Changes on Hormones (MtF) Part 2

As mentioned in Part 1, there are 3 major areas that hormones affect. The first two emotional and sexual/reproductive have already been covered in Part 1. Note, that these are mostly my experiences and the disclaimer that “Your Mileage May Vary” applies greatly for the physical changes.

Physical

Starting hormones at a low level allows your body to start to adapt slowly to the reception of higher levels of estrogen while slowly bringing your testosterone levels down. In my case, I had no major issues with this change in my blood work, but I did have a slight headache for the first three days.  It eventually disappeared and I never experienced it again.

Some of the first noticeable physical changes occur to your skin as it will become a bit drier and thinner.  I noticed this early on and still notice that I am colder a lot more than before. You may notice that you sweat less, and that the odour of your sweat changes. I definitely noticed this, and I can go for a few hours after a shower without deodorant, where I wouldn’t last 15 minutes before.

Once your hormone levels reach a desired level you  begin to develop small “buds” beneath your nipples. These may be slightly painful, especially to the touch and the right and left side change at different rates. Because I started at such a low dose to ensure there were no side effects or other health issues, I didn’t experience this for about 6 weeks after starting. But yes, they were very sensitive for a while. Typically, breast development for trans women is slower, with cup sizes ranging from 1-2 sizes less than other female relatives.  I can’t say what my mother had for size as I never really noticed, however I know my sister (sorry, sis) has complained about her size so I’m not expecting much for me.

One of the most important changes for me, but one that’s not really known by most people, is that your body begins to redistribute your weight. Fat will collect around your hips and thighs and the muscles in your arms and legs will become less defined and have a smoother appearance as the fat just below your skin becomes a bit thicker. I’m not sure where the fat is coming from, because I still have a gut, but I do notice the general smoothing out of the body. One of my favourite changes is to the back of my hands and tops of my feet.  I never noticed how much I disliked their appearance with the veins and tendons sticking out.  I much prefer the smoother look they have to them now – especially when they’re all done up.

Over time, your muscle mass will decrease mostly because the protein is used elsewhere. This has been very gradual for me, even though I didn’t have much to begin with. I have noticed some muscle loss when lifting heavy things and putting them on the top shelf in the garage.  Some of those things are never coming down.

The eyes and face will begin to develop a more feminine appearance as the fat under the skin increases and shifts, particularly around the cheeks. What won’t change is your bone structure, including the bones of your face (brow, jaw) as well as your hips, arms, hands, legs and feet. What’s interesting though is that I’ve lost about an inch of height since starting hormones and my feet have shrunk a little. This apparently is due to tightening of ligaments and muscles of the feet and spinal column and not changes to the bones.

The hair on your body, including your chest, back and arms, will decrease in thickness and grow at a slower rate. Facial hair may thin a bit and grow slower, but it will rarely go away entirely without electrolysis or laser treatments. I’ve been working on getting rid of my facial hair for the last 16 months and I’d say I still have another 2 years of weekly appointments before I won’t have to shave every morning.  If you have had any scalp balding, hormone therapy will usually stop it, however the extent to which it will grow back is variable. I did experience some regrowth but it was never going to be enough to have a full head of hair and so I had to seek alternative solutions.

Feminizing hormone therapy does not have any effect on voice pitch or character.  For trans men that are taking testosterone, there is usually a change in pitch. This means that the only changes to happen with a trans woman voice is through hard work and lots of practice or through surgery which can be unpredictable. One of my greatest sources of dysphoria comes from my voice and so I’ve been working on my pitch and resonance for quite a while.  Still have a way to go there, too.

I hope you have enjoyed my recap of what I’ve experienced on hormones.  Some of these changes occurred in the first few months, others throughout the first year. I’ve been told that the changes won’t stop until sometime between years 5-8, just like normal puberty.