nder affirming hormone therapy
Texas Diabetes Offers Gender Affirming Hormone Therapy

Texas Diabetes and Endocrinology’s team of board-certified endocrinology experts treat common endocrinology issues which are closely associated with the body’s hormonal system. 

One of the services we offer patients is gender affirming hormone therapy. In this blog, Dr. Valerie Espinosa explains everything you need to know about the gender affirming hormone therapy we offer in Austin, TX. 

What is gender affirming hormone therapy? 

This form of treatment is used in transgender and non-binary patients in order to help better align the body with a person’s gender identity, whether it be feminizing or masculinizing therapy. 

Feminizing therapy is mainly achieved with the administration of the hormone estradiol in transgender women and non-binary individuals. 

While estradiol is the mainstay of treatment, other medications may sometimes be

added (such as progestins and anti-androgens). Treatment with these medications induces several physical changes that are more consistent with a feminine appearance. These changes


  • Breast development
  • Less facial and body hair
  • Softer skin
  • More body fat and a decline in muscle mass
  • Smaller testicles
  • Lower libido and fewer erections

Masculinizing therapy which uses testosterone in transgender men and non-binary individuals will also bring about several physical changes which include:

  • Cessation of the menstrual cycle
  • Deepening of the voice
  • Growth of facial and body hair
  • Clitoral enlargement
  • Increase in strength and muscle mass

How long does it take to see changes with gender affirming hormone therapy?

Changes generally start to occur within a few months, but full effects may not become apparent

until two to five years after starting hormone therapy.

What are the possible risks and side effects? 

Gender affirming hormone therapy does not come without serious risks/side effects. 

Estrogen-related side effects are: 

  • Blood clots
  • Higher cholesterol
  • Elevated prolactin
  • Weight gain
  • Hypertension
  • Potential for stroke
  • Mood changes, anxiety or depression 

Testosterone-related side effects are:  

  • Weight gain
  • Acne
  • Male pattern baldness
  • Higher cholesterol
  • Hypertension
  • Sleep apnea
  • High red blood cell counts
  • Blood clots

Both hormones will cause the transgender individual to develop infertility, which may or may

not be permanent.

What is the process to begin gender affirming hormone therapy?

Prior to starting therapy, we require a physician referral. Then, we will provide patient education including the risks and benefits of treatment to ensure that you are well informed enough to consent to treatment. Following this initial step, you will:

1.         Undergo a complete medical evaluation, including physical exam and laboratory diagnostics, to determine any treatment risks.

2.         Learn about and discuss options for fertility preservation. 

3.         Seek a mental health evaluation in order to confirm a gender dysphoria diagnosis and to rule out any co-existing mental health issues.

Once you have begun your hormone therapy, you will visit with our providers on a regular basis so that we can track your response to treatment and check for any signs of complications. 

We are ready to facilitate your journey through this process.

If you’d like to learn more about our gender affirming hormone therapy services, please call Texas Diabetes and Endocrinology at (512) 458-8400 or request an appointment online.  

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