In my personal experience, HRT has been great, but really didn’t turn into another gender. I’ve taken estrogen for over half a decade now and am still figuring out who I am…
The troponin threshold to predict cardiovascular events is lower for women due to the greater cardiac mass typically seen in men.
Since estradiol and testosterone were not thought to directly impact cardiac mass, researchers expected that troponin would remain similar to individuals’ assigned gender at birth.
However, they found the opposite to be true.
The clinical research team found that troponin levels shifted towards the affirmed gender after 12 months of hormone therapy.
Troponin decreased in transgender women to a level not statistically different from cisgender women, but which was 78% lower than in cisgender men.
and on the molecular level, estrogen changes the protein biomarkers:
“For transgender women, we found gender affirming hormone therapy alters the levels of many protein biomarkers,” Novakovic said, noting that this could impact risk assessments for things like autoimmune disease and heart conditions. Usually, these assessments factor in any number of variables, including sex as well as lifestyle or genetic components.
“Feminizing GAHT [gender-affirming hormone therapy] skews the plasma proteome toward a cis-female profile,” the study concluded. It should be noted that people of any sex or gender can exhibit a vast and evolving spectrum of these biomarkers—there is no “one size fits all” model for biodiversity.
so yeah, you don’t change your gender identity with hormones - but you definitely are changing the way your body functions and changing your biological sex (in most health-relevant ways, e.g. heart and stroke risks, drug metabolism, etc.), and so increasingly I’ve come to think trans women on estrogen are biologically female, and that’s probably true in multiple ways (if they weren’t in some way biologically female they wouldn’t have needed estrogen).
Since it seems like a gender identity in a body with the wrong hormones seems to make a lot of people suicidal, depressed, and anxious - having the right hormones seems to fix that (go figure! lol)
This honestly makes me so happy. Back before I cracked my egg and started learning about what hormonal transition really meant I thought that transitioning was purely cosmetic, like all the passing trans women just got really lucky with their body shape and put in a ton of work with cosmetic surgeries, makeup, hair removal, wearing clothes that made them look more feminine, etc. I thought they were still biologically men and nothing could change that, which looking back made me really sad and held me back from coming out to myself. After all, if there’s no hope of really being a woman what was the point? I’m so glad I got past that because learning how much changes with HRT is fucking awesome. I actually, biologically, get to be a woman, even if I never really pass to some people. I couldn’t be happier lol.
That is very mind-blowing. Is it like 100% conversion, or is there something left behind? Is it a morphology issue? Like, because they formed a bit the other way after leaving the womb, or would they turn out 100% the other gender if it was done early?
You can actually ask former member of the other gender what their lives are like, it’s mind-blowing @_@
I’m not sure what you mean by “100% conversion”, but no - there are developmental pathways that are irreversible, e.g. the fetal development of the genitals are not going to change by taking hormones later, and many changes during puberty are irreversible (like changes to the skeleton - length of bones, changes to the skull, angle of the hips, etc.).
In trans women, undergoing male puberty causes irreversible changes to the thickness of the vocal folds, and estrogen does not change or fix the voice (but for trans men, starting testosterone will cause the vocal folds to thicken, permanently masculinizing the voice).
Preventing the wrong puberty helps avoid a lot of distress for trans people, which is why it is so important those interventions are available to trans youth. It is no different than if a cis person were administered the wrong hormones and forced to live as the wrong gender - it causes distress and significantly increases likelihood of suicide.
But even for those who avoid the wrong puberty, there are sex differences that developed as a fetus that would require surgery to fix.
EDIT: in case it’s not clear, there is a huge variety in the ways bodies develop even just when looking at non-trans people, and so even though my body underwent male puberty and that resulted in permanent changes to my rib cages, skull, hip width, etc. - my body still more or less overlaps with other female bodies enough that nobody can really tell the difference.
Male and female genitals are actually homologous meaning they have the same structures - both men and women have a phallus, e.g. a penis is a large, spongy clit and women have a “prostate” (Skene’s gland) that like in men produces ejaculate, etc.
So with surgery, my genitals were able to largely be corrected and the various structures were simply altered to be like they would have been (scrotum is a fused labia, and with surgery is fashioned into labia).
So even my genitals would be “female” to most people (not that most people would see my vulva anyway).
My breasts have developed naturally through hormones alone, and at this point I have no complaints about size, and they certainly are large enough that nobody questions that I’m a woman.
I’m beginning to lose sight of in what medical or biologically significant ways I’m not “female” at this point, even if there are still plenty of residual signs of my initial male puberty I’m very aware of, nobody else seems to notice them, and more importantly, my history as a “male” is no longer relevant to my physical health - the current evidence seems to support what I experience: my body is a female body.
