So I spoke with my therapist on this subject and the response was that in most cases a cis male that takes female hormones would in most cases have NO negative impact. However, they would not experience the euphoria that most TG experiences. As far as the plecebo effect it would only be true if before you started HRT, the mental euphoria was explained or that you read it somewhere and you wanted it to work so much. Personally, I had no idea that the mental changes would be such a major part and I just thought that it was all about physical changes. Hope this helps