The spectrum of effects of hormone<unk>  in transfeminine people depend on the specific medications and dosages used. In any case, the main effects of hormone<unk>  in transfeminine people are feminization and demasculinization, and are as follows: + Effects of in transfeminine people Effect Time to expectedonset of effect Time to expectedmaximum effect Permanency if hormonetherapy is stopped Breast development and nipple/areolar enlargement 2–6 months 1–5 years Permanent Thinning/slowed growth of facial/body hair 4–12 months >3 years Reversible Cessation/reversal of male-pattern scalp hair loss 1–3 months 1–2 years Reversible Softening of skin/decreased oiliness and acne 3–6 months Unknown Reversible Redistribution of body fat in a feminine pattern 3–6 months 2–5 years Reversible Decreased muscle mass/strength 3–6 months 1–2 years Reversible Widening and rounding of the pelvis Unspecified Unspecified Permanent Changes in mood, emotionality, and behavior Unspecified Unspecified Reversible Decreased sex drive 1–3 months 3–6 months Reversible Decreased spontaneous/morning erections 1–3 months 3–6 months Reversible Erectile dysfunction and decreased ejaculate volume 1–3 months Variable Reversible Decreased sperm production/fertility Unknown >3 years Reversible or permanent Decreased testicle size 3–6 months 2–3 years Unknown Decreased penis size None Not applicable Not applicable Decreased prostate gland size Unspecified Unspecified Unspecified Voice changes None Not applicable Not applicable Physical changes Breast development Breast, nipple, and areolar development varies considerably depending on genetics, body composition, age of HRT initiation, and many other factors. Development can take a couple years to nearly a decade for some. However, many transgender women report there is often a "stall" in breast growth during transition, or significant breast asymmetry. Transgender women on HRT often experience less breast development than cisgender women (especially if started after young adulthood). For this reason, many seek breast augmentation. Transgender patients opting for breast reduction are rare. Shoulder width and the size of the rib cage also play a role in the perceivable size of the breasts; both are usually larger in transgender women, causing the breasts to appear proportionally smaller. Thus, when a transgender woman opts to have breast augmentation, the implants used tend to be larger than those used by cisgender women. In clinical trials, cisgender women have used stem cells from fat to regrow their breasts after mastectomies. This could some day eliminate the need for implants for transgender women. In transgender women on HRT, as in cisgender women during puberty, breast ducts and Cooper's ligaments develop under the influence of estrogen. Progesterone causes the milk sacs (mammary alveoli) to develop, and with the right stimuli, a transgender woman may lactate. Additionally, HRT often makes the nipples more sensitive to stimulation. Breast development in transgender women begins within two to three months of the start of hormone<unk>  and continues for up to two years. Breast development seems to be better in transgender women who have a higher body mass index. As a result, it may be beneficial to breast development for thin transgender women to gain some weight in the early phases of hormone<unk> . Different estrogens, such as estradiol valerate, conjugated estrogens, and ethinylestradiol, appear to produce equivalent results in terms of breast sizes in transgender women. The sudden discontinuation of estrogen<unk>  has been associated with onset of galactorrhea (lactation). Skin changes The uppermost layer of skin, the stratum corneum, becomes thinner and more translucent. Spider veins may appear or be more noticeable as a result. Collagen decreases, and tactile sensation increases. The skin becomes softer, more susceptible to tearing and irritation from scratching or shaving, and slightly lighter in color because of a slight decrease in melanin. Sebaceous gland activity (which is triggered by androgens) lessens, reducing oil production on the skin and scalp. Consequently, the skin becomes less prone to acne. It also becomes drier, and lotions or oils may be necessary. The pores become smaller because of the lower quantities of oil being produced. Many apocrine glands – a type of sweat gland – become inactive, and body odor decreases. Remaining body odor becomes less metallic, sharp, or acrid, and more sweet and musky. As subcutaneous fat accumulates, dimpling, or cellulite, becomes more apparent on the thighs and buttocks. Stretch marks (striae distensae) may appear on the skin in these areas. Susceptibility to sunburn increases, possibly because the skin is thinner and less pigmented. Hair changes Antiandrogens affect existing facial hair only slightly; patients may see slower growth and some reduction in density and coverage. Those who are less than a decade past puberty and/or lack a significant