Approach HRT carefully

by Allison Blaylock
Trans Issues Columnist

I'm MtF and I want to start on HRT. Could you tell me which method of administration has fewer side effects: injections, by mouth or patch? My doctor told me one thing but I'd rather get the opinion from someone who has done it.

I have a family history of heart disease and diabetes and want to be careful with anything I take.




Dear Janien,

When it comes to hormone replacement for transgender individuals there is a lot to think about. In your question, you’re asking about the side effects based on what I believe is the administering of estrogen.

Injections: Require the use of a needle. Many people, myself included, do not like or can not handle the sight and/or feel of a needle. You can either inject into your thigh or gluteal muscle (rear). Most who have a nurse inject them have it done in the gluteal muscle. Those who do it themselves typically inject in the thigh, since it’s easier to do.

This method has less stress on the kidney and liver, since it has minimal passage through that part of the body. Another pro is you can do injections weekly or every other week. Like any injection you can have a slight irritation at the injection point that lasts 1-2 days, but usually this does not occur.

By mouth: Taking hormone pills orally is very common and from my research and those I know, this is the most common way that MtF transgender individuals take estrogen. The biggest advantages I have had with this are that I can take them by myself. I do not need assistance or fear of the needles.

Also, if I miss a dose, it is not going to be a big issue. I can either take it later that day or the following day with no issues. The cons are this method places some stress on the kidneys as does any oral medication. The body must process the pill and get it into the blood stream to start working. Another disadvantage is that you do have to take it everyday for the rest of your life.

Patch: The patch is usually square and about 1 ½ inch by 1 ½ inch. It contains the estrogen inside and is absorbed through the skin which finally makes it into the blood stream. This has minimal issues with the kidneys and liver once again as it is being absorbed into the body, not broken down inside the body.

You will have to find a place in which you want to wear it. I can be a little vain about wearing the patches, especially during spring/summer season when I want to be in a cute bathing suit. You will want to move it to different spots for better absorption and possible skin irritation. You do not have to worry about taking it every day; in most cases it is replaced every 4-7 days.

There is more than just estrogen one needs to take when they are going through HRT as an MtF. You may also have to take some medications through a pill format since the only one that you can currently take via injection is estrogen.

If you choose to have gender reassignment surgery you will not be required to take some of the other medications. That will give you more flexibility with travel.

Please do not self-medicate. Get your prescriptions, needles and other items from a licensed pharmacy or physician.


This column does not substitute as a professional recommendation, nor is it to be used in lieu of consulting with a physician.

Copyright The Gayly – November 11, 2017 @ 10 a.m. CST.