MTF hormonal treatment

The male to female (MTF) person will usually seek hormonal treatment as the first step towards their new body.

In order to get oestrogen, the feminising hormonal therapy, it is necessary to have a prescription. It is possible to get these hormones illegally, but it is not advised, and can cause severe damage. An endocrinologist writes the prescription, and monitors how your organs are coping with the oestrogen once treatment has begun.

It is vital to note that unlike the hormonal therapy with regards to FTMs, the changes that occur with hormonal therapy for MTFs do not have very noticeable and body changing effects. However, all hope is not lost. There are many procedures, from breast enhancements to electrolysis that can aid you in looking as female on the outside, as you are on the inside.

Before we completely give up on oestrogen, lets evaluate what it will do for you. It will cause breast tissue to grow, in accordance to your body and the general sizes of your family. It causes fat to move from the waist and towards the hips and buttocks. Your skin will become softer, and the body hair will soften.

What it won't do
You need to have a clear understanding about what oestrogen will not do. It will not make your penis disappear, but your scrotum and prostate will shrink. It will not change your voice. Voice lessons can be taken in order to retrain your speech patterns. If you are balding, it will slow this down, and perhaps stop it altogether. Your Adams apple will remain its size, and your facial bones will stay the same size as well.

The side effects and health risks associated with taking oestrogen are a reality. These include: problems with liver functioning; an increased risk for blood clots, with the risk factor being increased if you are a smoker, or are over 35. Blood clots are very serious, and can result in a stroke. This is why it is so necessary to consult with an endocrinologist for the duration of your hormonal treatment.

Oestrogen promotes the risk of breast cancer, and it is important to have your breasts checked regularly. Your sex drive will decrease and erections will be difficult to get and maintain. The amount and quality of ejaculate will decrease. Oestrogen does not eliminate the risks of causing pregnancy in a female sex partner.

MTF surgery procedures

There is an abundance of surgeries that can be done to feminise the features of the Male to Female person.

It is important to note that many MTFs opt for plastic surgery, in order to more drastically feminise their appearance. A list of different kinds of surgeries is given below, with a short description of each.

 Otoplasty Facial Feminisation Surgery (FFS)
This is the surgical procedures that alter a 'masculine' face to become a 'feminine' face. FFS comprises bony and soft tissue surgery of the face and trachea. The surgical techniques come from soft tissue plastic surgery, maxillofacial surgery, and reconstructive surgery.

Vaginoplasty
Vaginoplasty is the surgical construction of a vagina through skin inversion. This procedure involves removing the organs and erectile tissue of the penis. The skin and tissue are used to create a vaginal opening, clitoris, clitoral hood and labia. The urethra is kept for urination and the skin and nerves of the glans of the penis can be salvaged for sensitivity.

After surgery, the patient must progressively stretch the vaginal opening, which is done with plastic dilation molds. There is a risk for the rectum or urethra to join with the newly created vaginal canal. Although rare, these complications can result in gas, faeces, and urine in the vagina. Other complications include hardening of the urethra and death of the vaginal tissue.

Bilateral orchiectomy This procedure is another bottom surgery procedure that MTFs can undergo. This procedure involves the removal of both testicles. This is done through an incision in the scrotum. After each testicle is pulled from the scrotum, its spermatic cord is clamped, double sutured to control bleeding, and cut, releasing the testicle. The end of the cord is then placed back in the body.

Transitioning MTFs undergo orchiectomy because it significantly reduces testosterone production. The reduction of testosterone may allow a person with a male body to transition to a woman and to take less oestrogen.

Tracheal shave
This involves surgically reducing the tracheal cartilage (the Adam's apple). A small incision is made at the front of the throat and the cartilage is carved until it is flat. This results in a throat contour that is flatter and more feminine in appearance. Although uncommon, there is a risk of shaving too much cartilage and affecting the vocal chords that lie just behind the trachea. This may permanently affect the voice.

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