amount of facial hair may have better results. Patients taking antiandrogens tend to have better results with electrolysis and laser hair removal than those who are not. In patients in their teens or early twenties, antiandrogens prevent new facial hair from developing if testosterone levels are within the normal female range. Body hair (on the chest, shoulders, back, abdomen, buttocks, thighs, tops of hands, and tops of feet) turns, over time, from terminal ("normal") hairs to tiny, blonde vellus hairs. Arm, perianal, and perineal hair is reduced but may not turn to vellus hair on the latter two regions (some cisgender women also have hair in these areas). Underarm hair changes slightly in texture and length, and pubic hair becomes more typically female in pattern. Lower leg hair becomes less dense. All of these changes depend to some degree on genetics. Head hair may change slightly in texture, curl, and color. This is especially likely with hair growth from previously bald areas. Eyebrows do not change because they are not androgenic hair. Eye changes The lens of the eye changes in curvature. Because of decreased androgen levels, the meibomian glands (the sebaceous glands on the upper and lower eyelids that open up at the edges) produce less oil. Because oil prevents the tear film from evaporating, this change may cause dry eyes. Fat changes The distribution of adipose (fat) tissue changes slowly over months and years. HRT causes the body to accumulate new fat in a typically feminine pattern, including in the hips, thighs, buttocks, pubis, upper arms, and breasts. The body begins to burn old adipose tissue in the waist, shoulders, and back, making those areas smaller. Subcutaneous fat increases in the cheeks and lips, making the face appear rounder, with slightly less emphasis on the jaw as the lower portion of the cheeks fills in. Bone/skeletal changes If estrogen<unk>  is begun at an early age, widening of the hips may occur. Unaffected characteristics HRT does not reverse bone changes that have already been established by puberty. Consequently, it does not affect height except for the aforementioned reasons; the length of the arms, legs, hands, and feet; or the width of the shoulders and rib cage. However, details of bone shape change throughout life, with bones becoming heavier and more deeply sculptured under the influence of androgens, and HRT does prevent such changes from progressing further. The width of the hips is not affected in individuals for whom epiphyseal closure (fusion and closure of the ends of bones, which prevents any further lengthening) has taken place. This occurs in most people between 18 and 25 years of age. Already-established changes to the shape of the hips cannot be reversed by HRT whether epiphyseal closure has taken place or not. Established changes to the bone structure of the face are also unaffected by HRT. A significant majority of craniofacial changes occur during adolescence. Post-adolescent growth is considerably slower and minimal by comparison. Also unaffected is the prominence of the thyroid cartilage (Adam's apple). These changes may be reversed by surgery (facial feminization surgery and tracheal shave, respectively). During puberty, the voice deepens in pitch and becomes more resonant. These changes are permanent and are not affected by HRT. Voice<unk>  and/or surgery may be used instead to achieve a more female-sounding voice. Facial hair develops during puberty and is only slightly affected by HRT. It may, however, be eliminated nearly permanently with laser hair removal, or permanently with electrolysis. Mental changes The psychological effects of<unk>  are harder to define than physical changes. Because hormone<unk>  is usually the first physical step taken to transition, the act of beginning it has a significant psychological effect, which is difficult to distinguish from hormonally induced changes. Mood changes Changes in mood and well-being occur with hormone<unk>  in transgender women. Sexual changes Some transgender women report a significant reduction in libido, depending on the dosage of antiandrogens. A small number of post-operative transgender women take low doses of testosterone to boost their libido. Raising the dosage of estrogen or adding a progestogen raises the libido of some transgender women. Spontaneous and morning erections decrease significantly in frequency, although some patients who have had an orchiectomy still experience morning erections. Voluntary erections may or may not be possible, depending on the amount of hormones and/or antiandrogens being taken. Managing long-term hormonal regimens have not been studied and are difficult to estimate because research on the long-term use of hormonal<unk>  has not been noted. However, it is possible
Feminizing hormone therapy
Masculinizing hormone therapy
Transgender hormone therapy
Hormonal therapy 
Estrogen deprivation therapy
Antihormone therapy
Hormone therapy
Androgen deprivation therapy