New to hormones? Start with what they change, and what they don’t →

About Trans HRT Guide

Nick Peplow

hi, I’m Nick — Welcome!

Nick Peplow

I’m Nick Peplow, the person behind every guide on this site

My day job is running Thailand Care, an independent service that helps international patients arrange treatment at accredited hospitals in Bangkok.

Most of the people who come to us are trans men, trans women and non-binary people planning surgery, and almost all of them have been on hormones for years by the time we meet. Hormones come up in nearly every one of those conversations. Do I need to stop estrogen before surgery? What happens to my testosterone after a hysterectomy? Is my level normal? Most people have pieced the answers together from forums, a rushed appointment and a leaflet written for someone else.

I write about what each medicine does, how fast, what the blood tests are for, how people get a prescription where they live, and what it costs. The site is new, and the guides are being added one at a time.

The result will be a guide to gender-affirming hormones in either direction, from the first appointment through the first two years of changes and on to long-term health, each page with an honest read of what is known and what is not, and the questions I'd want you to ask your prescriber.

Where the guides come from

I've sat beside enough patients to know how hormone care actually goes. People are told a number from a blood test without being told what it means. They get different rules from different clinics and assume one of them must be wrong. They find out about a surgeon's instructions on estrogen two weeks before their operation.

The guides draw on that experience and on published clinical guidance and research, including:

  • WPATH Standards of Care, version 8
  • Endocrine Society clinical practice guideline on gender-dysphoric/gender-incongruent persons
  • UCSF Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People
  • Peer-reviewed endocrinology literature

Clear answers, no agenda

This is an independent website that I own, pay for and run myself. It is not affiliated with any clinic, telehealth service, pharmacy or drug maker.

  • I review every guide against current clinical guidance and published research
  • Timelines and figures are given as ranges, and where the evidence is thin, which for several hormone questions it is, I say so
  • No clinic or service can pay to be mentioned or recommended
  • Your questions shape what I write next

My goal is to make hormone care understandable, whether you're booking your first appointment or you've been on hormones for ten years. How I research and check each guide is set out in the editorial policy.

The bit I do for a living. I also run Thailand Care, which arranges surgery for international patients at Bangkok hospitals. It's where the experience behind these guides comes from, and it's a commercial interest, so I'll be plain about how I handle it. Hormones are prescribed and monitored close to home, and nothing on this site steers you towards surgery or towards booking through me. If you do want help planning surgery, wherever you have it, you pay the hospital's own price with nothing added for my involvement. If a page ever reads like a pitch, tell me.

Are you new here?

I’d start with the [Start Here guide](/start-here), which explains what hormones change, how people get them and what staying on them involves.

Two good places to start

Frequently asked questions

Have you taken hormones yourself?

No, and I say that up front because people reasonably want to know where a site like this is coming from. I'm writing from years of sitting beside trans patients through consultations, surgery and recovery as the person coordinating their care, and from the clinical guidance and literature. Where lived experience matters more than that, I say so rather than pretend.

Are you a doctor?

No. I'm not a doctor, nurse, pharmacist or endocrinologist, and nothing on this site is medical advice. Never start, stop or change a dose because of something you read here; take it to your prescriber.

Who pays for this site?

I do. There are no sponsors, no paid listings and no ad networks. If that ever changes, the editorial policy and privacy policy will say so before anything goes live.

I found a mistake. What do I do?

Tell me. I check every correction, fix the page if you're right, and note the change at the bottom with the date.

Contact

Got a question, a correction or a clinic to suggest? [Get in touch](/contact), I read everything.