Today we live in a situation where access to feminising hormones is being restricted, especially for young people. In some cases, as in certain US States, this is the result of draconian and ill-advised legislation. In others, especially where prescriptions are needed to get the preparations, the technique has been to make this almost impossible. This is what happens, for example in the UK.
Feminising hormones are one thing, but what about masculinising ones? This page does not consider these, for several reasons. The first is that in many jurisdictions the possession of Testosterone supplements without prescription is illegal. Another is that Hormone Replacement Therapy and transition generally are far more complicated for females than males. The effects of Testosterone on a female are drastic and irreversible.
We absolutely do not advise anyone to take Testosterone or equivalent except under medical supervision and never, under any circumstances, under the age of twenty. Therefore this page contains no links to suppliers of it.
Supermodel Geena Rocero, a highly successful completion thanks to feminising hormones.Feminising hormones, often called HRT, are much milder in effect. Despite some theoretical evidence to the contrary, I have never seen severely deleterious effects from it and much of the criticism appears to come from people who do not understand its use.
For example, feminising hormones may be criticised for ‘damage to sexual function’. One has to ask why someone prepared to take them would care about not being able to get an erection.
In any case, the effects of oestrogen are fully reversible, even when begun at a young age. Just take away the feminising hormones and the individual will revert to a more masculine body-type.
We do not discuss surgeries here. In any case, no surgery, other than the purely cosmetic, should be carried out in adolescents. Specifically, Genital Reconstruction Surgery must be delayed. In our opinion, individuals should have lived at least five years as women and be fully passing and accepted as such, before it is even considered.
There are two main conditions which may provoke an individual male to want feminising hormones and these have been discussed at length on this site. They are: Homosexual Transsexualism, which is a function of Sexual Inversion, caused by anomalies in hormone delivery in utero; and Transvestic Autogynephilia, a paraphilia in which men are attracted to the image of themselves as women. In very general terms, the former appears around age 4-6 while the latter, 14-16 up, though cases as young as 9 have been recorded.
Irrespective of age of onset, however, Homosexual Transsexuals are normally markedly feminine from childhood while Autogynephilic Transvestites are not. This has implications for the use of feminising hormones, especially where these are begun later. Put bluntly, the older the individual, the stronger the dose should be and for transvestites it will be much stronger than needed for transsexuals. For many elderly transvestites, feminising hormones may have practically no visible effect, even in substantial doses. Such individuals should question whether it is really appropriate for them to take feminising hormones.
Types of feminising hormones
There are two main forms of feminising hormones: estrogen and progesterone, as well as androgen (testosterone) blockers called anti-androgens.
Oestrogen is the primary feminising hormone used by transwomen. Oestrogen affects many parts of the body, including fat cells, bones, some muscles, skin, and hair.
Oestrogen can also affect mood, with low oestrogen levels linked to reduced mood, depression, anxiety and even suicidality. If this last happens to you (it’s rare) seek professional help at once.
Some research suggests an increased risk of blood clots and other health issues as a result of taking oestrogen. There is limited research including trans women, which shows oestrogen hormonal therapy (especially oral oestrogen) can increase your cardiovascular risk to that of cis women.
Suggested Oestrogen regimens
Oestrogen is usually taken in one of the following forms:
Pills – Taken either orally, or sublingually (dissolves beneath the tongue or between the cheek and gums). Doses usually start with 2-6mg estradiol valerate tablets daily, increasing to up to 8mg as needed.
Patches – Placed onto the surface of the skin. Doses are usually between 100–150 μg/24 hours changed twice weekly.
Injections. A number of preparations, usually based on Estradiol, can be injected. This requires either a friend who has been trained to give injections ot being trained yourself and knowing how to do it. Most of these are designed for weekly injection but may cause more severe mood swings than pills.
Other vectors are gels and implants, but these are often harder to source.
Effects of feminising hormones
1–3 months after starting oestrogen: softening of skin; decrease in muscle mass and increase in body fat; redistribution of body fat to buttocks and hips; (possible) decrease in sex drive; fewer instances of waking up with an erection or spontaneously having an erection; some transwomen also find their erections are less firm, or can’t get erect at all; decreased ability to make sperm and ejaculatory fluid.
