HRT has a timeline. The results don’t happen instantly. If you’re considering hormone replacement therapy, or just starting them for the first time, it’s important to know what effects to expect and when to expect them. Bear in mind that everyone is different and that not everyone will have the same journey. These timescales are rough estimates to give you a sense of how the transition might progress. Here, we explore the FTM testosterone changes timeline and MTF HRT effect timeline.
*Please note: We use terminology like AMAB (assigned male at birth), MtF (male-to-female), and trans-feminine interchangeably for understanding across all age groups, cultures, genders, and identities. For more information. check out our glossary of terms. you’ll see us use it here with the likes of “FTM testosterone changes timeline and MTF HRT effect timeline”.
Predicted HRT Timeline for the Physical Effects of Hormones for Trans Men
Testosterone Timeline: The Changes for FTM Trans Men
Masculinising hormones induce physical changes that are more in line with a patient’s gender identity. Transmasculine patients can expect the following physical changes in their HRT timeline:
- deepened voice
- clitoral enlargement (variable)
- growth in facial and body hair
- cessation of menses
- atrophy of breast tissue
- increased libido
- decreased percentage of body fat compared to muscle mass
FTM: Masculizing HRT Timeline and Effects
While the degree with which an individual taking masculinising hormone therapy will experience changes varies from person to person, the following table provides an indication of the HRT timeline.
FTM Testosterone Changes Timeline:
| Effect | Expected Onset | Expected Maximum Effect |
| Skin oiliness/acne | 1-6 months | 1-2 years |
| Facial/body hair growth | 3-6 months | 3-5 years |
| Scalp hair loss | >12 months | variable |
| Increased muscle mass/strength | 6-12 months | 2-5 years |
| Body fat redistribution | 3-6 months | 2-5 years |
| Cessation of menses | 2-6 months | n/a |
| Clitoral enlargement | 3-6 months | 1-2 years |
| Vaginal atrophy | 3-6 months | 1-2 years |
| Deepened voice | 3-12 months | 1-2 years |
The degree and rate of the HRT timeline on physical effects depends in part on the dose, route of administration, and medications used. These are selected in accordance with a patient’s specific medical goals. (e.g., changes in gender role expression, plans for sex reassignment) and medical risk profile.)
There is no current evidence that response to hormone therapy – with the possible exception of voice deepening in transmasculine individuals – can be reliably predicted based on age, body habitus, ethnicity, or family appearance. All other factors being equal, there is no evidence to suggest that any medically approved type or method of administering hormones is more effective than any other in producing the desired physical changes.
Source: WPATH Standards of Care Version 7
Predicted Timeline for the Physical Effects of Hormones for Trans Women
Estrogen: The Effects of HRT for MTF Women
Feminising HRT induces physical changes that are more in line with a patient’s gender identity. Transfeminine patients can expect the following physical changes:
- breast growth (variable)
- decreased libido and erections
- decreased testicular size
- increased percentage of body fact compared to muscle mass
MTF: Feminizing HRT Timeline and Effects
While the degree to which an individual taking feminising hormone therapy will experience changes varies from person to person, the following table provides an indication of the HRT timeline.
MTF HRT effect timeline:
| Effects | Expected Onset | Expected Maximum Effect |
| Body fat redistribution | 3-6 months | 2-5 years |
| Decreased muscle/mass strength | 3-6 months | 1-2 years |
| Softening of skin/decreased oiliness | 3-6 months | unknown |
| Decreased libido | 1-3 months | 1-2 years |
| Decreased spontaneous erections | 1-3 months | 3-6 months |
| Male sexual dysfunction | variable | variable |
| Breast growth | 3-6 months | 2-3 years |
| Decreased testicular volume | 3-6 months | 2-3 years |
| Decreased sperm production | variable | variable |
| Thinning and slowed growth of body and facial hair | 6-12 months | >3 years |
| Male pattern baldness | No regrowth, loss stops 1-3 months | 1-2 years |
The degree and rate of physical effects depend in part on the dose, route of administration, and medications used, which are selected in accordance with a patient’s specific medical goals (e.g., changes in gender role expression, plans for sex reassignment) and medical risk profile.
There is no current evidence that response to hormone therapy – with the possible exception of voice deepening in trans masculine individuals – can be reliably predicted based on age, body habitus, ethnicity, or family appearance. All other factors being equal, there is no evidence to suggest that any medically approved type or method of administering hormones is more effective than any other in producing the desired physical changes.
Source: WPATH Standards of Care Version 7
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