Hormone Therapy Considerations

Many trans and gender diverse people are happy with their bodies, or find comfort with their bodies without hormone therapy. Only you can decide whether hormone therapy is right for you.

If you choose to begin hormone therapy, your primary care provider will provide you with more detailed information that is specific to your needs. The information on this page, although reviewed by medical professionals, is not intended to replace consultation with your primary care provider.

What is hormone therapy?

Hormone therapy is the use of sex hormones to alter secondary sex characteristics. The hormone estrogen (often combined with other medications) can be used to feminize the body. The hormone testosterone can be used to masculinize the body. Either can be used in lower doses to achieve a more androgynous effect.

Why hormone therapy?

If you experience discomfort or distress because your gender identity (internal sense of being male, female, or an alternate gender) and the sex you were assigned at birth are different, hormone therapy may provide significant comfort.

Hormone therapy may help you to feel more at ease in your body, which may have positive effects on your emotional wellbeing. It may also improve your ability to be read by others as your gender identity.

Who decides?

The decision to start hormone therapy is yours. Your primary care provider’s role is to encourage, guide and assist you in making fully informed decisions and becoming adequately prepared.

Primary care providers such as family physicians and nurse practitioners should be able to assist you to get started on hormone therapy or refer you to someone who can. Some will have received adequate training to assess hormone readiness and prescribe and monitor hormone therapy but unfortunately some may feel this is beyond their scope. In this case, they may suggest a referral for readiness assessment and/or hormone therapy initiation. We hope that as more primary care providers receive   education about providing gender-affirming care, this will occur less frequently. If you are having trouble accessing hormone therapy please call our care coordination team, see contact information at Contact Us

If you have a primary care provider who is interested in learning more about how to provide gender-affirming care please pass on our contact information.

They can also get support from a doctor with experience in this field by contacting the R.A.C.E. Line (Rapid Access to Consultative Expertise).

Who monitors hormone therapy?

It’s important to have regular follow-up and monitoring when you are on hormone therapy. Typically people will have this follow-up with whoever is prescribing their hormones such as your nurse practitioner, family physician or endocrinologist.

For adults, your primary care provider can monitor your medications. Just as a patient with diabetes can expect their primary health care provider to monitor their medications, you have a right to the same support with hormone therapy. If your primary care provider does not have the knowledge to monitor your hormone therapy, they can:

Children and youth typically have their medications overseen by an endocrinologist, due to changing needs during adolescence. However the endocrinologist can work with your local primary care provider for routine monitoring.

Hormone therapy for youth

There are two stages of hormone therapy for youth.

  1. When your body begins puberty, you can start taking a medication called a puberty blocker. This delays the changes that happen during puberty. Using puberty blockers does not mean that you have to start hormone therapy later on. 
  2. When you’re around age 16, you can decide if you want to start hormone therapy. Hormone therapy is used to make your secondary sex characteristics more masculine, feminine, or androgynous. Medications used by youth are generally the same ones used by adults.

Hormone therapy funding

You may have a benefit plan that covers the cost of hormone therapy medications (i.e. through an employer, income assistance or disability assistance).

If you are enrolled in the Fair PharmaCare program, depending on your income, many hormone therapies will be covered.

If the medication your doctor prescribes is not covered by the plan or program you are enrolled in, they can apply to have it covered by Special Authority.

If you are not covered by a benefit plan or social program, you will be required to pay for your hormone therapy.

Black market hormone use

When you buy hormone medications illicitly, you cannot be sure about the quality and dosage of the product. Unlike medications from a pharmacy, they may be diluted or mixed with unknown substances. Neither will you be able to have your use of these medications and your dosage monitored by a health care provider in order to manage risks. The dosage required for optimal effects varies from person to person and is best determined through blood work.

SOURCE: Hormone Therapy Considerations ( )
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