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From
The Endocrine Society Guidelines (Hembree et al. 2009), TABLE 14. Feminizing effects in MTF transsexual persons:
Effect | Onseta | Maximuma |
| Redistribution of body fat | 3–6 months | 2-3 yr |
| Decrease in muscle mass and strength | 3–6 months | 1-2 yr |
| Softening of skin | 3–6 months | Unknown |
| Decreased libido | 1-3 months | 3-6 months |
| Decreased spontaneous erections | 1-3 months | 3-6 months |
| Male sexual dysfuntion | Variable | Variable |
| Breast growth | 3-6 months | 2-3 yr |
| Decreased testicular volume | 3-6 months | 2-3 yr |
| Decreased sperm production | Unknown | >3 yr |
| Decreased terminal hair growth | 6-12 months | >3 yrb |
| Scalp hair | No regrowth | c |
| Voice changes | None | d |
a Estimates represent clinical observations.
b Complete removal of male sexual hair requires electrolysis, or laser
treatment, or both.
c Familial scalp hair loss may occur if estrogens are stopped.
d Treatment by speech pathologists for voice training is most effective.
From
Endocrine intervention for transsexuals (Levy 2003), "Specific effects of cross-sex hormone treatment":
(I'm just including the noticeable physical effects):
Hair folliclesAndrogen treatment in female-to-male transsexuals results in the induction of facial hair growth and increased sebum production that is in many cases evident within 4 months and con- tinues to develop beyond one year (Giltay & Gooren, 2000).
In male-to-female transsexuals, reduction in facial and truncal hair shaft diameter reaches a maximum after 4 months treatment with cross-sex hormones but does not progress further. Skin sebum production falls rapidly to almost undetectable levels but hair growth in length remained largely unaffected or responds only very slowly (Giltay et al., 2000). Thus male-to- female hair reduction is almost invariably inadequate with hormonal treatment alone and depends on physical means. Electrolysis is effective but uncomfortable, potentially scarring (particularly if the pain induces flinching) and often too slow to be practical as a sole treatment. Laser hair removal is more rapid, provided hair colour is dark (and skin colour is not), and becomes more comfortable as successive treatments reduce the density of hair shafts and hence the area of 'burn'.
Adipose tissueMagnetic resonance imaging (MRI) analysis of regional fat deposition in 20 male-to-female transsexuals before and
1 year after cross-sex hormone treatment demonstrates a significant increase in subcutaneous and visceral fat depots and a decrease in thigh muscle area (Elbers et al., 1999). In 17 female-to-male transsexuals a transient (Elbers et al., 1997b) reduction in sub- cutaneous fat and increase in thigh muscle area with increased visceral fat is seen (Elbers et al., 1999). Adipose tissue changes in male-to-female transsexuals, particularly increased fat around the upper thighs, is often insufficient to confer true female habitus and if the profile remains disturbing, surgical intervention may be required. The sex differences in circulating leptin levels, with women having higher levels than males irrespective of body habitus, are reversed by cross-sex hormone treatment (Elbers et al., 1997a).
BreastIncrease in breast size usually
begins 2–3 months after the start of female sex hormone treatment in male-to-female transsexuals and continues for 2 years (Meyer et al., 1986; van Kesteren, 2002). Unfortunately, only one-third of transsexuals achieve more than a B cup and with 45% not advancing beyond an A cup, at least 60% require breast augmentation to achieve the appearance they desire or at least find acceptable. Breast devel- opment seems to be more pronounced in subjects with higher body mass indices and it may be worth suggesting to slender male-to-female transsexuals that they do not make too stenuous efforts to avoid the modest oestrogen-induced gain in weight that is often experienced (van Kesteren, 2002). Various attempts to hasten transition to the preferred gender have been reported (Kay & Saad, 1983; Wylie, 2000), the most common being ingestion of higher quantities of hormones than prescribed. Sudden cessa- tion of oestrogen treatment can be associated with galactorrhoea (van Kesteren, 2002). There are case reports of breast carcinoma in hormonally treated male-to-female transsexuals (Symmers, 1968; Ganly & Taylor, 1995) but none in the van Kesteren et al. (1997) series of 816 hormonally and surgically treated male-to-female transsexuals.
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