Testosterone therapy is one major component of transitioning for female-to-male transsexuals. Testosterone is administered in varying ways, depending on availability and the unique needs of every individual, to spur the development of secondary male sex characteristics. Every man experiences hormone therapy differently, but this information is based on average experiences.
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Testosterone can be administered in a number of ways. According to Dimensions at the Castro-Mission Health Center in San Francisco (henceforth referred to as Dimensions), oral testosterone is not used for FTM hormone therapy because of the severity of side effects; according to the FTM Network, these included liver problems like temporary jaundice. Other methods include injections of testosterone enanthate or testosterone cypionate, topical testosterone gel and transdermal testosterone (a testosterone patch). According to Dimensions, testosterone patches are expensive, but indicated for use in people who require a constant dose of testosterone (due to a sensitivity to fluctuating levels of the hormone).
A set of changes generally known as masculinisation occur during the process of testosterone therapy. These can be either permanent or temporary. According to LGBT Health Channel, permanent masculinisation effects include sterility, male pattern baldness (more on hair growth can be found in the following section), a lowering of voice pitch and growth of the clitoris. The temporary masculinising of testosterone (those that could be reversed if treatment were stopped), according to LGBT Health Channel, include effects similar to male puberty, like aggression, increased sex drive and acne. Others include increased muscle mass and a more masculine distribution of fat around the midsection.
An increase in body hair is common in testosterone therapy. However, as is noted by both Transgender Health at Vancouver Coastal Health (VCH) and the FTM Network, beard and facial hair growth is a slower process that varies greatly among individuals. The FTM Network recommends looking at one's male family members to see what one's own beard will eventually look like; VCH notes that beard growth begins around 1 year after initiating testosterone and may take up to 4 years to develop fully.
VCH divides the changes experienced by FTMs into groups based on when they occur. Between 1 and 3 months after initiating treatment, increased libido, dryness of the vagina and clitoral growth, increase in body hair and acne, and masculinising fat redistribution may be observed. Sometime during the first 6 months, menstruation will stop, and the voice will generally drop sometime between 3 and 6 months after treatment starts.
Some changes do not occur with only the use of hormones. VCH notes that further vocal training may be required if testosterone does not drop the voice far enough and to encourage communication within socially gendered boundaries. The breasts may change in shape, but top surgery may be desired to develop a more masculine-appearing chest. Testosterone also does not change vaginal or bone development.
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