The 4 main categories of HRT changes are body, sexual, mental, and reproductive. Within these categories, the mileage of medication will vary from person to person. Some trans guys might develop a deep voice while others might not. It all depends on how you and your body reacts to your new hormonal state.
Image is taken from https://www.researchgate.net/figure/Hormone-Effects-and-Expected-Time-Course_tbl1_247510694
The changes you might experience as a trans man on HRT (FTM)
Physical – One of the first things you will start to notice is the change in your skin texture and your skin’s oil production. Your skin will become thicker. Not only that, but in the next weeks and months, you will also start to notice a change in odor to your sweat and your urine. Ance can accrue during this time, so it would be a good idea to make sure you are doing precautionary steps, such as washing your face every night, to minimize this.
”Generally, acne severity peaks during the first year of treatment, and then gradually improve.” As the fat decreases in your face, you might notice yourself having a more “angular” or “rougher” appearance.
Your breast will not go away on testosterone. If you are interested in top surgery (the surgical removal of the breast or breast tissue), it is suggested commonly by surgeons to wait 6-12 months before pursuing. Since your breast might get smaller due to atrophy as well as allowing “the contours of the muscles and soft tissues of your chest wall to settle into their new pattern.”
You will also start to notice that your fat is being stored and distributed in different spots. The fat or muscle will start to be stored in the arms, legs, and abdomen. The fat around your hips or thighs can also diminish during this period of time as well. Gaining muscle will also start to become increasingly easier during your transition. Overall, your face and body will start to have a “rougher” and more conveniently masculine appearance.
One of the most exciting changes in Testosterone replacement therapy is the voice drop. Vocal cord expansion starts to happen around the first couple of months, but for your voice to fully drop, it can take up to 2 years. Like a cis boy going through puberty, you might start to notice your voice cracking. All of this is completely normal and should be reassuring that your body is reacting well to the new hormones!
Facial hair and body hair can be an exciting change for some. Your hair will become thicker and grow back quicker. You might also start to notice hair growing in places that it has never grown before, such as the face, butt, chest, and other areas. “You may expect to develop a pattern of body hair similar to other men in your family—just remember, though, that everyone is different and it can take 5 or more years to see the final results.”
A change that not a lot of trans men want/look forward to is male pattern baldness. It is common for trans men to experience their hairline start to recede during their time on testosterone. Unfortunately, there is no real way to prevent this, even though medications can help.
NSFW – One of the first things you can start to notice is bottom growth. The clitoris expands and moves more forward. This can look like a tiny penis. Your clitoris can also get “erect” and grow more when you are aroused. Some trans guys talk about being able to penetrate their partner with the clitoral growth they achieve.
Emotional – You might start to notice yourself being more irritable or intense during situations. You can also start to notice a smaller or more narrow range of emotions that you feel like you can access. All of this is completely normal and all part of the process that you are going on. Overall you and your emotions are changing; some will notice minimal changes, and others might have very noticeable ones. Of course, your mileage may vary.
Sexual – NSFW – Quickly, you will start to notice a change in your libido (sexual drive). You might feel more commonly aroused or aroused more often. Not only that, but your orgasms will start to feel different, especially with the changes happening to your clitoris. This can be an exhilarating time if you have a partner or sex toys. It is important to find out what feels good with your changing body.
Reproductive changes – HORMONES ARE NOT BIRTH CONTROL –
“You may notice at first that your periods become lighter, arrive later, or are shorter in duration, though some may notice heavier or longer-lasting periods for a few cycles before they stop altogether.”
Hormones are not birth control. Even though it is less likely for you to get pregnant while on HRT, it is still possible. If you are having intercourse with a person who can get you pregnant, make sure to use protection.
In short, Testosterone replacement therapy can do amazing things for you and your body. This can be a fascinating time for you and the people around you and a critical part of your journey.
Sources – https://transcare.ucsf.edu/article/information-testosterone-hormone-therapy
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