Prior to treatment

Before you begin your treatment, you will need to have the following tests and examinations done:

• Blood tests to ensure that your kidneys, liver, and metabolism are functioning normally. We also measure the level of triglycerides, as well as male and female hormones in your blood
• A physical examination includes measuring your height, weight, and blood pressure, and sometimes we also listen to your heart and lungs with a stethoscope
   

Hormone therapy

Female hormones

In most cases, we recommend that you start your treatment with the female hormone OESTRADIOL/ESTRADIOL, either in the form of tablets, patches, transdermal spray, or gel.

Generally, we recommend that you use a patch, transdermal spray, or gel. Transdermal patches should be replaced twice weekly, whereas transdermal spray, gel and tablets are taken daily. The patches sometimes leave adhesive residue on your skin. You can easily remove this with some nail varnish remover and cotton wool. Your age, weight, and any medical condition you may have determine your dose and treatment. We will adjust your dose at your regular check-ups.

The goal of the treatment is for you to have the same blood hormone level as a cis woman.  If you are over 50 years old, we recommend that you slightly lower your dose to reduce the risk of side effects. This reduction corresponds to female changes during menopause. 

Antiandrogen

In addition to the treatment outlined above, we also recommend that you take antiandrogens, because taking female hormones is not enough to suppress your natural production of male hormones. The two different sex hormones will counteract one another.

CYPROTERONACETAT (Androcur) is an antiandrogen that both inhibits your body’s own production of male hormone in the testes and inhibits the effect of male hormones on the cells. This boosts the effect of the female hormone introduced to your body. Please be aware that you will no longer be able to get or maintain a full erection.
 

Check-ups

Prior every check-up, it is important that you get a blood test done 1-2 weeks before your check-up appointment, so we can review the results together and adjust your treatment if necessary. 

If you have any questions about your hormone therapy, we recommend that you write them down and bring them with you to the appointment.
 

During the first year 

Your first check-up will be after three months of treatment. We will inform you about the results of the blood test over the phone. After six months and 12 months of treatment, we will check your hormone levels again. 

Check-ups beyond one year

After the first year, you will need to come in for a check-up once every one or two years.

In some cases, your general practitioner or medical specialist can take over these check-ups.  

If you are already receiving hormone therapy with female sex hormones

If you are already receiving hormone therapy with female sex hormones, prescribed by a physician, when you are referred to CKI, we will assess your situation based on blood tests and a physical examination. The objective of this is to assess whether we can proceed with your treatment, or whether we need to make some adjustments to ensure a healthy balance between the desired effects and any side effects.
 

What changes can you expect during your treatment?

You can expect to:

• Gradually develop breasts. How big or small they are, varies from individual - just as for individuals who were born female
• Gradually see a redistribution of your body fat to reflect that of a woman’s body 
• Gradually have less hair growth (facial hair and body hair on your chest, arms and legs, and pubic hair). Your facial hair (beard), however, will never completely vanish

Most of these changes will happen very slowly, and it can take several years before you see the full effect.

We can offer you free laser facial hair removal.  
 

 What are the side effects of the treatment?

The treatment has several side effects, which you need to know about. Therefore, you need to come in for regular check-ups at the beginning of your treatment.

• Red and irritated skin in the area around the transdermal patch
• Bodily fluid retention
• If your dose is too high, there is a risk of venous thrombosis
• Reduced sex drive
• Mood swings
• Slightly increased risk of cardiovascular disease, i.e. high blood pressure and risk of coronary thrombosis
• Effect on liver function
• Weight gain
• Effect on metabolism
• Increased risk of breast cancer
• Treatment with antiandrogens inhibit erection
• Testicles will shrink and sperm cell production will be reduced or may cease completely. Renewed sperm cell production requires that you stop your treatment with female hormones

We can help you if you want to store your sperm for later use. This service is free of charge. You should collect and store your sperm before you begin your hormone treatment.

Prescriptions

We generally ensure that you have the prescriptions you need until you come in for your next check-up. However, if you run out of medicine because you have rescheduled your appointment, you must remember to contact us in good time. Sometimes you will have to wait 2-3 weeks for a prescription renewal.

Gender reassignment surgery

If you decide to have your testicles removed at a later point, you must cease treatment with antiandrogens; however, it is important that you keep taking female hormones as they will be your only source of sex hormones. You need sex hormones to ensure your body functions normally and to prevent osteoporosis.

Research at the Centre for Gender Identity

The Centre for Gender Identity is involved in various research projects. You may be asked to participate in a project. You will always receive detailed information about the specific project. 
 
We want you and others to have a positive experience at the Centre for Gender Identity. We therefore continuously evaluate patient satisfaction to improve it. We are aware that there is always something that can be done differently and better.  
 
To better understand our patients’ perspectives on some of our initiatives, we have established a patient group of user representatives. For example, the group provides us with input on written information for patients.
 
One of our current projects is the Cohort of Gender Identity.