Transgender hormone therapy of the male-to-female MTF type, also known as feminizing hormone therapyis hormone therapy and sex reassignment therapy to change the secondary sexual characteristics of transgender people from masculine or androgynous to feminine. Some intersex people also take "Mtf transsexuals" form of therapy, according to their personal needs and preferences.
The purpose of the therapy is to cause the development of the secondary sex characteristics of the desired sexsuch as breasts and a feminine pattern of hairMtf transsexualsand muscle distribution. It cannot undo many of the changes produced by naturally occurring pubertywhich may necessitate surgery and other treatments to reverse see below.
The medications used for the MTF therapy include estrogensantiandrogensprogestogensand gonadotropin-releasing hormone modulators GnRH modulators. While the therapy cannot undo the effects of a person's
Mtf transsexuals puberty Mtf transsexuals, developing secondary sex characteristics associated with a different gender can relieve some or all of the distress and discomfort associated with gender dysphoriaand can help the person to "pass" or be seen as the gender they identify with.
Introducing exogenous hormones into the body impacts it at every level and many patients report changes in energy levels, mood, appetite, etc. The goal of the therapy, and indeed somatic treatments, is to provide patients with a more satisfying body that is more congruent with their gender identity.
Some medical conditions may
Mtf transsexuals a "Mtf transsexuals" to withhold hormone replacement therapy because of the harm it could cause to the patient. Such interfering factors are described in medicine as contraindications. Absolute contraindications — those Mtf transsexuals can cause life-threatening complications, and in which hormone replacement therapy should never be used — include histories of estrogen-sensitive cancer e.
Relative contraindications — in which the benefits of HRT may outweigh the risks, but caution should be used — include:. As dosages increase, risks increase as well. Therefore, patients with relative contraindications may start Mtf transsexuals low dosages and increase gradually.
"Mtf transsexuals" therapy for transgender individuals has been shown in medical literature to be safe when supervised by a qualified medical professional. A variety of different sex-hormonal medications are used in feminizing hormone therapy for transgender women.
Estrogens are major sex hormones in women, and are responsible for the development and maintenance of feminine secondary sexual characteristics, such as breasts, wide hips, and a feminine pattern of fat distribution. In addition Mtf transsexuals producing feminization, estrogens have antigonadotropic effects and suppress gonadal sex hormone production.
Prior to orchiectomy or sex reassignment "Mtf transsexuals"the doses of estrogens used in transgender women are often higher replacement doses used in cisgender women. Androgenssuch as testosterone and dihydrotestosterone DHTare the major sex hormones in people with testesand are responsible for the development and maintenance of masculine secondary sexual characteristics, such as a deep voice, broad shoulders, and a masculine pattern of Mtf transsexuals, muscle, and fat distribution.
In addition, they stimulate sex drive and the frequency of spontaneous erections and are responsible for acne, body odor, and scalp hair loss. "Mtf transsexuals" act by binding to and activating the androgen receptortheir biological target in the body.
In contrast to androgens, antiandrogens are medications that prevent the effects of androgens in the body. The purpose of antiandrogens is to suppress or block residual testosterone that is not Mtf transsexuals by estrogens alone.
Steroidal antiandrogens are antiandrogens that resemble steroid hormones like testosterone and progesterone in chemical structure. Spironolactone is an antimineralocorticoid antagonist of the mineralocorticoid receptor and potassium-sparing diureticwhich is mainly used to treat high blood pressureedema high aldosterone levelsand low Mtf transsexuals levels caused by other diureticsamong other uses.
Cyproterone acetate is an antiandrogen and progestin which is used in the treatment of Mtf transsexuals androgen-dependent conditions and is also used as a progestogen in birth control pills. Medroxyprogesterone acetate is a progestin that is related to cyproterone acetate and is sometimes used as an alternative to it. Numerous other progestogens Mtf transsexuals by extension antigonadotropins have been used to suppress testosterone levels in men and are likely useful for such purposes in transgender women as well.
Nonsteroidal antiandrogens are antiandrogens which are nonsteroidal and hence unrelated to steroid hormones in terms of chemical structure. The nonsteroidal antiandrogens that have been used in transgender women include the first-generation Mtf transsexuals flutamide Eulexinnilutamide Mtf transsexuals, Nilandronand bicalutamide Casodex. GnRH modulators are powerful antigonadotropins and hence functional antiandrogens. There are two types of GnRH modulators: GnRH modulators are highly effective for testosterone suppression in transgender women and have few or no side effects when hormone deficiency is avoided with concomitant estrogen therapy.
In adolescents of either sex with relevant indicators, GnRH modulators can be used to stop undesired pubertal changes for a period without inducing any changes toward the sex with which the patient currently identifies. There is considerable controversy over the earliest age at which it is clinically, morally, and legally safe to use GnRH modulators, and for how long. The sixth edition of the World Professional Association for Transgender Health 's Standards of Care permit it from Tanner stage 2 but do not allow the addition of hormones until age 16, which could be five or more years later.
Sex steroids have important functions in addition to their role in puberty, and some skeletal changes such as increased height that may be considered masculine are not hindered by GnRH modulators. They are used in the treatment Mtf transsexuals prostate disorders and pattern hair loss in men, and have also been found to be effective in the treatment of excessive hair growth in women. Since they do not decrease testosterone levels however, they do not affect the actions of testosterone in most of the body.
Progesteronea progestogenis the other of the two major sex hormones in women. There are two types of progestogens: The clinical research that has studied the use of progestogens in transgender women is very limited. Though the role of progestogens in visible breast development is uncertain, progestogens are essential for Mtf transsexuals maturation of the mammary glands, "Mtf transsexuals" hence are required for any transgender woman who wishes to lactate or breastfeed.
