Physical: Your body will change over time. Your hair, skin, muscle mass and fat distribution will become different to varying degrees.

Emotional: Hormone therapy can have some of the same effects on your emotions as puberty does. For example, you may swing from highs to lows often. You may have new feelings, and your interests may change.

Sexual: You probably will experience erotic pleasure differently. You may get aroused by different body parts. Your orgasms will probably change.

Reproductive: Testosterone will gradually stop menstruation. It’s still possible for someone with ovaries and a uterus to become pregnant, though, so using birth control is recommended. Estradiol, a form of estrogen, may decrease sperm counts for those with testicles. This may be reversible if hormone therapy stops for several weeks, but it’s not for some people.

Many transgender men and women seek hormone therapy as part of the transition process. Exogenous testosterone is used in transgender men to induce virilization and suppress feminizing characteristics. In transgender women, exogenous estrogen is used to help feminize patients, and anti-androgens are used as adjuncts to help suppress masculinizing features. Guidelines exist to help providers choose appropriate candidates for hormone therapy, and act as a framework for choosing treatment regimens and managing surveillance in these patients. Cross-sex hormone therapy has been shown to have positive physical and psychological effects on the transitioning individual and is considered a mainstay treatment for many patients. Bone and cardiovascular health are important considerations in transgender patients on long-term hormones, and care should be taken to monitor certain metabolic indices while patients are on cross-sex hormone therapy.