Key Takeaways
Transfem is short for transfeminine, a term for gender identities or experiences connected to femininity.
A transfeminine person can be a trans woman, nonbinary, genderfluid, or another gender identity.
Transfem and trans woman are not interchangeable terms.
Feminine of center describes a gender experience that leans toward femininity.
MTF means male-to-female and is an older term that some people still use.
You can be transfeminine without taking estrogen or other hormones.
Estrogen can cause breast development, softer skin, and changes in body fat distribution.
Some people take estrogen with a testosterone blocker, while others use estrogen alone.
Estrogen does not typically change an adult voice, so voice training may be an option.
There is no single way to be transfeminine or transition, and medical transition is not required.
If you’re learning about transfem or transfeminine identities, you may have questions about what these terms mean and how they relate to being transgender, nonbinary, or a trans woman. You may also be wondering what a transfeminine transition can look like.
There is no single way to be transfeminine. Some people change their gender expression, some pursue medical transition, and some make no physical or social changes at all.
What does transfeminine or transfem mean?
Transfeminine, often shortened to transfem, is a term some transgender people use to describe a gender identity or experience connected to femininity.
The term is often used by people who were assigned male at birth (AMAB) and whose gender identity or expression is more feminine than the gender they were assigned at birth. Some transfeminine people identify as women, while others identify as nonbinary or use another gender identity.
Being transfeminine does not require a particular appearance, gender expression, medical treatment, or transition goal.
A transfeminine person might:
Identify as a trans woman.
Identify as nonbinary and feminine.
Use transfem without another specific gender label.
Take estrogen.
Use an androgen blocker or other gender-affirming medication.
Have gender-affirming surgery.
Change their name, pronouns, clothing, or presentation.
Make no medical changes at all.
There is no single way to look or feel transfeminine.
Is transfem the same as transgender?
Not exactly.
Transgender is an umbrella term for people whose gender identity differs from the sex or gender they were assigned at birth.
Transfeminine is a more specific term that describes a feminine direction or relationship to gender. Many transfeminine people are transgender, but not every transgender person is transfeminine.
For example, a transgender woman may identify as transfeminine, while a transgender man would not typically use the term transfeminine.
Is transfem the same as trans woman?
No. Transfem and trans woman are related terms, but they are not synonyms.
A trans woman is a woman who is transgender. A transfeminine person may be a trans woman, but they may also identify as nonbinary or use another gender identity.
Some people use transfem because it describes their experience without requiring them to identify specifically as a woman.
Can a nonbinary person be transfeminine?
Yes.
Some nonbinary people identify as transfeminine because their gender is connected to femininity. A nonbinary person might also identify as feminine, femme, feminine of center, transfem, or another identity.
Being nonbinary does not mean being completely disconnected from femininity or masculinity.
What does feminine of center mean?
Feminine of center is a term some people use to describe a gender identity or presentation that falls toward the feminine side of the gender spectrum.
It can overlap with terms such as transfeminine, transfem, femme, or nonbinary. These terms do not mean exactly the same thing, though, and their meanings can vary from person to person.
What does MTF mean?
MTF stands for male-to-female. It has historically been used to describe people who were assigned male at birth and transition to living as women.
Today, some people still use MTF to describe themselves, while others prefer terms such as trans woman or transfeminine.
MTF is not the preferred term for everyone. Some people find it useful, while others feel that it makes their gender sound like something they changed from one gender into another.
The language people use to describe their gender is personal, and terminology continues to evolve.
What are some other names for a transfeminine identity?
People who identify as transfeminine may also use terms such as:
Trans woman
Nonbinary
Genderqueer
Genderfluid
Feminine of center
Femme
Gender-nonconforming
Trans
MTF
AMAB
These terms have different meanings, and not everyone who identifies as transfeminine will use them.
The best label is the one that feels accurate and comfortable to you.
Can you be transfeminine without transitioning?
Yes.
There is no required checklist for being transfeminine. You do not have to change your name, pronouns, clothing, body, or medical care to have a transfeminine identity.
Transition looks different for everyone.
Some people make social changes. Some use gender-affirming hormones or surgery. Some make only certain changes. Others do not medically or socially transition at all.
How do I know if I’m transfeminine?
