A guide to gender-affirming microdosing

By: William Cuthbert (he/they). Reviewed by Dr. Jenny Wares (she/her), Associate Medical Director of Clinical Services. Additional review by Elaina Tully, MD (she/her), Medical Director of Clinical Services.

When taking steps towards how we want to see ourselves in the mirror, some of us won’t be happy or comfortable with a higher dosage in gender-affirming hormone therapy (GAHT, which some people call hormone replacement therapy or HRT). Here’s where microdosing comes in. This guide will explain the basics of microdosing hormones such as testosterone and estrogen.

What is microdosing?

Simply put, microdosing means taking a low dose of hormones for whichever reasons you need or prefer to do so for your transition goals.  Microdosing can be helpful for anyone looking for a gentle rate of physical change, whether you identify as MTF and want to take estrogen for a more culturally feminine appearance, or identify as FTM and seek the “masculinizing” effects of testosterone.

Microdosing reflects an individual person’s transition goals, not their gender identity. All kinds of people choose to microdose. Genderfluid, nonbinary and other gender non-conforming (GNC) folks might microdose to maintain a subtler change. Other folks may prefer microdosing because they benefit from the mental or psychological effects.

What are the effects of microdosing hormones?

Microdosing hormones can help you lean towards “masculine” or “feminine” physical traits. But you can also identify as binary trans and opt for microdosing! It all depends on what feels best for easing any gender dysphoria, and finding health and happiness.

The main thing to prioritize with GAHT is making sure the physical changes involved will support your mental health and your gender identity. If you do opt in for a GAHT prescription, the methods of microdosing hormones are the same as for higher doses. You can still inject your medication or apply it as a patch or cream. 

As an example, for transmasculine folks taking testosterone injections, a microdose could be significantly lower than the “standard” dose of 50-100mg per week. Pill, patch, cream and gel forms of GAHT can all be taken in lower doses too. For example, if you want to microdose E, follow your care provider’s instructions on the dose and frequency of medication.

Can I take herbal supplements instead of prescribed hormones?

Many people make lifestyle and dietary changes before trying hormones. While these methods don’t work for everyone, they seem to be fairly safe and have the desired effects for some. Obviously, you should always check with a doctor or other medical professional before starting any new medication—prescription or not.

Some people believe that they can get a “feminizing” effect from certain types of supplements, such as Vitamins D and B, soybeans, flaxseeds and sesame seeds, or herbal supplements like evening primrose oil. These supplements are not a substitute for medical support from an experienced and licensed care provider.

In our community, where people share a lot of anecdotal evidence or personal experiences, it’s really important to be careful with using supplements as a replacement for clinical advice. Overloading your body with vitamins, herbs, or other supplements can cause health problems. For example, higher levels of Vitamin D can suppress estradiol, which is why we don’t suggest using it to change your hormones. Too much Vitamin D that doesn’t come from the sun can make you sick! 

Gender-affirming hormone therapy is the safest option for transition

The best advice is to take the best care possible of your body, follow medical guidance, and be patient as your prescribed medication does its job. Eating plenty of healthy fats, carbs and protein, and making sure you get enough exercise can also reduce stress and improve your cardiovascular health.

The effects of natural supplements do not compare with gender-affirming hormone therapy (GAHT). Microdosing is safer, more powerful, and more effective than vitamins, exercise, or supplements for gender transition.

Don’t worry if you feel confused by all the available options: your Care Team is here to help you navigate your customized care plan. Ready to start? Get in touch and talk to Plume about what you want from your transition.

William Cuthbert (he/they) writes from his power as an autistic Pagan witch in the hope that his words help those who read them. You can find his work via Linktree, or get in touch on LinkedIn or Twitter, where he’d love to chat with his readers.

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.

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