F-to-M Transgenders: Physical Effects of Testosterone

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The appearance of secondary sexual characteristics is due to sexual hormones secreted by the body during puberty. When it comes to men, the main sexual hormone is testosterone.

Hormone therapy for an F-to-M transsexual consists of providing, by way of a medical treatment, the same testosterone level in a man at birth.

The body will react to the male hormone, provoking a masculine puberty. This puberty will trigger a number of physical, physiological and psychological modifications.

Beware. Affecting one’s hormonal balance bares dire consequences on the body, be it visible effects, complication risks affecting the metabolism or the organ’s health. Starting a hormone therapy must be a well thought out action.

In Part 1 of this series that explores the effects of testosterone on the body of an F-to-M transgender, we will look at the physical modifications resulting from testosterone therapy.

Physical Modifications

These modifications are, of course, the most impressive and interesting changes triggered by Hormone Replacement Therapy (HRT). We will list them in the chronological order of their appearance.

Important Note: Each person reacts in a personal way to a hormone treatment depending on his genetic code. The manifestation of effects may follow a different order at varying speeds and intensity depending on the case. Sometimes, certain modifications do not present themselves at all.

• Modifications of the Sex’s Appearance

Ah, yes. The first modification is not necessarily the one we immediately think of. At first, in our embryonic state, we all have a basic female-type sexual organ. During pregnancy, the appearance of sexual hormones will or won’t lead to the development of a penis at the base of the clitoris. It is therefore normal that the latter reacts to testosterone intakes.

The anatomy of the clitoris and that of the penis are very much alike: It consists of two cavernous bodies (erectile), spongy bodies, a glans, a frenum and a cap.

The clitoris begins to grow, forming a neo-penis. But don’t delude yourself. A “classical” penis will not gradually appear. Rather, the clitoris will develop into a small frenum with the growth of the glans (clitoral hypertrophy). This development of the sexual organ is generally painless. However, you may become a bit more sensitive at first. And you must not forget to properly pull back the foreskin. At first, pulling back the foreskin is not very pleasant, it could even be a little painful, but it passes quite fast with men.

Testosterone must be left to take its course over many years to see the end result: the growth of your neo-penis. The length and speed of the growth are directly linked to your genetic code. For some, this modification may simply not happen. For others, it may start only to stop shortly thereafter. It is impossible to know beforehand how your body will react. It may vary between few millimeters to several centimeters.

• Voice

During the first two to three months of the treatment, the voice will also change. The first signs manifest themselves in the form of mild throat aches, kind of like the beginning of a cold. Then, your voice will derail more frequently; you will get tired by the end of the day and sometimes, you’ll verge on becoming voiceless. Once your voice starts to break, it will take it one or two additional months to complete the transformation.

• Beard, Hair and Pilosity

The most emblematic secondary masculine sexual characteristic is unquestionably the beard. It is also usually the longest change to manifest itself. The first hairs appear on the chin and spread to the sideburns, below the jaw and finally the cheeks.

The speed of the growth varies from one person to the other. Usually, testosterone acts on the entire pilosity of the body. Below is a list of the zones where pilosity intensifies:

• Legs

• Stomach

• Forearms

• Torso

• Upper and lower back

• Above the hands and feet

• Buttocks

Again, the zones and the intensity of the change may differ from one person to the other.

Testosterone also affects hair implants and hair growth. Usually, men’s front and temples are clearer than women’s. You will also notice that the hairline will recede on the forehead and temples. Being an F-to-M transgender will not save you from baldness which is both hormonal and genetic. Testosterone affects the speed of hair growth. The faster the hair grows, the faster it falls, and the faster you won’t have any more new hairs to replace the old. If your father and your two grand-parents are bald, there’s a high risk that you will be too sooner or later.

• Figure, Muscles and Fat

Male hormones work inside the body cells and induce the production of proteins. In other words, this hormone induces the body to “build muscle.” Without making any effort in that respect, your musculature will slowly develop.

Men and women do not store fat the same way. With women, fat lodges itself in the buttocks and hips. With men, the area of preference for fat is the stomach. Once again, sexual hormones are at the heart of this difference. With your treatment, fat storage will happen in a masculine way. Gradually, the distribution of fat, and thus your figure will change. All this happens progressively and manifests itself over the years. Your figure will become straighter, but here, too, don’t hope for a miracle. Since women often have a larger pelvis than men, hormones can’t do anything for the thickness of the bones. However, you must beware of important weight gains due to hormone intakes.

• Frame

Testosterone reinforces your physique with not only muscles but bones. To detail the effect of testosterone on bones, we must make the difference between the people who’ve completed their growth and those who haven’t. Growth ends at 16 or 17 years of age for people born with a female sex, but it can sometimes last until the age of 20.

Complete Growth:

Testosterone doesn’t “modify” bones or the cartilage, it reinforces them and prevents risks of osteoporosis by ensuring a strong mineralization of bones (calcification). This mineralization decreases agility, and can also potentially cause joint pain and/or discomfort (cracking) based on the movement. This action on the bones can also affect your physique. The jaw can become more squared, your legs bigger, increasing one or two sizes even. The wrists may become larger, even though a change in the width and size of the hands is not normally noticeable.

Incomplete Growth:

Testosterone affects the epiphysial cartilage. It’s the cartilage that fuses into bone and ensures body growth (not to be confused with the hyaline articular cartilage). Testosterone acts strongly on the cartilage, welding it faster. Testosterone intakes thus lead to a peak in the growth, but also the premature death of the latter, if hormone levels are too high for your age.

• Skin

Nothing escapes hormones. They even affect the skin. Your treatment will make the skin thicker, more granular and stimulate the secretion of sebum. In other words, your skin will become greasier, which will make you predisposed to one of the effects everybody wants to do without: acne! No puberty without a good deal pimples. Acne doesn’t affect everybody the same way. If, during your first puberty, you had acne, you’d better bet that you’ll have a problem with it again.

Translated from French by Joelle

Tags: FTM, Health, hormones, transsexual