There is no test that determines whether someone is transfeminine.
Some people have a strong sense of their gender from an early age. Others explore their gender over time. You might begin questioning your gender because you feel uncomfortable being seen as a man, feel more comfortable imagining yourself as feminine or female, or feel that another gender identity fits you better.
You can take your time exploring what feels right.
You also do not need to have a specific transition plan before using the term transfeminine.
What is estrogen?
Estrogen is a hormone naturally produced by the body. Estrogen is also used as gender-affirming hormone therapy (GAHT) for people who want to develop more feminine physical characteristics.
For gender-affirming hormone therapy, estradiol is a commonly used form of estrogen.
Estrogen can cause changes such as:
Breast development.
Changes in body fat distribution.
Softer skin.
Decreased testosterone-driven changes.
Reduced spontaneous erections for some people.
Changes in sex drive.
Changes in body hair growth over time.
The timing and degree of these changes vary from person to person.
Not every transfeminine person wants estrogen, and taking estrogen is not required to identify as transfeminine.
What are the options for taking estrogen?
Estrogen can be prescribed in several forms, including:
Pills
Patches.
Gels
Injections
The best option depends on factors such as your health, preferences, goals, and access to care. A qualified clinician can help you understand the different options and determine what may be appropriate for you.
Do I need a testosterone blocker if I take estrogen?
Not necessarily.
Some people take estrogen by itself, while others also use an androgen blocker, sometimes called a T blocker, to reduce the effects of testosterone.
One example is spironolactone. Other medications may also be used depending on a person’s individual treatment plan.
Whether you need a testosterone blocker depends on factors such as your body, hormone levels, health history, treatment goals, and the type of gender-affirming hormone therapy you are using.
Your clinician can help determine which medications, if any, are appropriate for you.
What are testosterone blockers?
Testosterone blockers, also called androgen blockers, are medications that reduce the effects or production of testosterone in the body.
They may be used as part of gender-affirming hormone therapy for some transfeminine people.
Spironolactone is one medication that may be used as an androgen blocker. The right medication depends on your individual health and transition goals.
Can transfeminine people take estrogen without identifying as women?
Yes.
You do not have to identify as a woman to take estrogen. Some nonbinary and genderqueer people use estrogen because they want some of its physical effects.
Your gender identity and your medical treatment do not have to fit a particular formula.
What physical changes can estrogen cause?
Estrogen can cause a range of physical changes. Some changes begin within the first few months, while others develop gradually over time.
Common changes can include:
Breast development.
Changes in body fat distribution.
Softer skin.
Decreased muscle mass.
Reduced body hair growth over time.
Changes in sex drive.
Changes in erectile function.
Everyone responds differently to estrogen. Some changes may be permanent, while others may change after stopping hormone therapy.
If you are considering estrogen, a clinician can explain expected changes, timelines, side effects, and monitoring.
For a more detailed look at estrogen and physical changes, learn more about how estrogen can affect your body.
Does estrogen affect hair growth?
It can.
Gender-affirming hormone therapy can affect the pattern and texture of body hair over time. Some people notice changes in body hair growth after starting estrogen, while others notice little change.
Estrogen does not necessarily remove existing facial hair. Many transfeminine people use additional options such as shaving, waxing, laser hair removal, or electrolysis depending on their goals.
Learn more about how estrogen can affect hair.
Does estrogen affect your skin?
Yes. Hormone changes can affect skin texture, oil production, and dryness.
Some people notice that their skin becomes softer or less oily after starting estrogen. Your skincare needs may also change over time.
A simple skincare routine can help you manage changes in oiliness, dryness, acne, or sensitivity.
Does estrogen cause mood changes?
Estrogen can affect mood and emotions, but everyone’s experience is different.
Some people notice changes in their emotional experience after starting estrogen. Others notice little change.
Hormone levels, other medications, stress, life circumstances, and many other factors can affect mood. If you experience significant or persistent mood changes after starting hormone therapy, talk with your healthcare team.
Learn more about estrogen and emotions during gender-affirming hormone therapy.
Can estrogen change your voice?
Estrogen does not typically raise a voice that has already deepened during testosterone-driven puberty.
