Treatment
14
Table 12. Masculinizing Effects in Transgender Males
Effect Onset Maximum
Skin oiliness/acne 1–6 mo 1–2 y
Facial/body hair growth 6–12 mo 4–5 y
Scalp hair loss 6–12 mo
—
a
Increased muscle mass/strength 6–12 mo 2–5 y
Fat redistribution 1–6 mo 2–5 y
Cessation of menses 1–6 mo
—
b
Clitoral enlargement 1–6 mo 1–2 y
Vaginal atrophy 1–6 mo 1–2 y
Deepening of voice 6–12 mo 1–2 y
Estimates represent clinical observations: Toorians AWFT, et al. J Clin Endocrinol Metab. 2003;88(12):
5723–5729. Asscheman et al. Clin Endocrinol (Oxf ). 1988;28(6):583–588. Gooren et al. Clin
Endocrinol (Oxf ). 1985;22(2):201–207. Wierckx et al. J Sex Med. 2014;11(8):1999–2011.
a
Prevention and treatment as recommended for biological men.
b
Menorrhagia requires diagnosis and treatment by a g ynecologist.
Table 13. Feminizing Effects in Transgender Females
Effect Onset Maximum
Redistribution of body fat 3–6 mo 2–3 y
Decrease in muscle mass and strength 3–6 mo 1–2 y
Soening of skin/decreased oiliness 3–6 mo Unknown
Decreased sexual desire 1–3 mo 3–6 mo
Decreased spontaneous erections 1–3 mo 3–6 mo
Male sexual dysfunction Variable Variable
Breast growth 3–6 mo 2–3 y
Decreased testicular volume 3–6 mo 2–3 y
Decreased sperm production Unknown >3 y
Decreased terminal hair growth 6–12 mo
>3 y
a
Scalp hair Variable
—
b
Voice changes None
—
c
Estimates represent clinical observations: Toorians et al. J Clin Endocrinol Metab. 2003;88(12):
5723–5729. Asscheman et al. Clin Endocrinol (Oxf ). 1988;28(6):583–588. Gooren et al. Clin
Endocrinol (Oxf ). 1985;22(2):201–207.
a
Complete removal of male sexual hair requires electrolysis or laser treatment or both.
b
Familial scalp hair loss may occur if estrogens are stopped.
c
Treatment by speech pathologists for voice training is most effective.
