UPDATE: This gist is now deprecated, please visit The Gender Dysphoria Bible for the latest version of this document.
This is a compilation of report medical transition changes, collected from testimonials of trans women from various discussion forums and chat rooms, backed up by my own experiences.
Note that this is a list of possible changes. There is no guarentee that a person on HRT will experience all of these. As always, your milage may vary.
- Reduction in general body odor and change in the smell of ones sweat. Many report gaining a sweet smell.
- Skin softens and becomes thinner.
- Reduction in skin oils, causing face to become drier. For most this means less acne.
- Finger nails thin and soften.
- Reduced body hair growth (wont remove it entirely), hairs become thinner and shorter.
- Emotional expansion
- Less stoicism, regain the ability to cry
- You need Estradiol in order to push this to its fullest
- Reduced muscle mass / harder to gain muscle
- This contributes significantly to feminine shoulder and neck line.
- Loss of random erections / morning wood
- Failure to regularly give oneself erections can result in atrophy of the tissue, leading to shrinkage.
- Prolonged atrophy can cause painful erections.
- Loss of sex drive, frequently a total loss of libido.
- Sterility + testicle atrophy
- Testicles shrink in size. Atrophy pain is common in the first year.
- Deepening or changes of eye color (Testosterone fades it)
- Hairline restoration (Testosterone converts into DHT which causes baldness)
- Reduced tolerance of caffeine and alcohol
- Testosterone increases body mass which increases alcohol tolerance. Additionally, spironolacotone and oral estradiol strain the liver and hinder metabolism of toxins.
- Salt/Pickle cravings (This is specific to those on Spironolacotone, which is a diurhetic that causes you to pee out all your sodium)
- Breast growth
- Extreme nipple sensitivity at the onset
- Expect aches and pains in the upper chest
- Nipples will get larger, areolas become more visible
- Fat redistribution into feminine proportions
- Reduction in the waist and upper body, flattening of belly, additions in hips and thighs.
- Lower center of gravity
- Facial feature changes (chin, cheeks, eyes, lips, eyelashes lengthening)
- Eye reshape altering focal depth
- Ligament stretching
- Slimmer hands, wrists and feet. Many go down a shoe size or two.
- Pelvic tilt causing an increase in curvature of back & butt, potentially a loss of up 1-3 inches in height). Note: This is NOT the same as the hip rotation that occurs in AFAB puberty.
- Improved flexibility
- Change in stride, walking more with the hips
- Scalp hair becomes thicker and follicles grow stronger, allowing hair to grow to longer lengths.
- Hair can also become curlier
- Hair may change color
- Emotional expansion
- Higher highs and lower lows
- Mood swings, random crying
- Crying from joy
- Erogenous zone development
- Multiple. Full body. Female. Orgasms.
- Penis and scrotal tissue changes
- Increased sensitivity
- Skin moistening, change in odor (scrotum and penis begin to smell vaginal)
- Coloration changes, particularly along the perineal raphe
- Skin along the shaft and glans thins and becomes more prone to tears/bruising during sex
- Perspiration distribution changes
- Sweating becomes more of a full body experience, less focused on the scalp.
- Changes in body temperature placement, women have warmer cores but colder extremities.
- Reduced tolerance of temperature changes
- Oral and skin thermometers may show a lower temp (~97.6)
- Improved color perception
- Significantly improved sense of smell, especially of other bodies
- Chocolate addiction
- Increased appetite, food cravings, heightened metabolism
- Increased libido / sex drive
- Breast fullness, an increase of breast development
- Portential improvement in impulse control
- Deeper sleep with potential for much more vivid dreams
Some of these may simply be the brain getting what it finally wants.
- Drastic reduction in depersonalization / derealization symptoms
- Improved clarity of thought (many reports of improved multitasking)
- Chattiness and generally more extroverted
- Less likely to engage in arguments or fights, more likely to attempt to defuse or escape heated situations
- Improved balance & spacial awareness (less bumping into walls or kicking doorways)
- Changes in ADHD symptoms and/or intensity (for some it improves, for others it gets much worse)
- Note, worsening may be related to side-effects of spironolactone
- Lactation
- A few drops is to be expected, especially while nipples are being stimulated, and is merely a sign of milk ducts forming properly.
- Anything more than that may be a sign of a dangerous hormone imbalance and should be checked by a doctor.
- Cyclical period symptoms. Yes, for real. No menstruation, because there is no uterus, but all other typical period symptoms can manifest in 28 day cycles. Symptoms vary greatly (just as in cis women) and typically last for 4-5 days. Use of a period tracker can reveal the pattern.
- Abdominal Cramps
- Bloating, Gas, Diarrhea and other intestinal issues ("period shits")
- Emotional instability and irrational thoughts (heightened depression, increased dysphoria)
- Muscle aches and pains
- Beast engorgement and nipple tenderness
- Fatigue
- Appetite changes
Anecdotal, but in my case I was able to isolate the cause of worsening ADHD symptoms to low testosterone levels. They got dramatically better once I started taking testosterone. Waiting to get my levels back, but I expect they're currently within the normal cis woman range.