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Medical Transition

Please note that some of the language on this page may cause gender dysphoria, as anatomical terms are used.

 

Hormone Therapy

Gender-Affirming Hormone Therapy

For many trans people, gender-affirming hormone therapy (masculinising or feminising), is a very important step during their transition. Gender-affirming hormone therapy is different for everybody, so it is important to go through the right avenues to obtain and use hormone therapy.​​

Where to find a doctor:

  • In Victoria (where we are based), Northside Clinic, Prahran Market Clinic, Equinox Gender Diverse Health Centre, Eleanor Clinic, Ballarat Community Health, Your Community Health (based at PANCH with Austin Health) and Monash Gender Clinic are specialised clinics designed to help trans, gender diverse and non-binary people seek hormone therapy.

Traditional Pathway to Accessing Hormones:

  • This pathway to hormones involves obtaining an approval letter to start hormones after a detailed assessment and support (usually 3–6 appointments) with a specialised mental health professional experienced in gender transition. Whilst there is criticism that this process is ‘gate-keeping’, many find this process beneficial and valuable to support them through gender transition, and prepare them for starting hormones.

Informed Consent Pathway:

  • Under an ‘Informed Consent’ model of care, General Practitionersperform the initial assessment, play a key role in mental health and risk assessments for trans clients, and organise referral for secondary consultation where required. This process was designed to reduce unnecessary barriers.

Hormone therapies can make trans people infertile. Feminising hormones with oestrogen can block sperm production, and if biological children are desired in the future, sperm storage is recommended before starting hormones. This can be done at some hospital andrology clinics and some specialised pathology clinics (ask your GP) and there is a cost involved (usually a few hundred dollars) for collection and then annual storage costs (a few hundred dollars).

 

Feminising Hormones

Feminising hormone therapy, for transgender people who are assigned male at birth, typically increases the feminising hormone estradiol, and lowers the masculinising hormone testosterone. Estradiol is the mainstay, but often testosterone blockers are needed too.

 

Estradiol

Estradiol in Australia comes in three different forms: oral tablets, patch and gels. Tablets are taken everyday and patches are changed twice weekly or weekly depending on the brand. Gels are applied to the skin daily. There are no TGA-approved implants or injections available in Australia. Medications are covered by the PBS (maximum $40.30 or $6.50/month for health care card holders).

Estradiol

Estradiol in Australia comes in three different forms: oral tablets, patch and gels. Tablets are taken everyday and patches are changed twice weekly or weekly depending on the brand. Gels are applied to the skin daily. There are no TGA-approved implants or injections available in Australia. Medications are covered by the PBS (maximum $40.30 or $6.50/month for health care card holders).

Estradiol

Estradiol in Australia is available on the PBS which comes in three different forms: oral tablets, patches and gels. Tablets are taken everyday and patches are changed twice weekly or weekly depending on the brand. Gels are applied to the skin daily. Medications covered by the PBS cost a maximum $40.30 per month or $6.50/month for health care card holders. There are no Therapeutic Goods Administration (TGA)-approved or PBS implants or injections available in Australia (speak to your doctor about compounded medications).

Testosterone Blockers (Anti-Androgens)

There are several types of anti-androgens (all are daily tablets) with the most common types being cyproterone acetate (not available in the US), spironolactone and micronized progesterone.

 
 

Masculinising Hormones

Masculinising hormone therapy consists of a testosterone formulation which increases a person’s blood testosterone concentrations, typically to the male reference range. Some people, particularly non-binary people, may choose to use a lower dose of testosterone to achieve partial masculinisation.

 
 
 

Types of Testosterone

  • 3 monthly injections (Reandron)

  • 2 – 3 weekly injections (Primoteston)

  • Daily testosterone gel in a pump pack (Testogel). The pump pack makes it easy to provide low doses which often suits people wanting partial or slow masculinisation.

  • Daily testosterone cream (Androforte)

Surgery

For many trans people, surgery is an important step. Many do not have surgery. Our research has found that many more desire surgery than have had surgery. Cost is the biggest barrier as surgery in Australia is only performed in the private sector. There are many different types of surgeries available.

Feminising surgery includes:

  • Facial Feminisation Surgery: FFS is a combination of facial reconstructive procedures thats aim is to change the effects testosterone has had on the person’s face and to create a more typically feminine face.

  • Voice surgery: The effects testosterone has on someone’s voice permanently deepens their voice and for some voice training (more information in Social Transitioning) isn’t enough to help feminise the voice so voice surgery can help raise the pitch of your voice and create a more feminine sounding voice.

  • Laryngeal shave: This reduces the appearance of the Adam's apple in the neck.

  • Bottom surgery/gender confirmation surgery: bottom surgery for trans women is when a surgeon surgically constructs a vagina from the existing genitals the person was born with at birth.

Masculinising surgery includes:

  • Chest reconstructive surgery: chest reconstructive surgery or top surgery removes breast tissue to create a more flat, masculine chest. There are many methods to do this but some of the popular methods include keyhole surgery and the inverted “T” method.

  • Reproductive surgery: Reproductive surgery involves removing the reproductive system including the uterus and fallopian tube with either a hysterectomy and or bilateral oophorectomy.

  • Bottom surgery/gender confirmation surgery: For trans men there are multiple options for having bottom surgery. The most common types include metoidioplasty and phalloplasty and are usually done over multiple stages.

You can find a list of Australian Professional Association of Trans Health member surgeons here.

 

Videos About Surgery

 
 
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A fair go for all Aussies!

We acknowledge the Traditional Custodians of the lands on which we work, and pay our respects to the Elders, past, present and emerging. We also acknowledge and express our gratitude to our LGBTIQ+ Elders, past, present and emerging, who have tirelessly paved the road for us to be where we are today. 

All information provided on this website is intended as a guide only. Please see your local doctor for specific health advice for your individual circumstances.

Website Design © 2020 Jake Kidson-Purry.