Transgender hormone therapy, also called hormone replacement therapy (HRT) or gender-affirming hormone therapy (GAHT), is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals for the purpose of more closely aligning their secondary sexual characteristics with their gender identity. This form of hormone therapy is given as one of two types, based on whether the goal of treatment is masculinization or feminization:
Masculinizing hormone therapy – for transgender men or transmasculine people; consists of androgens and antiestrogens.
Feminizing hormone therapy – for transgender women or transfeminine people; consists of estrogens and antiandrogens.
Eligibility for transgender hormone therapy may be concluded by assessing a patient for gender dysphoria or persistent gender incongruence, though many medical institutions now used an informed consent model. This model ensures patients are informed of the procedure process, including possible benefits and risks, while removing many of the historical barriers needed to start hormone therapy. Treatment guidelines for therapy have been developed by several medical associations.
Some intersex people may also undergo hormone therapy, either starting in childhood to confirm the sex they were assigned at birth, or later in order to align their sex with their gender identity. Non-binary people may also engage in hormone therapy in order to achieve a desired balance of sex hormones or to help align their bodies with their gender identities.
The formal requirements to begin gender-affirming hormone therapy vary widely depending on geographic location and specific institution. Gender affirming hormones can be prescribed by a wide range of medical providers including, but not limited to, primary care physicians, endocrinologists, and obstetrician-gynecologists.
Historically, many health centers required a psychiatric evaluation and/or a letter from a therapist before beginning therapy.
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Masculinizing hormone therapy, also known as transmasculine hormone therapy, or female-to-male (or FTM) hormone therapy, is a form of hormone therapy and gender affirming therapy which is used to change the secondary sexual characteristics of transgender people from feminine or androgynous to masculine. It is a common type of transgender hormone therapy (another being feminizing hormone therapy), and is predominantly used to treat transgender men and other transmasculine individuals.
An estrogen (E) is a type of medication which is used most commonly in hormonal birth control and menopausal hormone therapy, and as part of feminizing hormone therapy for transgender women. They can also be used in the treatment of hormone-sensitive cancers like breast cancer and prostate cancer and for various other indications. Estrogens are used alone or in combination with progestogens. They are available in a wide variety of formulations and for use by many different routes of administration.
A transgender person (often abbreviated to trans person) is someone whose gender identity differs from that typically associated with the sex they were assigned at birth. Many experience gender dysphoria, which they may seek to alleviate through transitioning, often adopting a different name and set of pronouns in the process. They may pursue gender affirming care such as hormone replacement therapy and various gender-affirming surgeries. Not all transgender people desire these treatments and others may be unable to access them for financial, medical or legal reasons.