Feminizing hormone therapy
When you receive feminizing hormone therapy, it induces physical changes caused by female hormones during puberty (secondary sex characteristics) to promote matching your gender identity and your body (gender congruence).
Feminizing hormone therapy can be completed alone or in conjunction with feminizing surgery. During therapy, a patient receives medication to block the action of testosterone and promote estrogen. This decreases testosterone production and influences feminine secondary sex characteristics. The changes caused by the medications may be temporary or permanent.
Feminizing hormone therapy isn't right for all transgender women. It may affect your fertility, sexual function, or cause other health problems. Talk to your doctor about the risks and benefits.
Therapy can:
- Make an incidence of gender dysphoria less severe
- Reduce your psychological or emotional distress
- Improve your psychological and social functioning
- Increase your sexual satisfaction
- Improve your quality of life
Research suggests that feminizing hormone therapy can be safe and effective.
Your doctor might discourage therapy if you:
- Had or have a hormone-sensitive cancer
- Have a thromboembolic disease, such as deep vein thrombosis or a pulmonary embolism
- Experience uncontrolled behavioral health conditions
- Have uncontrolled significant medical conditions
- Have a condition that limits your ability to provide informed consent
What to Expect
You should notice changes to your body within weeks to months. Here are some of the changes:
You will notice these one to three months after treatment begins.
- Decreased libido
- Fewer spontaneous erections
- Slower scalp hair loss
After three to six months of treatment:
- Softer, less oily skin
- Testicular atrophy
- Breast development
- Redistribution of body fat
- Decreased muscle mass
After six to 12 months:
- Decreased facial and body hair growth
During your first year of therapy, you'll need to visit your doctor for a checkup quarterly, as well as when you change your hormone regimen.
You will need to diligently maintain routine preventive care visits, including:
- Breast cancer screening
- Supplementation – particularly vitamin D for bone density
- Prostate cancer screening
Masculinizing hormone therapy
This therapy induces the typical physical changes in your body during puberty (secondary sex characteristics) to promote the matching of your gender identity and body (gender congruence).
During masculinizing hormone therapy, you'll be given testosterone, which suppresses your menstrual cycles and decreases the production of estrogen from your ovaries. The changes caused by the medications may be temporary or permanent.
Masculinizing hormone therapy can:
- Make your gender dysphoria less severe
- Lessen your psychological and emotional distress
- Improve your psychological and social functioning
- Enhance your sexual satisfaction
- Improve your overall quality of life
Therapy isn't appropriate for all transgender men. It can affect your fertility, sexual function, or cause other health problems. Talk to your doctor about the risks and benefits.
What to Expect
You should notice changes to your body within weeks to months. Here are some of the changes:
- Your period stops. Within two to six months of treatment.
- Your voice deepens. Three to 12 months after treatment. The maximum effect - within one to two years.
- Facial and body hair growth. Begins three to six months after treatment. The maximum effect - within three to five years.
- Body fat redistribution. Begin within three to six months. The maximum effect - within two to five years.
- Clitoral enlargement and vaginal atrophy. Begin three to 12 months after treatment. The maximum effect - within one to two years.
- Increased muscle mass and strength. Begins within six to 12 months after treatment. The maximum effect - within two to five years.
You will need to meet with your doctor on a regular basis and get routine preventive care if you haven't had certain surgical interventions.
- Breast cancer screening
- Cervical cancer screening
- Evaluation of vaginal bleeding
- Supplementation
Meet Your Team
Your expert team offers integrated medical, psychosocial and surgical intervention to individuals with gender dysphoria or incongruence and to those with differences of sexual development (intersex).
Kristin Emilia Rojas, MD, FACS
Breast Surgical Oncology, Surgical Oncology
Kristin E. Rojas, M.D., FACS is a fellowship-trained breast surgical oncologist and board-certified gynecologic surgeon with a passion for comprehensive wellness in women’s cancer care. Originally from Texas, she graduated from UT Southwestern Medical School and completed her residency training at Brown University/Women and Infants Hospital followed by a Society of Surgical Oncology (SSO) Breast Surgery Fellowship at Maimonides Medical Center in New York City.
As an attending surgeon, her research focuses on opioid-minimization in breast cancer care, sexual health in women’s cancer survivorship, and the use of preoperative MRI in women with early-stage breast cancer.