Progestogens have adverse effects. Progesterone is most commonly taken Mtf transsexuals. The main effects of hormone therapy in transgender women are feminization and demasculinizationand are as follows:. Breastnippleand areolar development varies depending "Mtf transsexuals" genetics, body composition, age of HRT initiation, and many other factors.
Development can take a couple years to nearly a decade for some. However, many transgender women report there is often Mtf transsexuals "stall" in breast growth during transition, or significant breast asymmetry. Transgender women on HRT often experience less breast development than cisgender women Mtf transsexuals if started after young adulthood.
For this reason, many seek breast augmentation. Transgender patients opting for breast reduction are rare. Shoulder width and the size of the rib cage also play a role in the perceivable size of the breasts; both are usually larger in transgender women, causing the breasts to
Mtf transsexuals proportionally smaller.
Thus, when a transgender woman opts to have breast augmentation, the implants used tend to be larger than those used by cisgender women. In clinical trialscisgender women have used stem cells from fat to regrow their breasts after mastectomies.
This could someday eliminate the need for implants for transgender women. In transgender women on HRT, as in cisgender women during
Mtf transsexuals, breast ducts and Cooper's ligaments develop under the influence of estrogen.
Progesterone causes the milk sacs mammary alveoli to develop, and with the right stimuli, a transgender woman may lactate. Additionally, HRT often makes the nipples more sensitive to stimulation. The uppermost layer of skin, the stratum corneumbecomes thinner and more translucent.
veins may appear or be more noticeable as a result. Mtf transsexuals decreases, and tactile sensation increases. The skin becomes softer,  more susceptible to tearing and irritation from scratching or shaving, and slightly lighter in color because of a slight decrease in melanin.
Sebaceous gland activity which is triggered by androgens lessens, reducing oil production on the skin and scalp. Consequently, the skin becomes less prone to acne. It also becomes drier, and lotions or oils may be necessary. Many apocrine glands — a type of sweat gland — become inactive, and body odor decreases. Remaining body "Mtf transsexuals" becomes less metallic, sharp, or acrid, and more sweet and musky. As subcutaneous fat accumulates,  dimpling, or cellulitebecomes more apparent on the thighs and buttocks.
Stretch marks striae distensae may appear on the skin in these areas. Susceptibility to sunburn increases, possibly because the skin is thinner and less pigmented. Antiandrogens affect existing facial only slightly; patients may see slower growth and some reduction in density and coverage.
Patients taking antiandrogens tend to Mtf transsexuals better results with electrolysis and Mtf transsexuals hair removal than those who are not.
In patients in their teens or early twenties, antiandrogens prevent new
Mtf transsexuals hair from developing if testosterone levels are within the normal female range.
Body hair on the chest, shoulders, back, abdomen, buttocks, thighs, tops of and tops of feet turns, over time, from terminal "normal" hairs to tiny, blonde vellus hairs. Arm, perianal, and perineal hair is reduced but may not turn to vellus hair on the latter two regions some cisgender women also have hair in these areas. Underarm hair changes slightly in texture and length, and pubic hair
Mtf transsexuals more typically female in pattern.
Lower leg hair becomes less dense. All of these changes depend to "Mtf transsexuals" degree on genetics. Head hair may change slightly in texture, curl, and color. This is especially likely with hair growth from previously bald areas. The lens of the eye changes in curvature. Because oil prevents the tear film from evaporating, this change may cause dry eyes. The distribution of adipose fat tissue changes slowly over months and years. HRT causes the body to accumulate new fat in a typically feminine pattern, including "Mtf transsexuals" the hips, thighs, buttocks, pubis, upper arms, and breasts.
Fat on the hips, thighs, and buttocks has a higher concentration of omega-3 fatty acids and is meant to be used for lactation. The body begins to burn old adipose tissue in the waist, shoulders, and back, making those areas smaller.
Subcutaneous fat increases in the cheeks and lipsmaking the face appear rounder, with slightly less emphasis on Mtf transsexuals jaw as the lower portion of the cheeks fills in.
HRT causes a reduction in muscle mass and distribution towards female proportions. Male-to-female hormone therapy causes the
Mtf transsexuals to rotate slightly forward because of changes in the tendons.
Hip discomfort is not uncommon.
This can cause a reduction in total body height. If estrogen therapy is begun prior to pelvis ossification, which occurs around the age of 25, the pelvic outlet and inlet open slightly. The femora also widen, because they are connected Mtf transsexuals the pelvis. The pelvis retains some masculine characteristics, but the end result of HRT is wider hips Mtf transsexuals a cisgender man and closer to those of a cisgender woman. HRT does not reverse bone changes that have already been established by puberty.
Consequently, it does not affect height; the length of the arms, legs, hands, and feet; or the width of the shoulders and rib cage. However, details of bone shape change throughout life, with bones becoming heavier and more deeply sculptured under the influence of androgens, and Mtf transsexuals does prevent such changes from progressing further.
MtF is an older term to refer to transgender people who were assigned male at birth and who identify as women. It stands for “male to female”. The term has its. A trans woman is a woman who was assigned male at birth. Trans women may experience The book describes a trans woman as "a male-to-female transgender or transsexual person." This definition is widely Levitt Mtf transsexuals how the abbreviation "MTF" is commonly used, meaning male-to-female.
A final perspective by. Mtf transsexuals July, Mount Sinai launched the country's first medical fellowship dedicated explicitly to transgender surgery. Ting will be training one fellow.