HRT 4 ALL / MTF Guide
The guide for praticing safe DIY Hormonal Treatment
Made by teens for teens
Estrogen
is a category of sex hormones that are responsible for the maintenance and development of female characteristics,
posing vital roles in female puberty and female sexual reproduction.
Estradiol also called E2 for short, is the most potent form of estrogen.
Throughout this guide you'll see me using it interchangeably with estrogen.
Some of the typical female characteristics estrogen is known to promote are
bigger hips, breasts, decreased muscle mass, decreased height and overall lack of body hair and softer skin.
Though estrogen production occurs in both men and women alike, playing significant roles in our biology and health.
Women just typically have significantly more estrogen while men have less.
Which is why women undergo feminization during their puberties.
When someone has female ranges of Estrogen, they'll develop the female dimorphic features listed above.
Beginning to look and sound like the other women they see within their family.
You see the occurrence of this starting in a girl's puberty, she'll develop breasts and sound more feminine.
When you do
hormone replacement therapy
with Estrogen you can expect to develop these
bodily effects above.
A rough timelapse where you can expect these changes is provided, but of course this very much varies upon age and dosage.
Please note that Estrogen's effectiveness is increased if you take it before or during your male puberty.
After your male puberty is done, no bone-changing altercations will occur.
This is due to the fact Estrogen is not as potent as Testosterone
and can't reverse the bone created during your puberty nor can it build bone.
You will not experience any feminization of the voice, or rather obtain any typical
female skeleton characteristics if you have finished male puberty (Tanner 5) and your bones have fused.
You will still obtain some female characteristics though, like fattier thighs and breasts.
Effects with * are irreversible.
Currently working on this guide... Please come back in a week.
If you're questioning if you should do HRT, your first concern may be if it's dangerous.
Short answer, no.
It's not dangerous but as with all medical procedures, there are risks.
Though the chances of adverse effects actually occurring is extremely low.
In fact, HRT and exogenous hormones are taken by
over a hundred million women globally.
Which goes to show how possible safe administration is.
Especially if you manage your dosage wisely, go here for recommended dosages.
Once again, note the chances of adverse effects actually occurring is extremely low.
I am merely stating these risks so you are informed about what estrogen has been shown to promote.
This does not mean HRT is unsafe, this means HRT has risks albeit minimal.
Major risks depend highly on the method of estrogen taken (ex. pills)
Major risks are observable amongst every person with female estrogen levels
Minor risks are generally non-issues and shouldn't be worried about
Minor risks are observable amongst every person with female estrogen levels
If you happen to take too much estrogen, it's generally fine.
Women during their menstrual cycle actually can peak all the way up to
550-750 pg/mL of Estradiol Mid-cycle.
This is about 3x times above the female estrogen median.
But staying at prolonged high estrogen levels generally is never good,
so avoid messing up your doses.
Just know if you happen to mess up, the health consequences are minimal.
Regardless of tanner stage or age.
If you take too little estrogen, you will not receive full feminization effects and will continue going through male puberty.
Though if you utilize anti-androgens which are mentioned furthermore below.
You will not continue masculinizing so there is a lower consequence if you end up underdosing yourself.
To prevent this from occurring, use the recommended dosages.
Hormonal therapy for transgender girls has many complicated nuances.
For example, trans girls typically have to take 2 medicines instead of one, estrogen and anti-androgens.
Anti-androgens also known as anti-testosterones or testosterone blockers,
are incorporated because many trans women don't reach high enough estrogen levels to suppress their testosterone.
Monotherapy
is the term for this, when you use only one medicine to treat a condition.
Monotherapy can only be practiced when a trans girl decides to inject her estrogen.
Other methods of administration like pills, patches or gel aren't strong enough on it's own to suppress testosterone.
Which like I said earlier, is why we need anti-androgens.
You can also use a hormone called progesterone, which will help breast growth after you've been on HRT for at least two years.
I discuss more about this below.
For anti-androgens, you can use the following 3 medicines.
