Gender-Affirming Hormone Care
Gender-affirming hormone therapy helps transgender and non-binary adults align their physical characteristics with their gender identity -- estrogen with an anti-androgen for feminizing therapy, testosterone for masculinizing therapy, or a non-binary approach using partial doses of either. We follow the informed consent model described in the WPATH Standards of Care, Version 8 (2022), so a letter from a mental health provider is not required to begin.
Symptoms
This is not a diagnosis with symptoms -- it is medically supervised hormone therapy for people experiencing gender dysphoria or otherwise seeking to affirm their gender identity. Changes are gradual: mood and skin changes appear within weeks to months, while breast development, voice change, and hair growth typically become apparent over six to twenty-four months of consistent therapy.
Causes and risk
Candidates include transgender women seeking feminizing therapy, transgender men seeking masculinizing therapy, non-binary individuals exploring a partial or gender-neutral approach, and anyone transitioning from another provider who wants continued care. Baseline health -- liver function, red blood cell count, lipids, and cardiovascular risk factors -- shapes the specific protocol and monitoring schedule.
How it is evaluated
An affirming consultation covers gender identity and goals, followed by comprehensive baseline labs (hormones, metabolic panel, lipids, CBC) and a review of medical history and any prior hormone use, per the Endocrine Society Clinical Practice Guideline (2017).
Treatment
Feminizing therapy typically combines estradiol with an anti-androgen such as spironolactone or bicalutamide. Masculinizing therapy uses testosterone, administered by injection, gel, or patch. Either protocol includes follow-up labs at three months, then every three to six months ongoing, with dosage adjusted to lab results and goals, per Endocrine Society monitoring recommendations.
When to seek care
Hormone therapy itself is not an emergency. Contact us promptly for symptoms of a blood clot (leg swelling or pain, chest pain, shortness of breath), since estrogen and anti-androgen therapy carry a small increased risk.