Medically transitioning

Always follow your doctor’s recommendations!
Remember, we are not doctors.

What is HRT? Hormone replacement therapy is a medication used to help adjust hormones in the body to better reflect gender identity and/or medical needs.
Anyone can use HRT including transgender, Intersex and even Cis people (folks who are not transgender, and whose gender identity matches their assigned sex at birth).

What are the effects of HRT?
for Trans men(testosterone) and Trans women(estrogen):
gendergp.com/hrt-timelines-hormones-effects/
FYI-Both Cis & Trans People can have similar effects from hormone levels side effects.
Ex: both cis and trans men may or may not be impacted by baldness.
This can be due to family genetics.

HRT - how to do injections

• PP-How to inject hrt: plannedparenthood.org/ - hormone therapy self injection tutorials
• PDF version of how to inject hrt: plannedparenthood.org/ - pplm gender affirming hormone therapy injection guide
• Explanation of needle sizes: goodrx.com - Is it safe to reuse needles and syringes?
• Folxhealth: How to do injections

Video of step by step Injections & safety:
TW: needles are shown in videos, for educational purposes.

• Step1: youtube - Hormone Self-Injection - Step 1: Drawing Up
  
• Intramuscular injection: youtube - Hormone Self-Injection - Step 2a: Intramuscular Injection
  
• Subcutaneous Injection: youtube - Hormone Self-Injection - Step 2b: Subcutaneous Injection
  

Follow your doctor’s instructions on your vile, ask your doctor which method is best.

Afraid of needles or get weekly shot anxiety?
Try an auto injector: unionmedico.com/super-grip/

Methods of HRT

* see a doctor or licensed medical professional to start HRT and get regular blood work for your health and safety.
Everyone’s body is different and unique, what works for you friend might not work for you. Always follow your doctor's instructions!

HRT for Trans Masc

* testosterone doesn't need an estrogen blocker or another med with it.
(different than fem transition)

• Injections of Testosterone 1x a week or 2x a month, at home (subq or intramuscular)
• Medication-pills (testosterone)
• Patches on skin (testosterone) - if you are allergic to adhesive this might not be for you
• “Testo-pellets” (testosterone) - in office procedure with numbing
• “Andro-Gel” for testosterone (or gel for estrogen HRT to rub into skin) - risk to spread to other humans and pets in household
• Long Term injections 5x a year called “aveed” (testosterone) - ask your doctor about potential risks (mine made me stay 30 mins after shot in case of rare side effect. I was fine)
• Topical cream for estrogen (atrophy of genitals, not main source)

HRT for Trans Fem

* You need Estrogen higher than Testosterone and an anti-androgen to block T.
Progesterone might be added to treatment later into HRT journey, ask your doctor if this is right for you.

• Medication-pills (estrogen, spironolactone, progesterone)
  
  • anti-androgen alternatives to Spironolactone are Cyproterone Acetate,Bicalutamide.
    
• Patches on skin(estrogen)if you are allergic to adhesive this might not be for you
  
• Injections of Estrogen 1x a week or 2x a month, at home (subq or intramuscular)
  
• Gel for Estrogen ( HRT to rub into skin)-risk of rubbing off onto other humans or pets in household.
  
• Topical creams of HRT (for atrophy of genitals, not main source)
  
• Spray and internal rings might also be an option for main source or add on to your hrt.

Nonbinary options for HRT

Lower dose of Estrogen or Testosterone for slower results, can stop if needed.

DIY HRT

Normally I wouldn't advise anyone to ever consider doing DIY HRT, as it can be very dangerous to purchase, produce, administer and regulate your own hormone levels.

Even if you're in an unsupportive place in the US such as Tennessee, Texas or a small rural town there are still ways to get gender affirming care nearby or online. Checkout the HRT map in the medical section. DIY is a last resort.

If you need support locating resources for your area to avoid relying on DIY, please feel free to reach out!

email: worldwidelgbtresources@gmail.com
Please include a return email or discord/telegram name, reason for needing help, general location such as country/state/province.

However, due to certain countries' current laws (Turkey, Egypt, etc.) and regulations as well as healthcare programs and LGBT rights being a severe issue...
I believe it's best to get people the care they need in the safest way.

• If you are a minor/child under age 18, I wouldn't advise this.
• If you are not able to safely get bloodwork done by a local doctors clinic, I also wouldn't advise this, as lack of testing can cause severe organ issues, seizures and other major issues if mishandled.
• If you're an adult and willing to take personal responsibility for your own medical care and have NO other options for transitioning or receiving HRT, and are aware of the outcome of outing yourself in your community by physical changes that happen...
  then maybe DIY HRT is right for you.

• DIY HRT how to guide for mtf & ftm: diyhrt.wiki
• DIY HRT CAFE
• DIY Estrogen blog site: ashleyxadamson.com
• Folx health - how to inject HRT safely

If you need safe and clean needles, see a local pharmacy, harm reduction drug center or order online from a medical supply website in bulk.

Surgery

• Trans Masc-Surgery options & doctors: ftmsurgery.net
• Nonbinary/Intersex options: salmacian.org
• Trans Fem-Surgery options & doctors: mtfsurgery.net
• verify your plastic surgeon’s medical license: abplasticsurgery.org - SurgeonSearch

Affording surgery

* see our insurance section

Grants for surgery:

• Jim Collins Grant for gender confirming surgery: jimcollinsfoundation.org/apply/
• Trans justice fundraiser: transjusticefundingproject.org/apply/
• Gender care grant: genderbands.org/grants
• POP Surgery grant: pointofpride.org/annual-transgender-surgery-fund
• Trans United grant: tufforg.com/tuffnew/apply
• Black trans masc top surgery grant: blacktransmen.org/top-surgery-grant/
• BIPOC trans masc surgery fund: dembois.org/apply-for-a-grant

Advice for surgery consults

Do a lot of research before choosing the surgery and doctor.
Ask your doctor about:

1. how far they are booking out.
2. Pre Surgery preparation for you, your home and anything you'd need to buy/they recommend.
   (needing to quit nicotine, stop any meds, buy a special pillow or binder,etc.)
3. Ask if they have a BMI limit or anything they need to qualify you for surgery (HRT, letters,etc)
4. Ask about post op recovery (how long it is, pain levels, medications, other people helping you, hospital stay, etc)
5. Risk of complications, how often it occurs and if hospital stays are common.
   • For Top surgery ask about dog ears (skin/fat under arms needing liposuction)
   • Nerve damage/loss of feeling (all surgery)
   • Loss of pleasure for bottom surgery
6. How long they've been doing this type of surgery as a surgeon, if any other surgeons are assisting the surgery
7. How long the surgery is day of and how the surgery day will be.
8. Ask about pictures of surgery before and after from that surgeon if they allow you to see them.
   (you can also look online at peoples reviews of that surgeon)
9. Make sure your insurance and or payment method will work, talk to your doctor and insurance in depth about this.
   • Ask about nipple grafts, sometimes they aren't covered (top surgery for trans masc)

Caregiver guide for after surgery:
Top surgery guide (can be used in general for most surgeries)