For the male-to-female: There are a number of feminising hormones that over time will alter a man’s hair growth, breast development, weight distribution, skin texture and even temperament. The overall effect is to replace male hormones with female ones. In order to achieve this, two things have to happen: the overpowering effect of the male hormones (chiefly testosterone) must be removed or inhibited; and female hormones (mostly estrogen) must be supplied, since the male body produces at best only minimal quantities of them.
Spironolactone is one of the commonest of the testosterone blockers. It’s available by prescription only. It’s well-tolerated and has few side-effects. In small doses it’s used to treat high blood pressure. In higher doses it blocks the action of testosterone. You can usually expect reduced body hair growth, some slight breast development and a nosediving libido. In the short term these effects are reversible if you stop taking spiro. In much higher doses, spiro can completely shut down your sex drive. Your family doctor can usually prescribe spiro without referring you to an endocrinologist.
Estrogen is available in several different forms and dosages. In conjunction with spiro, it alters the hormone balance to be closer to a genetic female’s – with the consequent effects on body shape, skin texture and so on. Embark on estrogen only with the help of your doctor and a good endocrinologist.
For the female-to-male: one of the most powerful masculinising hormones is testosterone. It can affect body mass, hair growth patterns, temperament and libido. All females produce some naturally; in most, the effects are variations on the above. In higher doses it can easily produce masculinising effects. As with other hormone therapies, proceed with caution, after a lot of thought and with the help of a good doctor and an endocrinologist.