Table 13.

Feminizing Effects in Transgender Females

EffectOnsetMaximum
Redistribution of body fat3–6 mo2–3 y
Decrease in muscle mass and strength3–6 mo1–2 y
Softening of skin/decreased oiliness3–6 moUnknown
Decreased sexual desire1–3 mo3–6 mo
Decreased spontaneous erections1–3 mo3–6 mo
Male sexual dysfunctionVariableVariable
Breast growth3–6 mo2–3 y
Decreased testicular volume3–6 mo2–3 y
Decreased sperm productionUnknown>3 y
Decreased terminal hair growth6–12 mo>3 ya
Scalp hairVariableb
Voice changesNonec
EffectOnsetMaximum
Redistribution of body fat3–6 mo2–3 y
Decrease in muscle mass and strength3–6 mo1–2 y
Softening of skin/decreased oiliness3–6 moUnknown
Decreased sexual desire1–3 mo3–6 mo
Decreased spontaneous erections1–3 mo3–6 mo
Male sexual dysfunctionVariableVariable
Breast growth3–6 mo2–3 y
Decreased testicular volume3–6 mo2–3 y
Decreased sperm productionUnknown>3 y
Decreased terminal hair growth6–12 mo>3 ya
Scalp hairVariableb
Voice changesNonec

Estimates represent clinical observations: Toorians et al. (149), Asscheman et al. (156), Gooren et al. (157).

a

Complete removal of male sexual hair requires electrolysis or laser treatment or both.

b

Familial scalp hair loss may occur if estrogens are stopped.

c

Treatment by speech pathologists for voice training is most effective.

Table 13.

Feminizing Effects in Transgender Females

EffectOnsetMaximum
Redistribution of body fat3–6 mo2–3 y
Decrease in muscle mass and strength3–6 mo1–2 y
Softening of skin/decreased oiliness3–6 moUnknown
Decreased sexual desire1–3 mo3–6 mo
Decreased spontaneous erections1–3 mo3–6 mo
Male sexual dysfunctionVariableVariable
Breast growth3–6 mo2–3 y
Decreased testicular volume3–6 mo2–3 y
Decreased sperm productionUnknown>3 y
Decreased terminal hair growth6–12 mo>3 ya
Scalp hairVariableb
Voice changesNonec
EffectOnsetMaximum
Redistribution of body fat3–6 mo2–3 y
Decrease in muscle mass and strength3–6 mo1–2 y
Softening of skin/decreased oiliness3–6 moUnknown
Decreased sexual desire1–3 mo3–6 mo
Decreased spontaneous erections1–3 mo3–6 mo
Male sexual dysfunctionVariableVariable
Breast growth3–6 mo2–3 y
Decreased testicular volume3–6 mo2–3 y
Decreased sperm productionUnknown>3 y
Decreased terminal hair growth6–12 mo>3 ya
Scalp hairVariableb
Voice changesNonec

Estimates represent clinical observations: Toorians et al. (149), Asscheman et al. (156), Gooren et al. (157).

a

Complete removal of male sexual hair requires electrolysis or laser treatment or both.

b

Familial scalp hair loss may occur if estrogens are stopped.

c

Treatment by speech pathologists for voice training is most effective.

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