles (or balls) will shrink a LOT, probably down by at least one half their original size. The penis can sometimes decrease slightly in size as well, and it is important to be aware that if the penis is not regularly stimulated so as to maintain the “stretchability” of its skin, then it can be quite painful later on as you age when you get an erection.

Fertility: It is recommended to store sperm before beginning hormones as there is a very real chance of becoming infertile. This is a serious decision. Banking sperm is relatively easy, but a tad bit expensive at around $1500-$3000.

Likely, after a few months of hormones, you will become at least temporarily infertile, or at least decreased in fertility. This does not mean that it is completely safe to have penetrative intercourse with someone who has a functioning uterus and ovaries. Accidents can still happen and someone could end up pregnant.

Masculinizing Therapy

Masculinizing therapy most typically includes treatment with testosterone by injection or transdermal gels/patches. Injection tends to be the most popular, though, because transdermal gels/patches are quite expensive and many insurance companies do not cover them.

It should be noted before reading about the changes that occur that everyone is different. Everyone will develop along a different timeline and with different results. Hormone dosages and route will vary between person to person because of age, metabolism, lifestyle habits, goals, etc. So don’t think that just because someone is on a higher/different dose that they are getting a better transition than you are.

This will be a second puberty, and it will take time. So be patient. The average puberty takes anywhere from 2-5 years.

Hair: Body hair will thicken and darken and increase in amount to reflect a more male body hair pattern. A beard doesn’t typically fill out for a year or so, and can take up to 5 years. This is partly due to genetics. You will also likely experience some receding of your hairline near the temples. And if baldness runs in your family, that could be in your future, too. Minoxidil (Rogaine) and other treatments can help mitigate this a bit.

Breasts: These will be there, unfortunately. Not much to be done besides bind or have surgery.

Fat/Muscles: Your fat will redistribute itself in a more male pattern, less on the hips, butt, and thighs and more to the shoulders, back, and abdomen. The fat around your face will shift and give you a rougher appearance. Your muscle mass will likely eventually increase by about 30%. Regular exercise can help maximize these results. If top surgery is in your future, good muscle development of the chest, back, and shoulders will gain better surgical outcomes. Bone structure does not really change much, that is a myth. There are subtle changes to cartilage, bone density, and whatnot, but you will not get taller.

Skin: The skin will get thicker and you will likely experience some degree of acne, so get a good facial cleansing routine going. You will also sweat more and smell differently.

Emotions/Personality: It is a myth that your personality changes. You will still be yourself. However, this is a second puberty, and mood changes can happen. Testosterone usually encourages aggression and increases sexual drive. Many patients have also told me that they no longer experience emotions the same. For example, the Hallmark movie that they used to cry during no longer affects them as much.

Sex: As in, intercourse and libido. Your clitoris will enlarge a great deal. Also, your sex drive will increase a lot. This is a time to explore what feels good to you. You may find new things that give you pleasure. Experiment!

Genitals: As mentioned above, the clitoris will enlarge a lot. You may also notice vaginal atrophy and decreased ability to naturally lubricate this area, which can cause infections and discomfort. Sometimes, topical estrogen applied to this area can help ease the discomfort. If you still desire penetrative sex, then get a good water-based lubricant to use during, and be generous with its application.

Estimated Price List for Common Hormone Medicines In Mississippi

In general, I have found these prices below to be the averages reported to me by my patients. The variability in price depends on many things, such as the dose, physical location where you buy it (city, county, etc), which pharmacy, and the quantity of medicine ordered.

These estimates are only provided as a general guide and are in no way to be taken as 100% accurate as prices change every few months, and these are just self-reported price ranges that my patients and friends have told me. If you are unclear, always be sure to call your pharmacy first so they can tell you the exact price you will pay.

Oral Estradiol- $15-$30 or less for one month supply.

Injectable Estradiol- $80-$150 for 3-5 month supply.

Transdermal Estradiol- $30-$90 for one month supply.

Oral Progesterone- $20-$45 for one month supply

Rectal Progesterone- $50-$200 for one month supply

Injectable Testosterone- $80-$200 for a 2-4 month supply.

Spironolactone (anti-androgen)- $5-$15 for a one month supply.

Casodex (anti-androgen)- $25-$120 for one month supply.

I didn't list transdermal testosterone (patches and gels) because the price varies so widely and is generally so expensive that none of my uninsured patients can afford it anyway. I've seen anywhere from $200-$500 per month.

I hope all of this information helps someone out there!

Stacie, NP

Spectrum: The Other Clinic

Transgender Hormone Therapy

Telemedicine Clinic in Mississippi

601-466-9495 Text Me!

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