Transgender Breast Development, Gender Dysphoria, Hormone, Estrogen Treatment
In hormone replacement therapy, taking estrogen oraly or via injection will cause sterility and loss of sex drive in biological males, from what I understand in my research. There are currently hormone creames available that claim to only work on the area they are rubbed on (ie breasts). I am wondering if these cremes will cause sterility and
loss of sex drive, the same as oral medication or injections, or if the cremes are safe to use to achieve only localized results.
Dr. Joshua’s Answer:
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I am not an expert on this matter, but I did a little bit of research in order to be able to provide a helpful answer to your question (see references below).
Hormone treatment for transgender individuals is based on the systemic effect, meaning that the desired effects occur once the hormone is distributed by blood circulation to the whole body.
Estrogen treatment induces feminine breast development in the transgender person, but this is just one of the combined physical and psychological effects.
One of the effects of estrogen as well as surgical treatment in male-to-female treatment is infertility. Therefore, if you wish to father a child in the future, you should employ the services of a sperm bank before initiating hormone therapy.
I don’t know that there is any evidence that transdermal (through the skin) estrogen creams or the like would be locally effective for breast development or that such treatment would reduce the incidence of decreased libido (sex drive) or infertility.
Generally, it does not matter which route is used for the administration of estrogen: The goal is to achieve certain therapeutic levels of the hormone in blood.
However, there is some evidence that transdermal estrogen may be less harmful to the health of the transgender individual in other respects; there may be less interactions with other medication, and smaller risk of such estrogen treatment complications as deep venous thrombosis, diabetes, and increased blood lipid levels.
Please do not initiate any hormone or other transgender treatments on your own -
medical treatment of gender dysphoria carries significant health risks and serious adverse effects can occur, but the treatment is reasonably safe when it is appropriately monitored by a physician experienced in cross-sex therapy.
Here is a link to a good article on the subject of gender dysphoria and health issues:
Minnesota Medical Association Article on Transgender Health
References:
EVA MOORE, AMY WISNIEWSKI, AND ADRIAN DOBS
Endocrine Treatment of Transsexual People: A Review of
Treatment Regimens, Outcomes, and Adverse Effects
The Journal of Clinical Endocrinology & Metabolism 88(8):3467–3473
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