This guide is intended for anyone interested in estrogen-based/"feminising" hormone therapy, with a focus on atypical medication regimens. I have been on hormones in one form or another for almost two years now, and in my time, I've taken my fair share of pills, injectables, and tablets. Though this guide is not meant to be exhaustive nor to cover all anatomies, and while I can't make any promises that my experience is universal, I hope the information I have here is useful.
Before I share the information I can on what to know and expect from HRT, I'd like to mention my background and positionality as it relates to being trans. My goals for HRT have been feminising and non-microdosing therapy; I know nothing about microdosing beyond my brief flings with estrogen-only therapy. Also, my experience of HRT is exclusively that of a USA resident. I don't know what it looks like to access HRT in other countries. Finally, I have no medical background; the most of what my knowledge background is osmosis from transfems on the internet and sites like transfemscience.org.
I started hormones in June of 2021 at the age of 18. I originally started on sublingual estradiol tablets and nothing else, and have since been on and off spiro, started on progesterone in various routes of administration, and switched to injectable estradiol (both from brick-and-mortar pharmacies and from grey market sites). As of my last round of bloodwork in February, I have reached my ultimate goal for my hormone levels and am satisfied with where I'm at.
This is the cornerstone of feminising hormone therapy; it is responsible for the majority of the feminising effects and usually comes in some formulation of estradiol (e.g. tablets, transdermal patches, gel) or a derivative thereof (like estradiol valerate or estradiol cypionate). If you've heard of "titty skittles", this is what they're talking about.
This is another aspect of feminising hormone therapy, and is used more for suppressing the effects/levels of testosterone in the body. This class of medications includes things like spironolactone, cyproterone acetate, and bicalutamide. These are not always necessary for your hormone therapy, depending on what effects you're looking for and what other medications you're on.
This medication is not always used by individuals, nor is it immediately added to most regimens, but there is a vast amount of anecdotal evidence on its benefits. For me and many other people, it has brought about mood changes and further breast development, and is usually taken in the form of a pill either orally or rectally (WE WILL GET TO THIS).