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What are the Most Common Myths about Hormone Replacement Therapy (HRT)?

Hormone Replacement Therapy HRT

What are the Most Common Myths about Hormone Replacement Therapy (HRT)?

Even though gender-affirming hormone replacement therapy (HRT) has been around for about 100 years, there are still many myths surrounding this type of treatment for transgender people. Mostly, these sentiments come from other people not understanding the transitioning process or even fearing it. 

Here are some of the top myths about HRT for estrogen and testosterone. By debunking these myths, you will have the correct information about HRT and have realistic expectations of how this treatment works. 

Hormone Replacement Therapy- Estrogen 

Myth #1 – You will feel out of control with your emotions when taking estrogen.

The idea that cisgender women, non-binary, or other gender-diverse people get hysterical due to estrogen is a sexist trope and stereotype. This sentiment usually comes from a place that regards femininity as emotionally unhinged. 

Even though it is perfectly fine to feel worried about how your emotional experience of the world will change, estrogen will not make you feel out of control or hysterical. Hormonal fluctuations can create mood changes in some people; however, research studies prove that gender-affirming hormones enhance mood and mental health for transgender or gender-non-conforming people. Many people find that taking estrogen will help them be in better touch with their feelings, which can help with the numbness that many transgender femmes report feeling before trying HRT. 

Myth #2 – You will get blood clots or have a stroke if you take estrogen for a long time.

According to a recent study, even though the rate of blood clots for transgender women on estrogen was higher than the rest of the population, it was lower than the rate in premenopausal cisgender women taking oral contraceptives. Technically, estrogen HRT increases the risk of blood clots but not any more than birth control pills. Even though the chance of developing a blood clot or having a stroke is relatively low, some people could be at a higher risk. These people include smokers, those with a history of heart disease or blood clotting disorders, and more. 

Myth #3 – You have to tell people when you start taking estrogen right away because it will be very noticeable. 

Many transgender femmes and non-binary people may put off starting estrogen because they feel that they aren’t ready to come out yet. They may believe that creating hormones means that everyone will notice right away. However, HRT is a more gradual process where the changes will happen more and more each day. As a result, you don’t have to tell anyone that you are on hormones until you feel ready.

Hormone Replacement Therapy- Testosterone

Myth # 1 – Testosterone will make you aggressive, irritable, violent, and misogynistic.

Testosterone will not dull your senses and turn you into a person who is raging all the time. Even though “T” can be powerful, it won’t overtake your personality. Over time, you will notice desired effects like a deeper voice, broadening your shoulders, and other gender-affirming results. However, T is just a hormone and can’t turn you into an angry, irritable person when this is out of character. 

Myth # 2 – You need to get a blood test once a year. 

Before beginning HRT, your doctor should always take a blood test and an extensive panel. That way, you’ll ensure that you have an established baseline. In addition, when you’re just starting, it is essential to get blood tests every three months so that your medical professional can determine your levels and see if your dose is too high or low or if there are any adverse health consequences such as high blood pressure, high cholesterol, liver or kidney issues, and more. 

However, after the first year and when you establish the correct dosage, you will only be required to undergo yearly testing for maintenance. There are some exceptions to this rule, like if you have certain medical conditions, then your testing may be more frequent if that is what your doctor suggests. 

In Summary

Many people can be fearful when starting hormone therapy. It can be challenging to distinguish between internalized transphobia and what is genuinely the right decision for a person. However, an essential thing to remember is that you are in charge and control of your body and everyone’s transitioning experience is unique to them. For example, some people may take a low dose for the rest of their lives, while others may take a higher dose for a shorter period and then stop.

In addition, hormones are just one aspect of some people’s transition journey. Essentially, it’s your gender and your decision for what path you want to take. Be sure to talk with a qualified and LGBTQ+-friendly healthcare provider to better understand the effects of HRT. 

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Kaitlen Knowles, Clinical Social Work/Therapist, LCSW (she, her), Rochester, NY
Pagano Wellness Clinic – Individual, Couple, and Family Therapy in Richmond Virginia

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