Finally! You got the prescription you need to start gender-affirming hormone therapy (GAHT, also sometimes called hormone replacement therapy or HRT). Maybe you got your medication by driving to the pharmacy or receiving a package in the mail. Today, you are taking your first dose of estrogen or testosterone.
As you open your medication, your mind may be buzzing with questions, such as:
- “How long until I start seeing the changes I want?”
- “How will people’s perceptions of me change?”
- “Will my feelings about using hormones change as time goes on?”
This article will share some common questions about physical changes and experiences after your first time using gender-affirming hormones.
Get the facts about your gender-affirming medication
First things first. People start gender-affirming hormone therapy at different times in their transition. Some people choose to start hormones shortly after they acknowledge their gender identity. Other people take their time, beginning hormones many years after coming out and transitioning socially.
Taking gender-affirming hormones such as estrogen, progesterone, or testosterone is a personal choice. Not every transgender, nonbinary, or gender non-conforming person wants or needs hormones. Your identity is valid—hormones are supposed to support your transition, not define it.
Before you take your medication for the first time, make sure you know:
- The name and brand of your medication
- Your hormone dosage
- The indicated injection frequency
- How to contact your health care provider
It’s unlikely that anything will go awry during your first time taking your medication. However, many people find that it’s helpful having someone on standby to be supportive or answer questions. It can also help to ask a friend to give you emotional support. Beginning hormones is an exciting, transformative journey, filled with changing menstruation cycles, skin oil and body fat adjustments, possible mood swings, and other changes. You don’t have to do any of this alone.
How to inject hormones for the first time
Before all that, you need to perform your first injection. This helpful video by our co-founder, Dr. Jerrica Kirkley (she/her), offers you some basic guidance on how to inject estrogen or testosterone safely. Click here to learn more about how to do an intramuscular (IM) injection or a subcutaneous (SubQ) injection.
Ensure you have disinfecting alcohol wipes, your E or T medication, your injection syringe with the correct gauge of needle, and a steady hand to perform the injection. Whether you perform an intramuscular or subcutaneous injection, you will want to be relaxed. So, if you have shaky hands, take time to calm down so you perform your injection calmly and avoid injury. If you’re really on edge, it would be best to get help from a loved one.
So you know, your medical provider (or Care Team if you’re a Member at Plume) will help you understand how to do your shot. They can answer any questions you have. Each type of medication might need to be given in a different area or with a different sized needle. Always follow your doctor’s instructions for your injection. This will help you get the right amount of your medication and also stay healthy.
- Locate the area of your skin or muscle where you would like to perform your injection
- Clean the area with your swabs and let the skin dry slightly
- Use your dominant hand to hold the needle. If you’re right-handed, hold the needle in your right hand. If you’re left-handed, hold the needle in your left hand.
- Use your other, non-dominant hand to pinch the skin or muscle where you want to inject
- Take a deep breath and insert the needle in a clean, swift motion
- Push down the plunger
- Remove the needle smoothly with a steady hand
This process will get easier with time and practice. Some people find it helpful to ice the injection area before taking their shot. Other people choose to inject right after a hot bath or shower, when the skin is softer. Playing music you enjoy during your injection, visualizing your transition goals, or asking a friend to sit with you can also help.
Your first time, it’s unlikely that you’ll feel a physical “cascade” of hormones in your body. Still, you may experience a lot of excitement and anxiety. Pause and breathe, and remind yourself that you are showing yourself love by giving yourself the medication you need to feel balanced and aligned. Taking your gender-affirming medication is a big deal, so let yourself breathe.
What happens after my first dose of gender-affirming hormones?
While some transgender folks experience dramatic physical and emotional changes while taking gender-affirming hormones, for others, the transition is more subtle. Most people experience body changes during the first 6 to 12 months. Some people feel like they plateau around a year or two, but everyone’s experience is different.
The changes you experience can also depend on your transition goals, your dosage, which type of gender-affirming hormones you are taking, and many other factors. Try not to compare yourself with other people. Your journey is yours and yours alone—and it’s just as unique as you are.
While some people believe that transition is a “one and done” process, we at Plume think of it as more a life-long process of self-discovery. As you transition, you may continue to have new experiences and emotions around trans identity. To best care for yourself, make sure you have a solid support system and that you are communicating with your medical provider about your medication. Your first injection is a big step toward living as your authentic self.
Do I need to make any changes after starting hormones?
When you start using gender-affirming hormones, you may already have a clear idea of your transition goals. Some of these changes may be internal. For example, many people begin GAHT because they want to feel an increased sense of joy, or gender euphoria. Other folks use hormones because it changes the way their body looks. Before your first shot, your care provider should give you a very clear idea of how the hormones will affect your body and emotions.
As you transition, you may find that you want to experiment with more feminine, masculine, or nonbinary gender presentations. All of these choices are beautiful and valid. Feel free to play with your gender presentation, which is the way that you look, behave, or “seem” to other people. (Remember that gender is a social construct, which means that it has to do with how we relate to other people and to ourselves.)
Everyone’s journey through GAHT and trans identity is different. Your individual dose of hormones, medication, and transition goals will influence your experience. When you’re just starting out, be gentle with yourself. Seek support as you move through this experience. You’re not alone, and you’re right on time.
Aleena Ortiz (he/she/they) is an independent world traveler, freelance writer, and contract book reviewer at Foreword Magazine. They obtained a Bachelor of Arts in Religion with a focus on Buddhism, Daoism, and Shintō at Reed College in May 2021. Eager to explore fictive worlds with respect to cultural sensitivity and the complexities of human emotion, he has published over 1 million words online over the last decade. Aleena strives to create space for nuanced understanding of historically underrepresented groups through her analyses of media and in fiction writing.
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.
