By: Plume Community Member (she/her)
- What is gender dysphoria?
- Social transition without gender-affirming hormone therapy
- Medical transition can help diminish feelings of gender dysphoria
- Gender-affirming hormone therapy for trans people
- How does gender-affirming hormone therapy ease gender dysphoria?
- Can gender-affirming hormones help with mental health?
- You deserve to feel balanced, healthy, and aligned
Gender transition is more than skin deep. Gender dysphoria is the feeling of discomfort or distress that many trans people feel in relation to their own body or sex assigned at birth. Not all trans people experience dysphoria. It isn’t a universal experience, but many of us do. Gender dysphoria might show up in different ways and to varying depths. Many trans people find relief from their gender dysphoria when they start hormones. Some trans people have likened starting hormones to “coming home” for the first time.
Hormones can bring about many physical changes. It can also change your emotions and the way you feel aligned with your body.
This article explores how gender-affirming hormone therapy (GAHT, sometimes also called hormone replacement therapy or HRT) can lessen symptoms of gender dysphoria. For the people who need hormones like estrogen and testosterone, these medications can have many psychological and physical benefits.
What is gender dysphoria?
Gender dysphoria can manifest in various ways. Some people experience it as anxiety, depression, social isolation, and a sense of alienation from their body. Gender dysphoria is not a mental illness, but it can lead to mental health problems if it’s ignored.
At Plume, we agree with the overwhelming consensus among clinical professionals (including global health organizations like WPATH and the American Psychiatric Association) that it is essential to recognize that gender dysphoria is a genuine condition that requires treatment, just like any other health issue.
Transgender and nonbinary people might experience gender dysphoria. This uncomfortable and awkward feeling can also occur in cisgender people. (Remember, gender identity is not a choice or a lifestyle. It is an inherent aspect of a person’s being.)
Social transition without gender-affirming hormone therapy
For some trans people, a social transition is enough to relieve these feelings of discomfort and unease. My social transition felt like a much-needed makeover. Within a few months, I made some gender-affirming choices about how I wanted to be seen.
Because I am transfeminine, I wanted others to understand that I’m a woman. I got a feminine haircut from a trans-affirming hairstylist and learned to style my hair differently. I also changed my name and pronouns. (First, I did this casually. Later, I made this change legally and updated my identification documents to reflect my new name and updated pronouns.) Over time, I also shopped for clothes that felt affirming.
Making these changes helped me feel like my appearance was more aligned with my gender identity. I experienced a lot of relief from my social transition. It felt really good to be called “miss” and for people to use my pronouns. However, I knew that I also wanted to pursue gender-affirming hormone therapy. This is what is known as a “medical transition.”
Medical transition can help diminish feelings of gender dysphoria
A medical transition can include gender-affirming hormone therapy, gender-affirming surgeries, and other types of clinical support. Many trans and nonbinary people begin with a social transition. Later, they may use different types of medical support.
Some people choose to transition socially and medically at the same time. Others choose to transition socially first, and medically second—or not at all. Everyone’s needs are different. There is no timeline for your transition, only what works for you.
Gender-affirming hormone therapy for trans people
Gender-affirming hormone therapy is the most common type of medical support for transgender, nonbinary, genderfluid, and gender non-conforming (GNC) people. This is a medical treatment that alters the hormonal balance in someone’s body. The effects of gender-affirming hormone therapy are well-studied and safe for most people. Our Plume clinicians prescribe GAHT based on the WPATH Standards of Care guidelines and the UCSF care guidelines for transgender patients.
The goal of gender-affirming hormone therapy is to bring a person’s hormone levels into alignment with their gender identity. For example, a transgender woman may take estrogen, while a transgender man may take testosterone. Folks seeking estradiol might want certain physical changes like reducing or lightening body hair, stopping hair loss, breast growth, softening of skin, and fat redistribution. People who want to take testosterone might look forward to facial hair growth, a deepening voice, and fat redistribution.
Everyone’s needs are different, so it’s important to talk to your doctor or a knowledgeable medical professional about your gender transition goals.
How does gender-affirming hormone therapy ease gender dysphoria?
For many trans people, beginning gender affirming hormone therapy (GAHT) can lead to relieving gender dysphoria in two ways. First, because the physical changes bring our bodies more in line with our perception of ourselves. These changes support us to feel at home in our bodies.
For instance, as a trans woman, I spent most of my teen years wishing I could wake up with breasts. I really wanted to have a “feminine” puberty. Instead, I struggled with gender dysphoria as my body became more “masculine” due to my natural testosterone levels. Starting gender-affirming hormone therapy in my 30s helped me feel comfortable with myself. My estradiol medication helped lessen my gender dysphoria, especially as I began to grow breasts.
Many of my transmasculine friends shared this experience when they started testosterone. One of my friends, a trans man, always wanted a hairy chest and facial hair. His gender dysphoria eased as he saw new, thick hair grow on his chest and face.
Can gender-affirming hormones help with mental health?
Gender affirming hormone therapy can also provide mental and emotional clarity. Many trans people report a near-instant change to their mental health after beginning hormones, often before they can even see any physical changes. Some folks get a feeling of ease and grounded-ness immediately after starting treatment.
Each person’s gender-affirming hormone therapy should be tailored to their specific needs and transition goals. For example, a transgender woman (or someone who identifies as MTF, transfeminine, nonbinary, or genderfluid) may take estrogen in the form of oral pills or skin patches. A transgender man (or someone who identifies as FTM, transmasculine, nonbinary, or genderfluid) may take testosterone injections or use a topical gel.
Of course, hormones are only one component of your personal treatment plan. You might also need medications like T-blockers or other medications for erectile function support or hair restoration. Also, know that it’s not typical for someone’s care plan to be the same forever. Most treatment plans will need to adjust over time as someone may choose to increase or decrease their dosage or explore different medication options.
Because of this, it’s important to be in close conversation with a medical professional with a deep understanding of the broad range of the available gender affirming treatments.
You deserve to feel balanced, healthy, and aligned
Gender-affirming hormone therapy can reduce symptoms of gender dysphoria. For me, it improved my quality of life, too. As my body and emotions changed, I noticed that my hormone medication helped increase my self-esteem, improve my body image, and gave me a greater sense of well-being. While it didn’t solve all my problems, it was very important to my mental health because it gave me relief from my gender dysphoria.
Hormones not for every trans person, nor will it relieve all gender dysphoria for every trans person all the time. For the people who need hormones, they are essential. Gender-affirming hormone therapy is one of the many tools that may be part of your gender transition. It is up to each person to determine what the best way forward is, but many of us who are on gender-affirming hormone therapy have found our gender dysphoria greatly relieved, even making room for gender euphoria.
This Plume Community Member (she/her) is a transfeminine creative and freelance writer. She lives in the Pacific Northwest with her wife and dogs.
As the largest provider of gender-affirming care for the trans and nonbinary community, Plume is committed to providing information about many types of information, including questions about hormones like estrogen and testosterone, gender transitioning tips and experiences, and guidance on social transition and self care.
While we strive to include a diverse range of voices and expertise, not everything will be for every person. Each individual’s experience is unique, and the information Plume provides is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Always first seek the advice of your primary and/or specialist physician, the Plume Care Team, or other qualified health provider with any questions you may have regarding a medical condition, your mental health and emotional needs, or your health care needs regarding gender-affirming hormone therapy. If you are experiencing an emergency, including a mental health crisis, call 911 or reach out to Trans LifeLine.