Gradual changes (maximum change after 1–2 years on oestrogen): nipple and breast growth; slower growth of facial and body hair; slowed or stopped balding; decrease in testicular size.
While there is limited evidence to support the use of progesterone as part of a feminising hormone regimen, some transwomen anecdotally report progestogens being an effective and important part of their hormonal care
Forms of progesterone
Micronised progesterone capsules – dosage recommendations of oral micronised progesterone can be 100-200 mg daily.
Medroxyprogesterone tablets – a progestin, which is different to progesterone.
Progestins are synthetic, and cannot be detected by a blood test.
Cyproterone acetate is used as an androgen blocker, it is also a progestin.
(This, along with Ethinyln Estradiol, is contained in the popular Diane 35 contraceptive pill. It is very popular amongst transwomen in southeast Asia.)
Side effects of medroxyprogesterone can include anxiety, low mood and depression.
Androgen blockers / anti-androgens
The role of androgen blockers (or anti-androgens) is to suppress production of testosterone and/or block its effects on the body. This allows a more effective use of oestrogen.
Cyproterone acetate – the most commonly prescribed form of androgen blocker in Australia. ‘Cypro’ is not commonly prescribed in the U.S. due to FDA restrictions, but it is a safe and effective form of androgen blocker.
Spironolactone – the second most commonly prescribed form of androgen blocker in Australia. ‘Spiro’ is a potassium sparing diuretic, which can result in needing to go to the bathroom more than usual.
Finasteride /Duasteride – far less commonly used. They work by blocking conversions of testosterone to the androgen dihydrotestosterone, and are sometimes prescribed to men (trans and cis) for male-pattern baldness.
Bicalutamide – an emerging non-steroidal anti-androgen that works by blocking the androgen receptor. This is not PBS-listed.
(I am grateful to Transhub in New South Wales. The site is at https://www.transhub.org.au)
In addition to the above, Gonadotropin-Releasing Hormone (GnRH) is popular with many clinicians as a puberty-blocker. It is usually taken as an injection. Its effect is to delay puberty and the development of secondary sexual characteristics. It is very effective but has become controversial; some studies have questioned its use. Although these studies are themselves questioned, I do not recommend the use of GnRH as a self-medication.
In brief, feminising hormones consist of two components: an oestrogen or equivalent and some sort of androgen blocker.
Acquiring feminising hormones
Before trying to access feminising hormones online, first try to get help locally, through official medical channels if they exist. If this is not possible or too expensive, please make sure you know the legal position regarding the possession of these feminising hormines without prescription.
In much of the world the most common. indeed practically universal form of feminising hormones are contraceptive pills, like the aforementioned Diane 35 and its equivalents. In much of the world these are freely available either from pharmacies or local shops, without prescription. They are relatively cheap and very effective. Most contraceptive pills are ‘combination pills’, like the above.
The more specialist feminising hormones mentioned above are similarly available without prescription but in a more restricted set of outlets. Serena Thailand, a well-known ladyboy YouTuber, recently suggested the pharmacies around large hospitals as these tend to be the best stocked.
Similarly, feminising hormones are available via drop-shipping and home delivery companies such as, in the Philippines, Lazada or Shoppee.
Failing that, there are a number of small traders who advertise on social media. These include:
The Fairygodbarbie (https://www.thefairygodbarbie.com/) is an online resource in the Philippines run by trans beauty queen Rui Mariano. It stocks a wide range of feminising hormones and ships overseas.
HRT Online Philippines: https://shopee.ph/hrt.online.ph
HRT Philippine: https://shopee.ph/hormonesph
HRT by Simon: https://shopee.ph/chrispothailand
Both Shopee and Lazada offer strong customer protection in the case of issues. All the above have fluent English-speaking staff. I have personally dealt with Miss Mariano and she is reliable.
HRT Shop Online (Thailand): https://www.instagram.com/hrtshop_online/?hl=en
A tremendous range of products. Overseas shipping.
In the West, a prescription is usually needed to access feminising hormones, but there are many online suppliers, for example:
Folx Health (USA) https://www.folxhealth.com/
TRT&HRT Europe: https://balancemyhormones.co.uk/trt-europe/
I do not supply hormones: please visit the sites above to purchase.