Gender Affirming HRT
What is Gender-Affirming Hormone Therapy?
Gender-affirming hormone therapy (GAHT) may be a form of medical change a transgender person can initiate to feel more aligned with their gender identity. For transgender persons, the sex they are assigned at birth does not match their gender identity — whether that’s male/female/both/neither. For example, a person born male may feel authentically female and want to take steps to support that identity.
What are Medications for GAHT?
Feminizing or masculinizing hormone therapy are medications that may help patients transition medically to the gender they identify with. Hormones for gender transition can work in multiple ways. The hormones prescribed may work to suppress some of a patient’s existing physical characteristics while also encouraging the development of the traits the patient wants. For example, hormonal support can help a patient grow or reduce body hair to better align with their individual identity. Patient-specific therapy plans target individual goals and responses to medication. It’s important to note that not all transgender patients take these steps to align their appearance with their gender identity.
What is Feminizing Hormone Therapy?
Feminizing hormone therapy may help transgender female patients (assigned male at birth, identifying as female) achieve therapeutic effects like breast growth, decreased muscle mass, and other body composition changes. These therapies typically involve estrogen and may help individuals reach physiologic ranges expected in menstruating populations. Patients transitioning from male to female may also need additional support to suppress testosterone, a masculinizing hormone. Anti-androgen therapy such as spironolactone or finasteride can be prescribed to decrease testosterone levels. Both methods can be encouraged, depending on the patient’s therapeutic goals.
Even with continued hormonal support, feminizing changes generally take 3-12 months to initiate effect and may take over 2 years to reach their maximum potential. Establish individualized goals for your transition with a trusted prescriber who can help set healthy expectations and reasonable timelines.
What is Masculinizing Hormone Therapy?
Masculinizing hormone therapy may help transgender male patients (assigned female at birth, identifying as male) achieve therapeutic effects like stopping menstruation, increased muscle mass, and other body composition changes. These therapies typically involve reaching male physiologic ranges of testosterone. Patients transitioning from female to male may also want additional support suppressing estrogen levels, a feminizing hormone. Therapeutic strategy will depend on the patient’s goals.
Even with continued hormonal support, masculinizing changes generally take 1-6 months to initiate effect and may take over 4 years to reach their maximum potential. Establish individualized goals for your transition with a trusted prescriber who can help set healthy expectations and reasonable timelines.
Therapeutic Options
Belmar compounds estradiol and testosterone as bioidentical hormones. Bioidentical hormones are produced from plant-based sources and have the exact chemical and molecular structure and function as the estradiol and testosterone produced by the human body.
Available Dosage Forms
At Belmar, our expert pharmacists dispense medications in a variety of dosage forms to suit different conditions and patient preferences. These include:
- Oral Tablets
- Sublingual Tablets
- Creams
- Injectables
Who Should Avoid These Medications?
Hormone therapy in transgender patients may limit fertility. It is unknown if fertility impact is reversible, which is why it’s important to discuss implications to reproductive health with a healthcare professional before starting any form of hormone replacement. There are ways to ensure options are available to transgender patients if or when the time is right to expand their families.
Transgender patients can be at risk for many health-related complications, in part because of trouble accessing care. Their unique needs highlight the importance of preventive health condition screenings and regular health visits. For example, feminizing and masculinizing hormones can impact a person’s mood. Mental health discussions with your healthcare provider can provide necessary support during this significant transition.
How Belmar Can Help
If you are a patient who is interested in any of the therapies available on this page, start a conversation with your doctor. Together, you can decide if a compounded prescription might be a good option for you.
If you are a clinician interested in prescribing compound medications to your patients, contact us for information on how to get started and how to access all of our clinical resources. If you are new to compounding, you may find our page on How to Write a Compounding Prescription helpful. You can also visit our Medication Options page to find a formulary and learn more about all the medication solutions available from Belmar.
