By: Plume Community Member (she/her)
Everyone experiences the effects of gender-affirming hormones differently. How estrogen affects someone’s body is dependent upon their adrenal system, age, diet, exercise, and physiological system. A month into gender affirming hormone therapy (GAHT, also called HRT or hormone replacement therapy), most transfeminine people who take estradiol will be experiencing emotional changes.
A second blossoming
The first and most present emotion I noticed when I started E was the expansion of gender euphoria in my body and mind. I began to feel euphoria as the hormones took hold in my adrenal system—even before I saw any physical changes.
Many trans people report a feeling of ease and grounded-ness when beginning hormones, some even likening it to a “blossoming.” That was my experience, too. As someone who spent my whole life disassociating from my physical and emotional bodies due to gender dysphoria, this part of my transition was amazing. As I moved towards an estrogen-dominant hormonal system, I started to feel emotional and physical experiences more deeply. As I allowed myself to strengthen my connection with my emotional self, I noticed I could be quicker to tears but also quicker to joy.
The first couple of years into a hormonal transition are referred to as “second puberty” for good reason. Just as during your first puberty, you may experience a wide range of contrasting emotions in a short period of time. I found that I could suddenly feel all my emotions in a bigger and deeper way after starting estrogen. This was something that felt destabilizing at first, since I was someone who’s always felt like I “controlled my emotions.” However, I was able to move past this.
Living as a trans woman in a misogynistic society where certain emotions like sadness or empathy are seen as invalid or weak, I realized that “controlling my emotions” actually meant repressing them. If this is your experience, I would say: Don’t be concerned if you’re quicker to tears, feel more emotional about the subtleties of life, or experience a widening of empathy. These are good things. Life is meant to be lived, and emotions are meant to be felt.
Mental health and taking estrogen
Many transfeminine, MTF, gender non-conforming (GNC), and nonbinary people on estradiol experience less depression and anxiety by the first month on E. For many of us, our anxiety, depression, and other mental health issues are closely related to gender dysphoria and the way trans people are perceived in our society. (This isn’t true for everyone. You can transition with E and still have mental health struggles like depression, anxiety, or other issues. Estrogen isn’t a mental health medication, but it can help alleviate the emotional pain of gender dysphoria.)
I was both anxious and depressed before beginning hormones. However, after being on hormones for even only a few weeks, I could start to see the positive emotional changes and even begin to feel real, unbridled joy. My negative self-talk began to fade as I felt the physical, emotional, and mental changes estrogen offered me.
My joy and ease of mind continued to grow as I started to see the physical and emotional changes that hormones bring. It was exciting to see how hormones were aligning my body with my identity. This phase of my transition took a lot of care and focus, but I did finally get to a place of ease with my physical transitions. It was helpful to have support navigating the healthcare system and negotiating when and to whom to come out.
Your hormonal cycle and E
Hormonal cycles are another way that estrogen affects our emotions. Every person’s body has a hormonal cycle that reflects the timing of your estrogen delivery. This means your hormone levels will rise and fall depending on when you last administered your hormones.
People who take a pill orally or sublingually will experience a hormonal peak shortly after taking the dose and a slow fall until their next dose (either twelve or twenty-four hours later). If you use the transdermal patch, your hormone cycle will recur every two to three days. With the injectable shot, your cycle will be every week or every other week.
You may feel a rush of euphoria shortly after administering estradiol and a dip in mood right before your next dose. If you experience headaches, difficulty sleeping, or night sweats, you should bring it up with a medical professional in your next appointment. These are symptoms of withdrawals, and you might need to change your dosage or uptake method.
Getting my beauty rest
Lastly, many people find they have an easier time sleeping at night. Studies have shown that some transfeminine people who had trouble sleeping due to breathing problems were able to fall asleep quicker and deeper after starting hormones. For me, my sleep issues seemed to be linked to my anxiety. Before starting E, my thoughts raced with anxiety and intrusive thoughts. These kept me up at night! I found that those thoughts were eased on hormones, making it much easier to fall asleep.
As with all things, your first month on hormones will vary greatly from other people’s experiences. There is no way to predict how estrogen will impact each of us emotionally. Hopefully the most overwhelming feeling you have is one of ease and peace, a decrease in depression and anxiety, and a deeper connection with your emotional self. It may feel strange, but soon it will feel familiar and settled. Make sure you’re extra generous and gracious with yourself while you explore this new world and your emotional state finds its new equilibrium.
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.