If you want to develop a higher, more feminine, or differently modulated voice, voice training can help you explore changes in pitch, resonance, speech patterns, and other aspects of your voice.
Voice training can be useful whether or not you take estrogen.
Learn more about vocalization exercises and voice changes.
What are breast forms, padding, and specialty lingerie?
Not everyone wants or has access to gender-affirming surgery. Clothing and other products can also help people explore their gender expression.
Breast forms are wearable forms that can create the appearance of breasts or cleavage. Padding can also be used around the hips, waist, or other areas to create a particular silhouette.
Some specialty lingerie and shapewear can provide additional support, padding, or tucking options.
These are optional tools for gender expression and are not requirements for being transfeminine.
How can I find feminine clothes that fit?
Clothing sizes can vary significantly between brands and between traditionally men’s and women’s sizing systems.
Before shopping, take measurements such as your:
Waist
Hips
Inseam
Shoulders
Chest
Then compare your measurements with the brand’s sizing chart.
Trying different cuts and sizes can help you find clothes that fit your body and match your personal style.
Can you be transfeminine without hormones?
Yes.
You do not need hormones to be transfeminine.
Gender identity is not determined by whether you take estrogen, use a testosterone blocker, have surgery, change your appearance, or make any other physical changes.
Some transfeminine people medically transition, some socially transition, some do both, and some do neither.
Your transition can be whatever feels right for you.
Do transfeminine people need surgery?
No.
Some transfeminine people pursue gender-affirming surgeries, while others do not. Surgery is not required to be transgender, transfeminine, or a trans woman.
The types of surgery someone may consider depend on their individual goals. Options can include procedures involving the chest, face, body, or genitals.
Whether or not to pursue surgery is a personal decision.
Does progesterone have a role in transfeminine hormone therapy?
Progesterone is another hormone that some people use as part of gender-affirming hormone therapy.
Some people take progesterone along with estrogen, while others do not.
Research on progesterone specifically for transfeminine people is more limited than research on estrogen. People considering progesterone should discuss its potential benefits, risks, and uncertainties with a qualified clinician.
Learn more about progesterone as a gender-affirming medication.
Can estrogen affect sexual function?
Yes.
Hormone therapy can affect sexual function, including sex drive, erections, genital sensitivity, and other aspects of sexual response. The changes vary from person to person.
Some transfeminine people may want to preserve or support certain aspects of sexual function while taking estrogen. Medications for sexual function may be an option for some people.
If changes in sexual function are affecting you, talk with your healthcare team about your options.
Is there a natural way to transition without synthetic hormones?
Some people explore herbs, supplements, or other approaches they believe may affect hormone levels. However, these options generally do not have the same evidence or predictable effects as clinically supported gender-affirming hormone therapy.
If you are interested in changing your hormone levels, talk with a qualified healthcare professional about evidence-based options and what may be appropriate for your goals.
How do I choose a transfeminine transition path?
There is no single transfeminine transition path.
Your goals might include changes to your appearance, voice, body, or gender expression. You might want estrogen, an androgen blocker, surgery, another type of gender-affirming care, or no medical treatment at all.
You can also change your mind about your goals over time.
If you are considering medical transition, a gender-affirming healthcare professional can help you understand your options and decide which treatments, if any, fit your goals.
Why do some people prefer “transfem” instead of “MTF”?
For some people, transfem better describes their gender experience because it does not imply that they transitioned from one gender into another.
MTF can also feel inaccurate for people who are nonbinary or who do not identify as women.
At the same time, MTF remains a meaningful identity or shorthand for many people. There is no universal rule about which term someone should use.
Where can I meet other transfeminine people?
Connecting with other transfeminine, nonbinary, and transgender people can be a helpful part of exploring your identity and transition.
Online communities, local LGBTQ+ organizations, peer-support groups, and gender-affirming healthcare communities can all provide opportunities to connect with people who have similar experiences.
Transfem identity and gender-affirming care
Being transfeminine does not require medical transition. But if you want gender-affirming medical care, options may include estrogen, androgen blockers, progesterone, surgery, voice-related care, or other treatments depending on your goals and healthcare needs.
Plume provides gender-affirming healthcare, including gender-affirming hormone therapy such as estrogen and testosterone, for eligible transgender and nonbinary adults.
