When taking male hormones (generally some form of testosterone) you are changing your hormonal morphology to that of a physiological male, so you adopt all the possible health risks that ordinary males have - ie. an earlier risk of heart attack, high blood pressure etc. However you do cut your risks of developing women’s diseases such as breast cancer, and thrombosis etc. So just when you thought life was getting better, healthy living is back in fashion!!!:-
A good male hormone regime will produce results fairly quickly. After the first 2 injections, taken fortnightly, of a hormone preparation such as Sustanon 250, your period should stop completely. In 12 to 26 weeks your voice should begin to break, and will be completed after 9 months to 1 year.
Testosterone is unlikely to make you grow, but many younger FTM’s (under 25) do report some small growth in height, and some say their feet get bigger. What does get bigger is the clitoris. This can develop until it can be as long as 5cm when erect, and it often becomes far more sensitive. Most FTM’s report an incredible increase in sexual libido when taking testosterone, and masturbation often becomes the order of the day (at least for a couple of years).
Many also report a huge increase in appetite, and it is really important to watch your weight particularly when waiting for surgery. Excessive fat around the breasts makes a mastectomy much more difficult.
Beard growth is more problematic to gauge- and its rate of growth (along with body hair) will probably vary with your ethnic origin, your family history, to try and work out what is likely to happen look at your brothers or father.
Baldness is a problem faced by FTM’s as well as ordinary men. However it does appear to be a less frequent problem. Technically to work out your likely baldness pattern you should look at your uncles on your mothers side of the family - but this doesn’t seem to be a rule that works too often. There is little you can do to avoid baldness if it is going to happen, but DO NOT stop taking your hormones to avoid baldness. It is better to be bald than to suffer from brittle bones. Furthermore baldness is meant to be a `sign of virility’.
The early testosterone treatments had certain problems, basically those forms taken as tablets such as methyl testosterone, and restandol, were metabolized through the liver - so there was some risk of liver damage and there is 1 reported case in the literature of liver cancer, there are also several of `jaundice’ though this is generally temporary. There are also several of increased blood pressure, some of `eye’ problems ie. cataracts.
But - you have to remember that the reported cases are very few. Nowadays though, most endocrinologists (doctors who specialise in hormonal medicine) reccommend testosterone injections, as they are only partly metabolized through the liver, and there have been fewer reports of associated problems.
The biggest danger in fact is from not taking hormones. After a period of time on testosterone, the ovaries cease working and producing oestrogen. Also if you have a hysterectomy then obviously there is no oestrogen production (except for a very small amount from the brain). This means that if you don’t take testosterone, you have no hormonal base at all. The risk is of developing Osteoporosis. More commonly know as `brittle bone disease’, this is what elderly ladies suffer from after the menopause. It is what makes their spinal columns shrink in size, and makes them prone to broken hips. The prevention of osteoporis is by taking Hormone Replacement Therapy. In the case of women this is obviously oestrogen (they don’t want to grow beards!!), but testosterone does the job just as well.
In the 1970’s very little was know about the risks of not taking hormones at all, or of taking oral preparations such as methyl testosterone. However by 1980, it was acknowledged that intra-muscular injections of testosterone were far better for FTM’s, and those males who needed such treatment (generally those with scrotal cancer) as they were not directly metabolized by the liver.
But this was only known in very specialised and limited circles - and on the whole the doctors treating FTM’s were not amongst those in the know. However by 1985, it was recommended treatment that intra-muscular injections (generally Sustanon) either as Sustanon 250 every 2 to 4 weeks, or Sustanon 100 every 10 to 14 days, should be the general dose of testosterone for FTM’s.
Many people had their hormones discontinued in the 1980s and it wasn’t until the early 1990s that it was realised that they were under a great risk of developing osteoporosis. Now in 1996 it has been thought that the dosages should be as follows:
(These are figures given by the team working at the Free University of Amsterdam, under the endocrinologist and leading world expert on the endocrinology and treatment of transsexual people; Professor Louis Gooren.)
Osteoporosis can now be treated - if you think you might be at risk, ask for a bone scan, and discuss the results with a specialist. A calcium supplement now could save many problems in the future - but this is only necessary if after several years on hormones, you then had a gap of several years.
It is now recommended that all FTM’s need a hysterectomy, preferably in the early years of treatment. There is an increased risk of developing pre-cancerous cells in the cervix. However there are risks associated with such major surgery, and it can also affect sports performance etc.
However it is important to realise that techniques in genital surgery are constantly advancing, and you need to discuss with any doctor you might be considering having genital surgery with whether s/he would prefer you to postpone a hysterectomy in order to save tissues which may prove useful at any time when a phalloplasty is performed.
To keep your options open - have a hysterectomy that is performed by extraction through the vaginal canal, or via a lateral incision (up/down) rather than an incision across the torso.