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Transgender Hormone Therapy:

Transgender Hormone Therapy: Masculinizing

The cornerstone of hormone therapy for trans masculine patients is testosterone. The goal of treatment is virilization – the development of masculine secondary sexual characteristics.

transgender LGBTQ

Hormonal Agents


At Biosymmetry, options for testosterone administration include injectable and transdermal preparations (patch or gel). Injectable formulations are most commonly used, due to their superior efficacy and affordability. While intramuscular injection (IM) is the most common means of administering parenteral testosterone, subcutaneous (SQ) delivery has also been used with clinical efficacy and is very well-tolerated. Proponents describe less discomfort for patients, a decreased rate of injection-site complications, and increased capacity for self-injection.

Expected Effects

What to expect from testosterone

The degree and rate of physical effects is dependent on the dose and route of administration, as well as patient-specific factors such as age, genetics, body habitus and lifestyle. Desired androgenic effects of testosterone therapy include deepened voice, cessation of menses, clitoral growth, increased muscle mass, and hair growth in androgen dependent areas including facial hair. Breast tissue may lose glandularity, but generally does not lose mass or hemi circumference.1 Typically, patients taking testosterone will experience masculinizing changes over a period of months to years. The timeframe of physiologic changes may be slightly slower with the use of transdermal preparations.

Transgender Testosterone Chart

Risk Mitigation

Absolute Contraindications

  • Pregnancy or breast feeding
  • Active sex hormone-sensitive cancer (e.g., breast, endometrial)
  • Unstable ischemic cardiovascular disease
  • Poorly controlled psychosis or acute homicidality
  • Psychiatric conditions which limit the ability to provide informed consent
  • Hypersensitivity to one of the components of the formulation

Precautions and Risk Mitigation

Pre-existing medical conditions and risk factors may impart increased risks with testosterone administration and should be considered in order to enable individualized discussions regarding the risks and benefits of treatment.

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*Individual results may vary.

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