Bicalutamide, Cyproterone Acetate or Spironolactone.
When you use these medications in combination with estrogen, it enhances the anti-androgen's effects.
Heads up, this is going kinda deep into mechanism of action so this may be confusing to you.
Cyproterone
is an anti-androgen that stops the production of testosterone so you no longer masculinize.
The primary benefits root from the anti-androgenic effects where testosterone and
dihydrotestosterone (DHT)
are directly blocked from being produced in the gonads (testicles) and while partially, from interacting with the androgen receptors.
For the anti-gonadotropic effects which also help reduce testosterone production, Cyproterone
inhibits the release of LH.
The Gonadotropin purposed for interacting with the Leydig Cells, which produce testosterone.
So not only does the testosterone in your body decrease, it also prevents the testosterone from producing any effects.
Cyproterone is the most recommended anti-androgen, despite being 2nd most effective on this list.
We recommend Cyproterone because it's an affordable,
potent anti-androgen that isn't a
Selective Androgen Receptor Modulator (SARM)
unlike Bicalutamide
Bicalutamide
is an anti-androgen that stops the effects of testosterone.
It doesn't stop the production of it, but it stops the effects.
So you won't masculinize but you'll still have male ranges of testosterone in your body.
This is because Bicalutamide is a SARM
that works by selectively inhibiting testosterones from interacting with the androgen receptors.
Bicalutamide is the 2nd most recommended anti-androgen,
though a more effective and potent anti-androgen than Cyproterone.
We rank Bicalutamide at 2nd due to it being expensive and untestable if you get
blood tests done albeit widely available.
At the end of the day, it does it's job as an anti-androgen.
Spironolactone
is a weak anti-androgen that stops the production of testosterone.
It's more likely to produce better effects in early tanner-stage trans girls.
This is because in younger girls their testes aren't as fully developed,
thus their body doesn't produce as much testosterone.
The biggest and only pro about Spironolactone is that it's low-risk in terms of adverse effects.
Spironolactone is the 3rd most recommended anti-androgen and the 3rd most effective,
because of it's low effectiveness and high interindividual variability.
It's slightly expensive but if you can, buy Cyproterone or Bicalutamide.
There's no reason to buy Spironolactone if you can buy the other two.
Currently working on this part of the guide...
I'll be listing two forms of obtaining estrogen, injections and pills.
I will also be listing other forms of obtaining estrogen like gel, patches, sprays and droppers but I do not suggest their usage in any capacity.
These methods are not recommended usually do their their ineffectiveness, lack of formal research or expensiveness.
Thus, my lack of confidence on recommending them.
If you decide to use other forms of estrogen not recommended on this guide,
please join the matrix server
or message me on Signal for guidance. DIY safely!
90$ - 130$ biyearly for Vials
20$ - 30$ biyearly for Supplies
Doing the math, you only pay about 135$ on median every 2 years.
For injections, you can administer this in two ways.
Monotherapy or non-monotherapy, which allows you to have the choice to take anti-androgens or not.
This is a major pro because this makes injections the most cost-effective method.
Not to mention, it's the most effective method of administering HRT because of it's high potency.
You usually only have to do an injection once every 7 days or 14 days.
Of course this depends on the type of ester/formulation of estrogen you buy.
For injections, there are several different types of estradiol formulations you can purchase.
For example, there is estradiol valerate, estradiol enanthate, estradiol cypionate, estradiol undecylate, estradiol benzoate and much more.
You may be wondering now which one you should buy then.
I recommend estradiol enanthate, estradiol cypionate or estradiol undecylate only.
This is because you won't have to inject as often if you were take an ester like valerate or benzoate.
Injections for these reasons above make this the most recommended form of administering estrogen.
It's the most convenient, cost effective and potent.
Obviously, the biggest downside being you have to use needles.
This is a common fear for many, so if you think this is too much of a drawback, try the method below.
