Masculinizing Hormones

By Nick Peplow·Founder and editor

Last reviewed 27 September 2026· How this site is researched

Masculinizing hormone therapy is, for almost everyone, one medicine: testosterone. Unlike feminizing HRT, there is usually no second drug to block anything, because testosterone at the levels a prescriber aims for is strong enough to override the body's own estrogen effects on its own. What varies is the form it comes in, how steady it keeps your levels, and how your body responds.

It works on the timescale of puberty. Skin and libido tend to change in the first weeks or months, periods usually stop within the first several months, and the voice drops across roughly the first year. Hair, muscle and fat keep shifting for several years after that. Some changes are permanent even if you stop, the voice and facial hair most obviously, and some things testosterone does not touch at all: it will not shrink a chest or make you taller once you have finished growing.

Plenty of people take testosterone for years and find it one of the easier parts of transition to live with. The monitoring is mostly routine blood tests, and the thing prescribers watch most closely, the concentration of red blood cells called hematocrit, is easy to measure and usually manageable when it rises.

Not everyone wants the full set of changes. Some non-binary people take a lower dose, or take testosterone for a limited time and stop once the changes they wanted have arrived. That is a real and common approach, with trade-offs of its own, and non-binary and low-dose HRT covers it.

In the Bangkok hospitals where I coordinate surgery, almost every trans man I have helped has been on testosterone for a year or more by the time he arrives, and the questions I hear are remarkably consistent. What will still change? Why haven't my periods stopped? Do I need to stop before the operation? Those questions shaped the guides below.

The guides cover testosterone itself and the forms it comes in, what changes and when, periods on testosterone, including contraception, and risks and side effects. How to get a prescription in the first place is under getting hormones, and blood tests, fertility and surgery planning are under staying healthy.

None of this is medical advice. I am not a doctor, and I have not taken testosterone myself. These pages explain how it works so you can have a better conversation with the person who prescribes it, and that person, who can see your blood results, is who decides the dose.