Sex and hormones

What is hormone treatment exactly? There are various types of hormones used in treatment in the Netherlands.

• Puberty blockers. Young people are often given these if they are being treated at a gender clinic before they turn 16. They ensure that puberty is postponed. If this treatment is stopped, it’s possible to reverse the effects.
• Hormones that suppress your own sex hormones. You don't get these until you turn 16. Trans girls are often given a medicine that suppresses testosterone; trans boys a medicine that stops your periods.
• Cross-sex hormones. You don't get these either till you turn 16. Trans girls and women are given oestrogen, and trans boys and men testosterone.

When you take oestrogen and a testosterone blocker, the following often happens:

• You grow breasts. This happens slowly in some people, rapidly in others. Some people don’t grow very big ones, while others do.
• You may feel less like having sex.
• You find it harder to have an erection or you can’t have one at all.
• After a while, you no longer ejaculate. A small amount of fluid may still come out of your penis.
• Your balls shrink.
• What usually doesn’t change is your sexual orientation.

Good to know: everyone reacts differently to hormones. You will not notice this all in the same way.

When you take testosterone, the following happens:

• You grow a beard and facial hair.
• You may feel less like having sex.
• Your clitoris grows. This may happen slowly or rapidly. And for some people the clitoris grows more than for others.
• Your clitoris may become slightly hard when you are turned on. When your clitoris has grown, you'll notice this a bit more.
• What usually doesn’t change is your sexual orientation.

Good to know: everyone reacts differently to hormones. You will not notice this all in the same way.

Many young people are happy with the changes. Trans boys and men often think it's great to be more in the mood for sex. Trans girls and women are often relieved that they gradually stop having spontaneous erections.

It can also be disappointing. Maybe things have changed less, or less rapidly than you would have hoped.

• For example, as a trans male you hoped you would be a lot more in the mood for sex, but you notice that’s not the case.
• As a trans female you were longing to have breasts, but there’s hardly any growth.

On the other hand, you may find it annoying that certain things change.

• As a trans female, for example, you think it is a shame that you are less interested in sex, that you no longer get an erection or that you no longer ejaculate.
• As a trans male you are overwhelmed by your desire for sex and you don't know how to deal with it.

• You can wait and see for a while. Perhaps something in your body will still change after a few months. Perhaps it will take time for you to get used to it yourself.
• Talk about it with your psychologist and your doctor at the gender clinic. Ask questions and decide on solutions together.
• Talk about it with a care worker who is knowledgeable about sexuality. More on seeking help.
• You may eventually decide to stop taking hormones. You can still carry on living your life as your desired gender as much as you want. Or as a person who is more in between, if that suits you better. Some changes to your body can no longer be reversed. But your body won't change any more than it has already.