80$ - 150$ yearly for Anti-Androgens
160$ - 190$ yearly for Regular Estradiol Pills
240$ - 320$ yearly for Estradiol Valerate Pills
Disregarding pill types, you should pay around 290$ every year.
For pills, you must take it with anti-androgens and you must take several tablets throughout the day.
This is because pills have low bioavailability,
thus can't reach high enough estrogen levels to suppress endogenous testosterone alone.
There are also 2 types of estrogen pills, the regular kind (Hemihydrate) and the less potent kind (Valerate)
This is vital information to know, not all estrogen pills are created equally in effectiveness.
If you buy valerate estrogen pills,
you will have to buy more since they're less effective than hemihydrate estrogen pills.
Make sure to keep this in mind...
Pills for these reasons above make this the 2nd most recommended form of administering estrogen.
It's expensive but overall an effective alternative to injections.
I do not recommend the following forms of estrogen listed below. There will be no price ranges or sources for their obtainment.
Gel is a transdermal method of intaking estrogen.
You pump some out of a bottle and apply it onto the skin throughout the day.
Typically in areas like the forearm, thigh or in rarer cases, the scrotum.
It's been shown that scrotal application can increase estradiol levels
roughly 5-fold relative to conventional skin sites.
While this analysis is done on specifically estradiol patches, it's presumed gel to be able to achieve the same levels.
Though gel has even higher varying interindividual levels than patches, being approximately
11-fold for gel and 7-fold for patches.
This makes gel a overall worse candidate than patches in general effectiveness, also a worse candidate for general HRT.
Due to it's lack of effectiveness I cannot recommend this form of estrogen.
Albeit multiple users of transdermal/topical estrogen have reported success, it's hard to guarantee it'll do the same with the absence of testing.
Patches are a transdermal method of intaking estrogen.
You apply them onto your skin and switch it out occasionally.
Applying it on the same areas you would apply estradiol gel.
As mentioned above, you can apply patches scrotally to increase estradiol levels
roughly 5-fold relative to conventional skin sites.
While not clinically praticed, it's a viable method of obtaining higher estrogen levels.
Due to it's lack of effectiveness I cannot recommend this form of estrogen.
Albeit multiple users of transdermal/topical estrogen have reported success, it's hard to guarantee it'll do the same with the absence of testing.
Sprays are a topical method of intaking estrogen.
You apply it onto areas where skin is thin, thus more absorbent.
Areas like the armpits or scrotum are best for this.
In any capacity, I cannot recommend this this form of estrogen.
It entirely lacks clinical research and the data to showcase it's effectiveness.
There's also a lack of consideration to important factors like penetration enhancers, which would significantly affect the pharmacokinetics.
So I do not know how effective sprays are, I'm also unaware how much concentration you would need to reach an estradiol goal.
Please do not utilize sprays and instead buy injections or pills.
Droppers are a oral method of intaking estrogen.
You drop a little bit of the liquid under the tongue and let it dissolve, sublingual method.
In any capacity, I cannot recommend this this form of estrogen.
It entirely lacks clinical research and the data to showcase it's effectiveness.
I do not know how effective it is, nor have I seen human outcomes to come to a robust conclusion on concentration needed to meet an estradiol goal.
Please do not utilize droppers and instead buy injections or pills.
To buy estrogen you'll be using online pharmaceutical stores or simple homebrewer websites.
Please refer to the guide above called "Estrogen Information" to learn more about the types of estrogen you can take.
When it comes to buying HRT, you may have to purchase cryptocurrency, go down below for a cryptocurrency link guide.
This is because crypto is privacy based, meaning whatever transactions you make will be private and can't be held against you.
So retailers use it to keep their identities secret, makes it safe for both parties.
Please checkout these HRT lists, they provide several updated sources to estrogen, anti-androgens and more.
Hrt Coffee
DiyHrt Market
Below are a list of estrogen sources you can buy from.
While yes, most of the estrogens listed below all look the same,
you should still consider the price range and look up reviews online.
