Gender affirming therapy with estrogen (1737)

Key points below

with estrogen

What is estrogen?

Estrogen is a hormone that is taken to make the body appear more feminine. It is usually taken melted under your tongue or as a patch like a small bandage. Some of the effects of this medicine are permanent. They cannot be undone even if you stop taking it. Some effects last only while you take the medicine.

What are the benefits and risks of taking estrogen for your gender?

Appearing more like a woman:
Develop breasts.
Less noticeable body hair.
Rounder hips and thighs.
Softer skin.
Decreased risk of heart disease.

Blood clots can cause:
chronic problems with veins in the legs.
heart attack.
pulmonary embolism (blood clot to the lungs).  This may cause permanent lung damage or death.
Decreased erections, in firmness and frequency.
Decreased sex drive.
Decreased strength.
More fat on hips and thighs.
Emotional changes.
Increased risk for:
High blood pressure.
Migraine headaches.
Prolactinoma (a benign tumor of the pituitary gland).

What parts of the body will not change much by using these medicines?

Though beard and mustache hair may grow more slowly it will not go away without treatments like electrolysis.
Pitch of voice will not rise, and speech patterns will not become more like a woman’s.
The “Adam’s apple” will not shrink.

What changes are likely to start if you stop taking estrogen?

You will have:
more body and facial hair.
fat on your belly instead of hips, and thighs.  
male pattern baldness. You may lose hair faster than if hadn’t taken estrogen at all.
more muscle mass and strength in upper body.
coarser skin.
What changes are likely to be permanent, even if you stop taking estrogen?
Breast development.

What are the effects of estrogen on fertility (your chances of having biological children)?

The body will make less testosterone. This may affect your sex life in different ways.  It may affect your future ability to cause a pregnancy.
Testicles may shrink to half their size.
Ejaculate will decrease.
Erections will decrease in intensity and frequency. You may not be able to get hard enough for penetrative sex.
Sex drive may decrease, and you may find it harder to ejaculate.
Sperm may no longer mature. This could make you less able to cause a pregnancy while taking hormones.  It might be a permanent change even if hormone therapy is stopped.
There is a risk that you might never produce mature sperm again.  This risk is even more increased if suppressing hormones were used.
Sperm could still mature even while taking hormones. A woman may become pregnant if you have vaginal intercourse without using birth control.


Call 911 if your child has trouble breathing or has swelling of the face or lips. Call your child’s doctor, nurse, or clinic if you have any other concerns.