Gender-affirming care helps individuals align their physical characteristics with their gender identity. For many trans women, hormone therapy is a crucial step in this journey. Traditionally, hormone therapy for trans women has included both oestrogen and antiandrogen medications. However, there is growing interest in exploring oestrogen-only hormone therapy as an alternative. In this article, we will delve into the concept of oestrogen-only hormone therapy for trans women, its potential benefits, considerations, and the importance of informed medical guidance.
Understanding Oestrogen-Only Hormone Therapy
Oestrogen is a primary hormone responsible for the development of secondary sexual characteristics, including breast development, softer skin, and changes in fat distribution. Traditionally, trans women have been prescribed both oestrogen and antiandrogens (such as spironolactone or cyproterone acetate) to suppress testosterone levels and enhance feminisation. However, some trans women are choosing to explore oestrogen-only hormone therapy, which involves taking oestrogen alone without an antiandrogen.
Oestrogen monotherapy involves the use of oestrogen as the sole hormone therapy, without the concurrent use of antiandrogens. This approach is preferred by some transgender individuals for various reasons, including those who have had genital reassignment surgery (orchiectomy) to remove the testes. Additionally, nonbinary individuals seeking a partial shift towards feminisation while preserving some masculine characteristics may find oestrogen monotherapy appealing.
Suitability for Trans Women
Oestrogen monotherapy may be a suitable option for transgender women under specific circumstances:
Post-Orchiectomy: Trans women who have undergone orchiectomy (testicle removal surgery) have significantly reduced testosterone production. For them, oestrogen monotherapy will be effective in achieving desired feminising effects without the need for antiandrogens.
Non-binary Individuals: Some non-binary individuals may desire a combination of feminising and masculinising effects. In such cases, oestrogen monotherapy can help achieve a partial shift towards feminisation while allowing the retention of some masculine characteristics associated with testosterone.
Benefits of Oestrogen-Only Hormone Therapy
Reduced Side Effects: One of the primary advantages of oestrogen-only hormone therapy is the potential reduction in side effects associated with antiandrogen medications. Antiandrogens can sometimes lead to side effects like fatigue, mood swings, and electrolyte imbalances. By avoiding antiandrogens, trans women may experience fewer of these side effects.
Individualised Approach: Strogen-only therapy allows for a more individualised approach to hormone therapy. Some trans women may naturally have lower testosterone levels, making it possible to achieve feminisation goals with oestrogen alone. A tailored approach can help avoid unnecessary medications and their associated risks.
Minimised Health Risks: Some antiandrogen medications may carry risks such as liver toxicity and potential interactions with other medications. Oestrogen-only therapy may help minimise these risks, especially for individuals with pre-existing medical conditions.
Considerations for Oestrogen-Only Hormone Therapy
Monitoring: It is essential for trans women considering oestrogen-only therapy to undergo regular hormone level monitoring. This helps ensure that oestrogen levels are within the desired therapeutic range and that testosterone is adequately suppressed. Adjustments to the hormone regimen may be necessary over time.
Individual Variability: Hormone therapy affects individuals differently. The effectiveness of oestrogen-only therapy may vary from person to person. Some trans women may find it sufficient, while others may eventually require antiandrogens for optimal results.