Being non-binary isn’t a single look or aesthetic. Rather, it encompasses a variety of gender expressions on a spectrum of masculine, feminine, both or neither.
Not all non-binary people pursue hormone replacement therapy (HRT). However, for some, altering their hormone profile with the addition of oestrogen or testosterone can help them in affirming their gender.
A non-binary person who was assigned female at birth (AFAB) might want to try testosterone without wanting to undertake a full transmasculine transition and vice versa a non-binary person who was assigned male at birth (AMAB) might want to try oestrogen.
There are also plenty of non-medical ways to alter your gender expression, including dress, voice and personal aesthetic.
Our bodies naturally produce oestrogen, testosterone and progesterone, with levels varying depending on your birth sex. This means that, in general, non-binary people do not need to take oestrogen and testosterone at the same time, because the body is already producing enough of one of them. For instance, an AMAB non-binary person taking oestrogen without first suppressing their endogenous (naturally produced) testosterone might experience a feminising effect without a substantial reduction in their masculine features.
The exception to this is if you do not produce endogenous hormones. This might be the case for people who go through menopause, or people who have had gender-affirming surgeries that affect the reproductive organs. In these cases, you may be able to take both hormones at once. This will be a delicate balance to preserve, and it’s important that you consult carefully with your prescriber.
Many transgender people who take HRT also take blockers. These suppress the endogenous hormones to allow for greater masculinisation or feminisation.
If you want an androgynous gender expression, you may not need to take blockers. If you are non-binary but still want a more feminine or masculine gender expression, then you can talk to your clinician about blockers alongside HRT.
Rather than pursuing full hormone treatment, some non-binary people pursue microdosing. Microdosing is the technical term for using any dose below the average prescribed for maximum effect.
Microdosing works by building up smaller quantities of a particular hormone in your body over a long period of time. Although some non-binary people may want to try microdosing to produce a more androgynous look (as opposed to full masculinisation or feminisation), there are a number of other reasons people might consider it. For instance, microdosing results in less financial pressure because less of the medication is consumed over time but can still be effective in easing dysphoria.
Microdosing is used instead of conventional gender affirming hormone therapy, and typically without blockers. It is important to note that the body requires certain levels of hormones to function, as such, microdosing whilst also taking blockers could be dangerous, as it may reduce your hormones to below the optimal levels.
While there is a lot of anecdotal evidence about the effects of microdosing, very little medical research exists. It is important to bear in mind that hormone use depends as much on each individual body’s ability to metabolise the hormone as it does on the dosage. Everyone’s journey and results will be different.
The outcomes of microdosing may be more subtle or slower than taking the dose for maximum effect. However, this does not mean that microdosing will give you some desired effects of transition but not others, especially if you microdose for a long time.
For instance, if you are AMAB and are microdosing oestrogen for a less masculine presentation, you might find that you still develop breasts. Like conventional HRT, some changes caused by microdosing (like a deeper voice in AFAB people taking testosterone) are irreversible. It is important to carefully discuss your desired outcomes with your clinician, and make sure that you fully understand what to expect.
Microdosing can be a really fulfilling way for non-binary people to explore their hormonal balance and find one that fits them. However, it is really important to ensure you have enough hormones to maintain good physical health, and you are fully aware of – and comfortable with – the long-term results.