All the homebrewers I listed below are community trusted and their vials have been tested and verified to hold no contaminants.
TransHarm Reduction's Testing
Individual Janoshik Tests if you click on Each Vial
As mentioned above in the "Estrogen Information" guide, there are 2 types of estrogen pills. The pair being Valerate Estradiol and Hemihydrate Estradiol. I listed both here for you to buy, refer to dosages in the guide below.
The guide on how to purchase Bitcoin/Crypto is rather long, thus I decided to make a seperate page here.
You only need anti-androgens if you aren't doing injections.
Please ignore these list of sources if you are practicing injections.
Please checkout these HRT lists, they provide several updated sources to estrogen, anti-androgens and more.
Hrt Coffee
DiyHrt Market
Cyproterone Note:
If you already took a peak at the dosages below,
you may have noticed the Cyproterone concentration in each pill is about 4-8x times higher than your age recommended dosage.
This is because Cyproterone actually only needs about 5mg to 10mg per day to be effective in suppressing testosterone.
Way lower than the provided dose in each pill...
So if you're planning on purchasing Cyproterone, I would recommend also purchasing a pill cutter to cut the pills into smaller doses.
Consider this a good thing, because if you buy a pack of 50 Pills, each being 50mg. That means it could last you 200 days or more!
The guide on how to purchase Bitcoin/Crypto is rather long, thus I decided to make a seperate page here.
This is a video from Dr. Meir Daller, here his assisting nurse is demonstrating how to do a thigh injection at home.
If you happen to hit any veins or notice blood leaking out, just know it's perfectly fine.
Simply apply pressure onto the injection site if this occurs.
They're trying to demonstrate estrogen injection, but overall it's the same procedure so don't worry.
Despite myself not being a trans girl, I still wanted to share my personal anecdote to encourage you on injecting estrogen.
When I first did my injection, I was nervous and afraid I'd do something wrong.
I didn't put the entire needle in and some of the testosterone oil leaked out.
After the more injections I did and as I gradually developed a routine, it all became something of great quick ease.
I can now do my injections in less than 5 minutes without feeling pain.
So if you mess up the first one, it's fine.
It's the fact that you're trying and the fact that you took such a large jump to get yourself the medical care you need.
You'll improve and know that everything has been worth it once you notice yourself feminizing.
Injection supplies are listed here in this guide. Please read the Injection Risks below and stick with buying the needles/syringes from the guide on this site.
I'm using Trans Harm Reduction's guides and resources to relay the risks to wrongfully doing injections. There are a few risks to doing injections, although they are nothing to be worried about if you learn how to avoid them.
Vial Coring
is a form of Vial Contamination that occurs when the rubber seal on a vial is broken or damaged.
The rubber seal's purpose is to stop contaminants from entering the oil.
Coring can cause rubber from the seal to break off into the oil, posing a major safety risk.
To avoid instances of this occurring, please use sharp and smaller needles.
As it's been shown, blunt and bigger needles break rubber easier.
For your convenience, I listed approved needles for injecting here in a guide.
When it comes to storing vials, it's recommended to keep it in standard room temperature. Your testosterone vials can last 2 years by doing this. If you refrigerate or store it in cold temperatures it may go through a process called Crystalization. If your estrogen has crystalized, it will likely be opaque or cloudy and contain small, needle-shaped crystals. This can cause pain when you inject, so simply store it in room temperature and do not refrigerate.
When it comes to taking estrogen pills, there are two methods of taking them.
One being oral, the other being sublingual.
When you take pills orally, you simply swallow like you'd do with any regular pill medicine.
Taking pills sublingually however, you instead place the pill under the tongue and let it dissolve.
You may be wondering, why would you do it sublingually?
The reason simply is because it offers higher estradiol levels.
This is because sublingually isn't entirely metabolized unlike oral,
it directly enters the bloodstream through the sublingual gland.
Thus, you don't have to take as many pills to obtain female estradiol levels when doing sublingual.
