What you can expect

During the procedure

You'll begin masculinizing hormone therapy by taking testosterone. Typically, your doctor will prescribe a low dose and slowly increase the dosage over a period of months. Testosterone is given either by injection or a gel applied to the skin. Other testosterone preparations can be used, such as a patch or pellets placed under the skin. In the U.S., testosterone also can be given as a long lasting injection or as twice daily pills (testosterone undecanoate). Oral methyltestosterone or synthetic male sex hormone (androgen) medication shouldn't be used because of potential harmful effects on your liver and lipids.

If you have persistent menstrual flow, your doctor might recommend taking progesterone to control it.

Masculinizing hormone therapy will begin producing changes in your body within weeks to months. Your timeline might look as follows:

• Stopping your period. This will occur within two to six months of treatment.
• Voice deepening. This will begin three to 12 months after treatment. The maximum effect will occur within one to two years.
• Facial and body hair growth. This will begin three to six months after treatment. The maximum effect will occur within three to five years.
• Body fat redistribution. This will begin within three to six months. The maximum effect will occur within two to five years.
• Clitoral enlargement and vaginal atrophy. This will begin three to twelve months after treatment. The maximum effect will occur within one to two years.
• Increased muscle mass and strength. This will begin within six to 12 months after treatment. The maximum effect will occur within two to five years.