This is not something I thought would ever happen, I didn’t think transition really makes you female or changes your sex, I always thought of it as more metaphorical or cosmetic. I underestimated the role hormones play in the body’s functioning and the way hormones seem to play a primary role in biological differences between men and women.
In my personal experience, HRT has been great, but really didn’t turn into another gender. I’ve taken estrogen for over half a decade now and am still figuring out who I am…
It doesn’t change your gender, only your body. Gender is not determined by it; it only makes you happier.
I think the emerging evidence is that HRT changes your sex, though - biological sex seems to be much more plastic than people realized
there was that recent study that found within 12 months on HRT, heart mass changed and matched the trans person’s gender:
https://www.medicalrepublic.com.au/gender-affirming-hormone-therapy-changes-the-heart/120596
and on the molecular level, estrogen changes the protein biomarkers:
https://www.nature.com/articles/s41591-025-04023-9
https://www.erininthemorning.com/p/study-finds-trans-womens-blood-proteins
so yeah, you don’t change your gender identity with hormones - but you definitely are changing the way your body functions and changing your biological sex (in most health-relevant ways, e.g. heart and stroke risks, drug metabolism, etc.), and so increasingly I’ve come to think trans women on estrogen are biologically female, and that’s probably true in multiple ways (if they weren’t in some way biologically female they wouldn’t have needed estrogen).
Since it seems like a gender identity in a body with the wrong hormones seems to make a lot of people suicidal, depressed, and anxious - having the right hormones seems to fix that (go figure! lol)
This honestly makes me so happy. Back before I cracked my egg and started learning about what hormonal transition really meant I thought that transitioning was purely cosmetic, like all the passing trans women just got really lucky with their body shape and put in a ton of work with cosmetic surgeries, makeup, hair removal, wearing clothes that made them look more feminine, etc. I thought they were still biologically men and nothing could change that, which looking back made me really sad and held me back from coming out to myself. After all, if there’s no hope of really being a woman what was the point? I’m so glad I got past that because learning how much changes with HRT is fucking awesome. I actually, biologically, get to be a woman, even if I never really pass to some people. I couldn’t be happier lol.
That is very mind-blowing. Is it like 100% conversion, or is there something left behind? Is it a morphology issue? Like, because they formed a bit the other way after leaving the womb, or would they turn out 100% the other gender if it was done early?
You can actually ask former member of the other gender what their lives are like, it’s mind-blowing @_@
I’m not sure what you mean by “100% conversion”, but no - there are developmental pathways that are irreversible, e.g. the fetal development of the genitals are not going to change by taking hormones later, and many changes during puberty are irreversible (like changes to the skeleton - length of bones, changes to the skull, angle of the hips, etc.).
In trans women, undergoing male puberty causes irreversible changes to the thickness of the vocal folds, and estrogen does not change or fix the voice (but for trans men, starting testosterone will cause the vocal folds to thicken, permanently masculinizing the voice).
Preventing the wrong puberty helps avoid a lot of distress for trans people, which is why it is so important those interventions are available to trans youth. It is no different than if a cis person were administered the wrong hormones and forced to live as the wrong gender - it causes distress and significantly increases likelihood of suicide.
But even for those who avoid the wrong puberty, there are sex differences that developed as a fetus that would require surgery to fix.
EDIT: in case it’s not clear, there is a huge variety in the ways bodies develop even just when looking at non-trans people, and so even though my body underwent male puberty and that resulted in permanent changes to my rib cages, skull, hip width, etc. - my body still more or less overlaps with other female bodies enough that nobody can really tell the difference.
Male and female genitals are actually homologous meaning they have the same structures - both men and women have a phallus, e.g. a penis is a large, spongy clit and women have a “prostate” (Skene’s gland) that like in men produces ejaculate, etc.
So with surgery, my genitals were able to largely be corrected and the various structures were simply altered to be like they would have been (scrotum is a fused labia, and with surgery is fashioned into labia).
So even my genitals would be “female” to most people (not that most people would see my vulva anyway).
My breasts have developed naturally through hormones alone, and at this point I have no complaints about size, and they certainly are large enough that nobody questions that I’m a woman.
I’m beginning to lose sight of in what medical or biologically significant ways I’m not “female” at this point, even if there are still plenty of residual signs of my initial male puberty I’m very aware of, nobody else seems to notice them, and more importantly, my history as a “male” is no longer relevant to my physical health - the current evidence seems to support what I experience: my body is a female body.
This is not something I thought would ever happen, I didn’t think transition really makes you female or changes your sex, I always thought of it as more metaphorical or cosmetic. I underestimated the role hormones play in the body’s functioning and the way hormones seem to play a primary role in biological differences between men and women.
Happy it worked out well for you! (and unhappy I can’t write a whole article to match yours).
EDIT: Oh I do have a question: how does it feel different to be a woman, if at all?