Though for both oral and sublingual methods alike,
you should split the pill dosages evenly throughout the day.
For example, if you have to take 6mg of pills everyday.
Instead try taking 3mg every 12 hours as an alternative of taking the entire dosage at the same time.
This makes it so your levels are more stable throughout the day, offering better results.
When you obtain an Estrogen vial, you will notice some text like "40mg/mL" or some text like "400mg/10mL"
This shows the amount of Estrogen (mg) within the total amount of oil (mL).
So if you have a Estrogen vial that says "40mg/mL" that means for every milliliter there is 40 milligrams of Estrogen.
Vials tend to have 10mL of liquid.
So if you multiply 40mg by 10, in reality the total concentration is 400mg/10mL in the entire vial.
So let's say you wanted to dose 5mg and you had a 40mg/mL vial of Estrogen.
Divide 5mg by 40mg, you'll get 0.125mL as the amount of liquid you should draw up in your syringe to get 5mg.
This singular vial can last you 80 weeks because 10mL divided by 0.125mL is 80.
Another example would be if you wanted to dose 6mg and you had a 50mg/mL vial of Estrogen.
Divide 6mg by 50mg, and you'll get 0.12mL as the amount of liquid you should draw up in your syringe to get 6mg.
This singular vial can last you 83 weeks because 10mL divided by 0.12mL is 83.
I know this is can be a rather new and confusing concept for some to grasp.
So please join our Matrix server or
Contact us here to ask any questions.
You only need anti-androgens if you aren't doing injections.
In this segment I'll be discussing estrogen and anti-androgen dosages respective to individuals' age.
The goal for injection monotherapy is to provide high enough estrogen levels
to induce the testosterone suppression needed to therefore obtain female testosterone levels.
If you buy any other formulation of estrogen like estrogen patches or estrogen gel,
please message me on Signal or
join the Matrix Server so I can provide guidance.
I can offer a tool you can use to model your estrogen dosage,
but it's limited solely for estradiol injection users.
Try the graph modeler out at this link.
Note that your actual levels may be different,
but it provides a decent enough graph for someone to get a better understanding of their levels.
Dosage Information
Before actually deciding which form of estrogen you'll be taking,
I want to explain the differences between shorter regimen versus longer regimen.
Just know it's fine to do either shorter or longer, the only significant difference is stability.
When taking shorter regimens you'll achieve more stable levels albeit doing more frequent injections.
When taking longer regimens it's the opposite, but with the pro of doing less frequent injections.
I personally recommend doing the shorter regimens.
There is no hormone dosage recommendation for transgender males for those 11 years old and younger.
I cannot safely guarantee any form of safe HRT administration within minors of this age range.
Please do not practice DIY HRT if you are 11 years old or under.
Contact your primary doctor about Puberty Blockers if you wish to stop future and present masculinization. This option is best recommended for those who live in transgender-tolerant countries or Democratic states.
Unfortunately if you live in anti-transgender countries or Republican states.
You will most likely be prohibited from receiving any hormonal treatment or puberty blockers due to state laws.
Please wait until you are 12 years old to DIY HRT.
Note that male puberty tends to begin around 12-13 years old.
So if you don't get estrogen around this time, don't panic because your puberty most likely hasn't started yet.
Please join our Matrix server to receive HRT support, regardless if it's DIY or not.
Girls within this age usually are Tanner 3 relative to puberty development.
Meaning they're in the mid-beginning of their female puberty.
The mean estradiol level for 12 year old girls is
25pg/mL, ranging from 7pg/mL to 60pg/mL.