She is the Founder of the Menopause, Urogenital, Sexual Health and Intimacy (MUSIC) Program, a program for women experiencing sexual dysfunction after cancer treatment. In 2019, she received the Rudolph Nissen Research Award, and her work was recently published in Breast Cancer Research and Treatment, Annals of Surgical Oncology, and The American Journal of Surgery.
Lydia Ann Fein, MD, MPH
Obstetrics and Gynecology
Lydia A. Fein, MD MPH, is an assistant professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of Miami Miller School of Medicine. Dr. Fein graduated from Georgetown University with a Bachelors in Science and then earned her doctorate and Masters in Public Health from the University of Miami Miller School of Medicine. She then completed her residency in obstetrics and gynecology at University of Miami/Jackson Memorial Hospital.
Dr. Fein’s primary clinical focus is in gender-affirming care. She currently leads the transgender health program within her department, where she specializes in the medical and surgical care of gender diverse patients. She offers both hormone therapy and a range of gender-affirming surgery.
Dr. Fein is a member of the World Professional Association for Transgender Health (WPATH). She conducts research in the field of gender-affirming medicine and surgery and has presented her work at national and international meetings as well as written book chapters and articles published in leading medical journals.
In addition to gender-affirming care, Dr. Fein’s also offers a wide range of care in obstetrics and gynecology, including minimally invasive surgery and prenatal care. Dr. Fein is a proud LGBT ally and welcomes all patients to her practice.
Judith Seline Simms-Cendan, MD
Obstetrics and Gynecology, Pediatric and Adolescent Gynecology
Dr. Judy Simms-Cendan is the Division Director of Pediatric Adolescent Gynecologist at the University of Miami Miller School of Medicine OBGYN department.
Dr. Simms-Cendan graduated from the University of Miami with her Bachelor BS Degree, and from the University of Florida College of Medicine with her MD degree. She completed her residency training in OBGYN at the University of Florida in 1995, then served on the faculty and started a Pediatric Adolescent Gynecology weekly clinic. She joined the founding faculty at the UCF College of Medicine in 2010 and opened the first practice in Florida fully dedicated to Pediatric Adolescent Gynecology patients in 2010 at Winnie Palmer Hospital in Orlando and founded a combined hematology/gynecology for adolescent girls with heavy menses and bleeding disorders in 2017. In July 2021 she joined the University of Miami faculty to develop dedicated clinics for Pediatric Adolescent Gynecology care.
Dr. Simms-Cendan enjoys her patients and their families understand and improve their reproductive health. She has written national guidelines for care of adolescents with heavy menses and bleeding disorders and complex cardiac conditions, and international advocacy statements to call attention to the need for improved care for adolescents girls with menstrual disorders.
Pasquale Patrizio, MD
Reproductive Endocrinology and Infertility
Pasquale Patrizio, MD, MBE, HCLD, FACOG, an internationally renowned specialist in female and male reproductive medicine, is joining the University of Miami Miller School of Medicine as professor of obstetrics, gynecology and reproductive sciences and chief of the Division of Reproductive Endocrinology and Infertility.
“I look forward to leading our clinical, research and education programs in the spirit of trust, transparency and inclusion,” said Dr. Patrizio, whose discoveries have changed the way reproductive medicine and in vitro fertilization (IVF) are practiced throughout the world. He has spent the last 17 years at Yale University, directing the fertility center and IVF program at Yale School of Medicine.
“Dr. Patrizio has made major contributions to the field of reproductive medicine since the 1990s,” said Michael Paidas, M.D., professor and chair of the Department of Obstetrics, Gynecology and Reproductive Sciences. “We are excited to welcome him to the UHealth-Miller School family and look forward to advancing our program.”
Dr. Patrizio, who holds a master’s degree in bioethics (MBE), takes a collaborative approach to patient care and research. He plans to develop a Center for Reproductive Health with a service for transgender individuals, similar to his highly successful program at Yale. He also expects to create a fellowship program with Dr. Paidas for training future generations of reproductive medicine specialists.
“I will be working closely with the Miller School’s urologists, oncologists, pediatricians, geneticists and other specialists to provide personalized care to our patients,” said Dr. Patrizio.
Dr. Patrizio is one of the few U.S. fertility specialists to see both men and women. “Couples appreciate being seen by one doctor in a supportive environment, so both individuals can express their feelings, and discuss their options based on the same information,” he said. “Patients love this approach, which improves the coordination of care.”