Explained: What are T-blockers and how do they work during gender transition?

By: Plume Community Member

Gender transition is a complex and multi-layered process, with many steps and considerations along the way. Some people’s gender transition includes the use of T-blockers to disrupt the body’s natural production of testosterone. 

T-blockers are hormones that can be taken in pill or injection form, and they are an integral part of gender transition for many trans and nonbinary people. In this article, we will explain what T-blockers are, how they work, and how they can be beneficial during gender transition. We will also provide a list of potential side effects and discuss the importance of finding the right dosage and monitoring hormone levels. Finally, we will conclude with a discussion of the importance of finding the right medical provider and support system for those transitioning.

What are T-blockers?

T-blockers are hormones that are specifically designed to prevent the production of testosterone in the body. They can be taken in pill or injection form and are designed to be a long-term solution for trans people who want to halt the effects of testosterone production and promote a more female hormone balance. 

There are several types of T-blockers, including spironolactone, cyproterone acetate, and finasteride. T-blockers are often used as an essential part of gender-affirming hormone therapy, especially when transitioning. Trans women, transfeminine people, nonbinary people, and folks who identify as male-to-female (MTF) may all use T-blockers. They are usually prescribed alongside gender-affirming hormone therapy (GAHT, sometimes also called HRT or hormone replacement therapy) like estrogen, another hormone that can be taken in pill or injection form. Blockers are also often used in conjunction with other medications to address potential side effects of T-blockers.

How T-blockers slow or stop T production

It is important to know that estrogen—not testosterone blockers—is primarily what lowers testosterone in your body. T blockers got their name because they block the effects of testosterone in different ways, but do not typically lower T levels directly. In fact, often at least initially, blockers increase the levels of testosterone detected in the blood because there is more T floating around with nothing to do! 

The body’s natural testosterone level is usually somewhere between 400-800 pre-GAHT for most folks, so for a brief period these hormone levels will be higher than usual. Then, estrogen will cause T levels to drop significantly.

Benefits of T-blockers during gender transition

Transitioning can be a complex and lengthy process, and many people will choose to use T-blockers as a part of their medical plan to achieve a more “female” hormone balance. While many of the benefits are long-term and will only be seen after a few months, some are immediate and can be noticed almost instantly. 

  • Increased breast size – When you begin to transition, you can use T-blockers to inhibit the production of testosterone and allow your estrogen levels to rise. 
  • Bump in mood – As estrogen begins to rise, so too can your mood. This can be a great benefit for individuals who struggle with depression or anxiety and will be a large factor in helping your transition be less stressful and more enjoyable. 
  • Increased libido – As estrogen increases in your body, your sex drive can also rise. This can help to return your sex drive to a more natural level. 
  • Less body hair – Another immediate benefit of T-blockers is a decrease in body hair. This can be a huge benefit for individuals who struggle with gender dysphoria due to unwanted hair and can help to make your transition easier.

Potential side effects

As with many medications, T-blockers are not without their side effects. Some of the most common side effects associated with T-blockers include dry skin, joint or bone pain, and mood changes. Many of these can be managed through adding a supplement to your daily routine. It is also important to remember that each person’s experience is unique and may vary from these general side effects. Additionally, it is important to remember that side effects can change as your body adjusts to the medication and they may be more or less noticeable over time. Finding the right dosage and monitoring your hormone levels can also help to minimize side effects.

Finding the right dosage

As with many aspects of transitioning, finding the right dosage of T-blockers can be a complex and individual process. Finding the right level of dosage is crucial to your transition and will vary from person to person. There are a few factors that can help you decide the best dosage for you, including your hormone levels, what other medications you’re taking, and any other health conditions you may have. It is very important to work with your Care Team to find the right dosage that works for you.

Monitoring hormone levels

As with any medication you take, it is important to monitor your levels to make sure they are at the right level. This can help to reduce the risk of side effects, find the right dosage, and make sure you are getting the most out of your transition. This can be done through a variety of methods, including blood work, urine tests, and saliva tests. It is important to keep in mind that not all methods are created equally and some are better for certain situations. Your Care Team will order regular lab work to ensure that you stay healthy while you’re taking any gender-affirming medications, including T-blockers.

Will I have to take T-blockers forever?

Once your T drops to very low levels, like less than 30, most people don’t need to be on T blockers anymore, because there is hardly any T to block anymore! Whether to go on T blockers or not is totally up to you. You could be on none, one, or all of these at the same time, depending on your personal situation. While T blockers can help limit the effects of testosterone on the body, you will have to weigh the different side effects, which are listed below. Ultimately, the only way to know how a medication will affect you is to try it, so if you are interested in a T blocker, we recommend you start with one. If you tolerate it well, you can then discuss adding another one.

Working with your Care Team to get the best results

As you begin your transition process, it is important to communicate with your Plume Care Team about your transition goals, health concerns, and questions. If you are already a Plume Member, you can access this amazing resource throughout your transition process. Working with your Care Team will help you to find the right dosage of T-blockers for your needs, find a support system, and get the most out of your transition.

Conclusion

As you transition, you may want to use T-blockers to halt the production of testosterone in your body. T-blockers are hormones that can be taken in pill or injection form and might be an integral part of gender transition. They can help to decrease body hair, increase breast size, and promote a different hormone balance. Blockers are also often used in conjunction with other medications to address potential side effects of T-blockers. It is important to find the right dosage and monitor your hormone levels to get the best results. Working with your Care Team can help you get the best results from your transition and make the process as smooth and seamless as possible. Your Care Team can provide guidance and advice throughout your transition, as well as a unique care plan customized to your transition goals. 

With Plume, you can have the peace of mind that you are taking the best steps to safely and effectively transition to your true self. Ready to start? Click here to become a Member today.

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