Though the goal for hormonal replacement therapy is to achieve a mean of 60pg/mL to induce testosterone suppression.
| Injection Formulation | Shorter Regimen | Longer Regimen |
|---|---|---|
| Estradiol Cypionate | 2mg every 14 Days | 3mg every 21 Days |
| Estradiol Enanthate | 2mg every 14 Days | 3mg every 21 Days |
| Estradiol Undecylate | 4mg every 28 Days | 6mg every 42 Days |
| Pill Type | Oral / Every 12 hours | Sublingual / Every 8 hours |
|---|---|---|
| Estradiol Hemihydrate | 1mg | 0.5mg |
| Estradiol Valerate | 2mg | 1mg |
| Anti-Androgen Type | Oral / Every 24 hours |
|---|---|
| Cyproterone | 6.25mg |
| Bicalutamide | 25mg |
| Spironolactone | 100mg |
Girls within this age usually are Tanner 4 relative to puberty development.
Meaning they're coming close to the end of their female puberty.
The mean estradiol level for 13 year old girls is
47pg/mL, ranging from 21pg/mL to 85pg/mL.
Though the goal for hormonal replacement therapy is to achieve a mean of 120pg/mL to induce testosterone suppression.
| Injection Formulation | Shorter Regimen | Longer Regimen |
|---|---|---|
| Estradiol Cypionate | 2mg every 7 Days | 3mg every 10 Days |
| Estradiol Enanthate | 2mg every 7 Days | 3mg every 10 Days |
| Estradiol Undecylate | 4mg every 14 Days | 8mg every 28 Days |
| Pill Type | Oral / Every 12 hours | Sublingual / Every 8 hours |
|---|---|---|
| Estradiol Hemihydrate | 1mg | 0.5mg |
| Estradiol Valerate | 2mg | 1mg |
| Anti-Androgen Type | Oral / Every 24 hours |
|---|---|
| Cyproterone | 6.25mg |
| Bicalutamide | 25mg |
| Spironolactone | 100mg |
Girls in this age usually are Tanner 4 transitioning to Tanner 5 relative to puberty development.
Meaning they're on the edge of finishing their female puberty.
The mean estradiol level for 14 year old girls is
79pg/mL, ranging from 28pg/mL to 128pg/mL.
Though the goal for hormonal replacement therapy is to achieve a mean of 225pg/mL to induce testosterone suppression.
| Injection Formulation | Shorter Regimen | Longer Regimen |
|---|---|---|
| Estradiol Cypionate | 4mg every 7 Days | 5mg every 10 Days |
| Estradiol Enanthate | 4mg every 7 Days | 5mg every 10 Days |
| Estradiol Undecylate | 8mg every 14 Days | 16mg every 28 Days |
| Pill Type | Oral / Every 12 hours | Sublingual / Every 8 hours |
|---|---|---|
| Estradiol Hemihydrate | 2mg | 1mg |
| Estradiol Valerate | 3mg | 1.5mg |
| Anti-Androgen Type | Oral / Every 24 hours |
|---|---|
| Cyproterone | 12.5mg |
| Bicalutamide | 50mg |
| Spironolactone | 200mg |
Girls in this age usually are Tanner 5 relative to puberty development.
Meaning they've fully finished female puberty.
The mean estradiol level for 15 year old girls is
110pg/mL, ranging from 34pg/mL to 170pg/mL.
Though the goal for hormonal replacement therapy is to achieve a mean of 300pg/mL to induce testosterone suppression.
| Injection Formulation | Shorter Regimen | Longer Regimen |
|---|---|---|
| Estradiol Cypionate | 5mg every 7 Days | 7mg every 10 Days |
| Estradiol Enanthate | 5mg every 7 Days | 7mg every 10 Days |
| Estradiol Undecylate | 10mg every 14 Days | 20mg every 28 Days |
| Pill Type | Oral / Every 12 hours | Sublingual / Every 8 hours |
|---|---|---|
| Estradiol Hemihydrate | 2mg | 1mg |
| Estradiol Valerate | 3mg | 1.5mg |
| Anti-Androgen Type | Oral / Every 24 hours |
|---|---|
| Cyproterone | 12.5mg |
| Bicalutamide | 50mg |
| Spironolactone | 200mg |
Currently working on this guide... Please come back in a week.
Currently working on this guide... Please come back in a week.
Currently working on this guide... Please come back in a week.
