Q: I am a 24 years old and in need of assistance with transitioning and not sure what is involved.
A: The aim of feminising hormone therapy is to assist in the development of female secondary sex characteristics, with minimisation of male secondary sex characteristics.
In keeping with the Tanner stages of development, various bodily changes can be expected: breast development (usually to Tanner stage 2 or 3), redistribution of facial and body subcutaneous fat, reduction of muscle mass, reduction of body and facial hair, changes in sweat and odour.
Sexual gland effects may include a reduction in erectile function, changes in libido, reduced or absent sperm count and ejaculatory fluid, and reduced testicular size.
Generally, the initial consultation will include a wellness check-up so that the baseline results assist with monitoring once hormonal treatment is started. The approach of therapy is the combination of different hormones, oestrogen being the main hormone.
The type of oestrogen used for feminising therapy is a "bioidentical" hormone in that it is chemically identical to that from a human ovary.
The mode of delivery most common and available in SA for transgender women is a transdermal patch, oral or sublingual tablet.
Suppression of testosterone production and blocking of its effects leads to the minimisation of male secondary sexual characteristics.
It is important to manage expectation of what oestrogen therapy can achieve as unfortunately many of the male characteristics are not 100% irreversible.
Laboratory monitoring for feminising hormone therapy at different intervals is recommended and with the guidance of a health-care provider.
There are a range of non-surgical facial and body treatments, and surgical treatments. Aesthetic medicine offers great results, from hair removal, acne treatment, hair and make-up styling that can improve the body image to the person's desires.
Speech therapy and voice coaching is also a great investment to make. It is also a good idea to find out early what the process and requirements are with the department of home affairs regarding name and gender change.
Always consult a trained medical practitioner. An online database of affirming practitioners can be found on ctrlaltsex.co.za.
• Dr Tlaleng Mofokeng (MBChB), sexual and reproductive health practice, Disa Clinic, safersex.co.za.
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