There are different medications used in the trans community to replace our natural bodies hormones, suppress these hormones, and others to help alleviate some of the side effects of the hormone replacements. Trans men, trans women, non-binary, and all other people on the trans spectrum might choose to take these medications as part of their transition. Of course some people who identify as trans may choose not to transition medically or at least not choose to take any medications to transition. Taking medications as part of someone’s transition is a personal choice and everyone has a separate journey to walk.
Lets start with some of the feminizing medications out there on the market today. Currently on the market there is estrogen (oestrogen), conjugated equine oestrogen, and ethinylestradiol. The most common drug used is estrogen (oestrogen) in a pill format, typically taken by trans woman. Estrogen (oestrogen) comes in different delivery methods other than just a pill. It also comes in a patch which is considered to be best for people over 40, smokers, and those with circulatory problems. Estrogen also comes in a gel delivery method which is applied to the thinnest part of your skin which is typically the under part of your forearm. With the gel you need to be cautious of not transferring it to other humans especially children and animals. The exposure to estrogen gel to children can be alarming, they can develop enlarged genitals, grow pubic hair, and grow breast. For animals who are exposed to estrogen gel they could act like they are in heat even if they have been spayed or neutered. Another form of feminizing hormones that can be used is conjugated equine oestrogen. This hormone is taken from mares’ urine and put into a pill delivery method. The method of collection of this hormone from horses over the years has been seen to be unethical so it is not commonly used as well has higher risk of side effects. The last feminizing hormone that can be taken but is not typically recommended by most medical professionals is ethinylestradiol. It is taken in a pill format and has the highest risk of side effects from all the feminizing hormones out there on the market today.
Individuals who take feminizing hormones are typically trans women who are also producing high levels of testosterone. Testosterone is considered a stronger hormone than estrogen so sometimes just taking a feminizing hormone isn’t enough to combat the effects of testosterone on the body. Medication to reduce testosterone effects is quite common when taking feminizing hormones, but isn’t always necessary in all cases. There are two medications typically given to help combat the effects of testosterone cyproterone acetate and spironolactone. Both medications are taken in a pill format and block the testosterone hormone. Cyproterone acetate works by blocking receptors and it is effective against testosterone produced by the adrenal glands as well as the testes. One thing people need to be cautious about with this medication is if you intake a large amount of alcohol it will reduce the effectiveness of this medication. Spironolactone is a well-tolerated and effective anti-androgen medication, but only focuses on the testosterone that is produced by the adrenal glands not the testes. Despite that this is the most common one dispensed by pharmacist for testosterone blocking medications.
Now on to masculinizing medications typically taken by trans men, but of course can be taken by anybody on the trans spectrum. Testosterone is the hormone used for trans men in their medical transition and is typically administered by way of intramuscular or subcutaneous injection every week to ten days. There are other ways in which to receive these medications as well, some of these methods are patches, gels, buccal (tablet held between cheek and gum until it’s dissolved), and tablets. Like I said the most common delivery method is injection because it more likely to consistently work and keep the testosterone levels up where they need to be. Depending on where you live depends on the type of testosterone you typically receive. The doctor may prescribe testosterone esters which is injected, testosterone enanthate which is also injected and typically used for people with peanut allergies, and testosterone undecanoate given in injection and pill format.
There are medications out there that someone could use to reduce their levels of estrogen. Typically this is not needed if the person is taking testosterone as the testosterone takes over the estrogen levels. There are two medications out there on the market that can be used to help reduce the amount of estrogen produced in the body. Goserelin and Leuprorelin are administered by subcutaneous injections and typically have few side effects. A lot of the time it is given to trans kids to stop puberty in order for them to determine later down the line if they would like to be put on testosterone.
Another medication that is used for trans men or individuals using testosterone is Finasteride. This medication is taken in a pill format and it reduces the effect of testosterone and promotes a modest regrowth of hair on the head if the hair follicles have not been inactive for too long. One of the side effects of testosterone is hair loss so this is one way that someone could combat this side effect. Typically your doctor will not readily prescribe this medication to you, you typically have to ask to have it prescribed.
The medications transgender individuals use need to be monitored by a license physician. Never try to monitor these medications yourself, or buy them off the black market. You are not a licensed physician and need to make sure you are monitored carefully to avoid any other health problems. Like any other medications these too have side effects and some can be life threatening which makes it even more imperative that you are followed by a licensed physician. If you have any questions about these medications leave a comment below.