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Here’s What Trans Women Wish They’d Known Before Starting Hormone Therapy

"Try not to go through it alone."

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We asked trans and gender-nonconforming members of the BuzzFeed Community what they wish they had known before beginning hormone replacement therapy, which can be a wild and confusing ride.

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Hormone Replacement Therapy, or HRT, is the process of taking hormones either orally or by injection. The act of replacing hormones that your body is no longer producing sufficiently, or adding hormones that your body does not produce at all, is a therapy used for many medical issues (most commonly, for treating menopause in older women).

For trans and gender-nonconforming people, it's often the first medical step to affirming one's gender identity. The supplementing of sex hormones — like estrogen, anti-androgens, or testosterone — allows an individual to develop physical characteristics that better match the gender they identify as.

For this post, Buzzfeed LGBT asked for some extra input from Dr. Meera Shah of the Callen-Lorde Community Health Center , and Dr. Asa Radix, MPH, senior director of research and education at Callen-Lorde.

Let's talk about HRT for trans women (we tackle testosterone treatment in this post). HRT with anti-androgens and estrogen results in the loss of body hair, muscle mass, and a redistribution of fat (hello, breast tissue!).

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"HRT with anti-androgens helps block testosterone, while estrogen increases female secondary sex characteristics," Shah explains. The full effects could take anywhere from two to three years and continue as long as the hormones are supplemented.

"While HRT may not be part of everyone's transition, for those who include it, it is considered medically necessary," she adds.

Here's what BuzzFeed Community members had to say about starting hormone therapy:

1. Changes won't happen overnight, so try to be patient with yourself.

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"Don't be surprised if you can't see changes in the mirror right away, because your mind can be a trickster when it comes to your appearance."

— Christienne Frank, Facebook

2. Find a doctor who is familiar with treating trans patients and has a real understanding of what you're going through.

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"The first person I went to was a nurse practitioner, and though she was able to prescribe me hormones, and gave me some basic idea of what to expect, she really dropped the ball on some crucial information."

— Narcissa Deville, Facebook

3. You may notice some changes in your metabolism, but don't assume drastic weight change is due to your hormone treatment.

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"[If you're concerned about weight management] Watch your caloric intake, you won't be able to eat like you used to without gaining weight. Love yourself as the universe loves you."

— Christienne Frank, Facebook"

"A decrease in muscle mass due to anti-androgens and fat redistribution due to estrogens may lead to a softer, fuller figure as opposed to a more muscular one. Weight gain can be result of many other reasons and not always attributed to hormone use," explains Shah.

4. And the ups-and -owns of all these changes may take you by surprise.

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"No matter how prepared you are, there are some things that will take you by surprise. My boobs jumped to B cups after six months, stayed there for two full years, and then jumped again to D cups just when I'd figured they'd probably stopped for good!"

— Ricki

“Redistribution of fat, whether it be to the chest and breasts, thighs or jawline, is part of the ‘feminizing effects’ of estrogen. This includes softened silhouettes or lines and the underside of the jawline is part of those effects," Shah says. "Keep in mind that while these changes are generally anticipated as part of feminizing HRT, they vary greatly from person to person and usually take two-three years to take full effect.”

5. It's OK to be strong, brave, and confident in your journey.

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"Be strong because It's inevitable that someone will say something to upset you. Ride the waves. Be brave because society is still a dangerous place for trans women. Be confident because It's OK to celebrate your changes."

— Cory Bantic, Facebook

6. Don’t feel the need to bend to society’s gender norms. You do you.

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"As a trans woman You can like 'boy' activities and still be a woman. Be patient with the changes and do not be too critical of your appearance."

— Madison Richard, Facebook

7. And remember it's not just about the outward physical changes, but the ones you can't see as well.

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"For me, before starting HRT I didn't know of the effect that it would have on me as a person and a woman as a whole. I was so very focused on the physical changes I didn't realize the discoveries I'd have on my journey to find my own personal identity aside from my gender identity. The emotional and mental growth was the biggest part."

— Bailey Estevez, Facebook

8. Practice self-care and don't be surprised by some mood swings — remember that you don't have to go through this alone.

Taylor Miller / BuzzFeed

"After one month on estrogen I had a severe relapse of my depression. I would suggest having a counselor, keeping a diary, or having a trusted person you can talk to. Try not to go through it alone."

— Faith Naff, Facebook

“Changes in mood may be a side effect of HRT. HRT should be under a physician’s guidance and you should definitely discuss any changes – both physiological or emotional – with your provider," says Shah.

9. Know that there is no universal transition timeline — your journey is completely unique to you.

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"Not everyone transitions the same. And that's ok. You may realize you are more feminine or masculine as you become more comfortable in your skin, and that is OK too. You may find new corners of yourself you didn't know existed. Enjoy the ride."

— Rian Grotberg, Facebook

10. And, always and most importantly, try to love yourself just as you are.

Lauren Zaser/BuzzFeed

"You must truly love you as who you really are... either as a trans-woman like me or a trans-man. Transitioning starts from the soul, your spirit, heart and mind. It's internal and you should feel happy as can be. Always try to be positive‚ you can finally be you."

— Ng Siaw Liong Rei, Facebook

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