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Testosterone Replacement Therapy (HRT) in FTM men

Transgender men often experience gender dysphoria, a condition in which they feel distressed due to the mismatch between their biological sex and gender identity. Hormone replacement therapy (HRT) is a medical treatment that can help alleviate gender dysphoria by promoting the development of physical characteristics that align with their gender identity. In this post, we will explore the physical and emotional effects of hormone replacement therapy on transgender men.

FTM testosterone Gel and injections

When it comes to FTM testosterone replacement therapy, there are a variety of different options available. Two of the most common methods are testosterone injections and topical testosterone gel.

Testosterone injections are typically administered by a healthcare professional every one to four or twelve weeks. This ensures that proper dosage levels are maintained for safe and effective treatment. These injections can be given either in the muscle or subcutaneously, which means under the skin. While this method is effective, it does require regular visits to a healthcare provider.

On the other hand, topical testosterone gel is applied daily to the skin and absorbed into the bloodstream. This method provides a steady level of testosterone, but it also requires consistent and accurate application of the correct amount. Some people may find this challenging, especially if they have difficulty remembering to apply the gel every day.

It is important to note that both methods have their pros and cons. For example, injections may be more convenient for some people, while others may prefer the ease of using a gel. Ultimately, the decision about which method to use should be made in consultation with a healthcare professional who can help determine which option is best suited to the individual's needs and preferences.

Some of the most used testosterone brands are: Nebid, Testavan and Tostrex.

Physical Changes

Testosterone HRT can have significant effects on physical characteristics, leading to a range of changes in transgender men. Some of the primary physical changes include:

Hair Growth

Testosterone, the hormone administered during HRT, can lead to significant changes in hair growth, including the development of facial hair, chest hair, and body hair. This is one of the most visible changes that transgender men experience during HRT. While the amount of hair growth varies from person to person, it is a common physical change that many transgender men desire.

Voice Deepening

One of the most desired changes among transgender men is voice deepening. Testosterone, in conjunction with vocal exercises, can lead to a lowering of the voice range, which can help transgender men feel more comfortable and confident in their identities. The deepening of the voice helps create a more masculine presence and can alleviate gender dysphoria.

Muscle Growth

Testosterone is also responsible for the development of muscle mass in men. HRT can lead to an increase in muscle mass, which can help transgender men develop a more masculine physique. This physical change can help transgender men feel more aligned with their gender identity and alleviate gender dysphoria.

Fat Redistribution

HRT can lead to a redistribution of fat in the body, resulting in a loss of body fat in the hips, thighs, and buttocks. This leads to a more masculine body shape, which can also help transgender men feel more comfortable in their bodies. This physical change can be especially important for transgender men who experience significant gender dysphoria related to their body shape.

Genital Changes

HRT can also cause genital changes over time, including clitoral growth and the development of male genitalia. While not all transgender men desire these changes, genital dysphoria can be a significant source of distress for many individuals. HRT can help alleviate this distress and help transgender men feel more comfortable in their bodies.

Emotional Changes

In addition to physical changes, HRT can also lead to emotional changes in transgender men. Some of these changes include:

Increased Confidence

HRT can help transgender men feel more confident and comfortable in their bodies. This can lead to an increase in self-esteem and a greater sense of well-being. Improved body confidence can also lead to increased social confidence, which can help transgender men navigate social situations with greater ease.

Improved Mood

HRT can also lead to an improvement in mood, with many transgender men reporting feeling happier and more content after starting treatment. This improvement in mood can be due to a variety of factors, including a reduction in gender dysphoria and an increase in self-esteem. Improved mood can also lead to increased motivation and productivity, which can have a positive impact on many areas of a transgender man's life.

Other effects


Acne is a common side effect of testosterone HRT. It can be frustrating, but there are a few things you can do to help treat it.

Firstly, it is important to wash your face twice a day with a gentle cleanser. This will help remove dirt and oil that can contribute to acne breakouts. Be sure to use lukewarm water, as hot water can dry out your skin and make acne worse.

Using non-comedogenic (non-pore-clogging) moisturizers and sunscreens are also important when treating acne. This will help keep your skin hydrated without clogging your pores, which can lead to more breakouts. Sunscreen is also important to protect your skin from further damage and aging.

It is also important to avoid touching your face as much as possible.

This may be difficult, but touching your face can transfer bacteria and oil from your hands to your face, which can lead to more pimples.

Avoid picking or squeezing pimples as well, as this can lead to scarring.

If over-the-counter acne treatments are not effective, consider using acne treatments containing salicylic acid or benzoyl peroxide.

These treatments can help exfoliate the skin and kill bacteria that contribute to acne breakouts.

However, it is important to talk to your doctor before using any new acne treatments.

Lastly, it is important to talk to your doctor about prescription-strength acne medications if over-the-counter treatments are not effective.

They may recommend topical or oral medications to help manage your acne.

It's important to note that acne can be a common side effect of testosterone HRT, but it's not inevitable. By taking good care of your skin and working with your doctor to find a treatment plan that works for you, you can help manage acne and maintain healthy skin.

Weight Gain

It is common for individuals to experience weight gain when beginning HRT, as testosterone can lead to an increase in muscle mass and changes in fat distribution.

Metabolism will change, and it's pretty common to experience an increase in hunger, especially during the very first months of HRT.

While weight gain can be seen as a positive aspect of HRT, as it often contributes to a more masculine physique, it is important for individuals to monitor their weight and maintain a healthy lifestyle during the process. Regular exercise and a balanced diet can help to prevent excessive weight gain and promote overall health. It may also be helpful to work with a healthcare provider or nutritionist to develop a plan for managing weight during HRT.

With proper care and attention, weight gain can be a natural and healthy part of the process of transitioning for transgender men.

Patience is the key

The changes described above may be different for each individual undergoing HRT testosterone treatment.

Timings are variable and subjective.

The best approach to successfully coping with a gender transition is to have patience and derive happiness and joy from every little step you take towards your wholeness as a human being.


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