The first changes usually show within a few months, and most of the rest take one to three years, much like puberty. Skin and mood tend to move first; breast growth, fat redistribution, facial hair and muscle take longer. The timelines for feminizing and masculinizing hormones set out what to expect when.

It depends on where you are. Many clinics, especially in the US, prescribe on an informed consent basis after one appointment. Others, including NHS gender clinics in the UK, assess you first, and the wait can be long. Getting hormones covers the routes in.

Some are and some are not. A voice that has dropped on testosterone and breast growth on estrogen generally stay if you stop, while skin, fat, muscle and libido mostly drift back. Which changes are permanent goes through them one by one.

To check the dose is doing what it should without causing problems: hormone levels, and things like potassium, red blood cell count and liver function depending on the medicine. Blood tests and monitoring explains each one and when it is done.

They can, and nobody can promise it will come back if you stop. If biological children might matter to you, talk about freezing sperm or eggs before you start. Fertility covers the options.

Not always, and practice has changed. Some surgeons still ask people on estrogen to pause for a few weeks because of clot risk, while many now keep it going and manage the risk in other ways; testosterone is usually continued. Your surgeon and prescriber decide, so ask early. Hormones and surgery explains what to expect.