Professor Marie-Pier Ysser, formally the showgirl "Bambi". Shown age 40, after 20 years on hormone therapy.
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In general, the increased estrogen and progesterone blood levels resulting from the female hormone treatment will stimulate and promote the growth of female secondary sexual characteristics (breasts, fat distribution, pubic hair pattern, ...).
Body shape
is controlled by estrogen so its use stimulates a female body shape to develop, and the woman's body shape and "figure" will become far closer to female norms in proportions.
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The effects of female hormone treatment will vary considerably by individual, and can take 2 to 5 years to fully achieve. In order to maximize the physical effects and benefits, hormone treatment should be begun as
young as possible
, before the body has completely matured and can no longer develop in response to stimuli. Maximum feminization occurs if hormonal treatment begins before a male puberty.
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If the testes have been removed in infancy or early childhood (usually because the child has been identified as
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intersex
or
AIS
, and a female gender has been agreed with the parents), hormone therapy is usually started at the age of about 10 or 11, in order to initiate a female puberty. Unfortunately of course this ideal situation is very rare - the average 'western' transwoman is in her 30's before she commences hormone treatment. If a male puberty has already occurred, whilst female hormone therapy will cause a reduction in the levels of 'male' androgens such as testosterone, this will have little or no effect on most of the already developed of male secondary sexual characteristics (e.g. deepening of voice, facial hair, narrow pelvis, ...). The longer after male puberty (which typically ends by age 18) that female hormone therapy is started the less effective it will be - but not on a linear scale, the effects tail-off rapidly as time since puberty increases. For example, a woman starting hormones at age 20 may experience good breast development and a near cessation of facial hair growth, the same woman starting treatment at 30 will get considerably less breast development and only a slight reduction of facial hair growth, while if she started at 40 the effects will be less again, but not so significantly.
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The following table shows the effects of female hormone treatment begun after male puberty has completed (i.e. after about age 17).
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Desired Characteristic
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Effects of
Hormone Treatment
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Possible or Additional Treatments
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Female type skull shape and facial features
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None
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Feminisation of jaw, brow ridges and skull possible via surgery
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Softer, clearer skin with no acne or spots
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Considerable improvement
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Deep chemical skin peel
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Smaller teeth
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None
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Dental surgery to improve teeth
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Smaller nose
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None
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Rhinoplasty surgery
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Smaller hands and feet
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None
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None
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Reduce height
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None
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None
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Broader pelvis
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None
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None
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Stop facial beard hair growth
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Little or no effect
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Electrolysis and laser treatment
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Thick female type scalp hair and forehead hairline
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Hair loss ceases, slight reversal of balding
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Wig, hair implants, some medications may help
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Develop female pubic hair pattern. Hairless trunk and limbs.
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Substantial improvement after prolonged treatment
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Electrolysis and laser treatment
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Higher pitched feminine voice
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None
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Voice training, voice change surgery
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Reduction of "Adams Apple"
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None
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"Tracheal Shave" (thyroid cartilage reduction) surgery
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Slimmer neck
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No effect not ascribable to dieting
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None
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Breast development
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Variable, from slight to substantial breast development (Note 1)
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Mammoplasty
(breast implants)
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Female type subcutaneous fat deposits (particularly thickening of hips, buttocks & thighs) and body shape.
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Variable, slight to substantial fat redistribution after prolonged treatment
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Fat transfer, implants
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Reduced weight
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Weight increase (Note 2)
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Liposuction, diet and exercise
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Small waist
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May actually increase unless supported by dieting and exercise
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Liposuction, lower rib removal, diet and exercise
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Reduced muscular development
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Some reduction
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None
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Reduce size of penis and testes
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Substantial to significant reduction(not necessarily good if SRS is planned)
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Surgery
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Good mental health
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Depression may occur
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Therapy, support of friends and family, anti-depressants
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Menstrual cycle
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PMS and Hot Flashes only (Note 3)
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None
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