Masculinizing Hormone Therapy

Our team can help you determine if masculinizing hormone therapy — using testosterone to develop masculine characteristics — is right for you.

Our team can help you determine if masculinizing hormone therapy — using testosterone to develop masculine characteristics — is right for you.

What to Expect: Masculinizing Hormone Therapy

Our gender-affirming care team specializes in providing masculinizing hormones for female to male transition. Masculinizing hormone therapy uses testosterone to help you develop masculine characteristics.

A number of different specialists at Rush offer masculinizing hormone therapy. Our team at Affirm: The Rush Center for Gender, Sexuality and Reproductive Health can help you find the right provider. And your provider will help you understand what to expect with masculinizing hormone therapy. 

Testosterone Therapy Effects

Testosterone therapy reduces the amount of estrogen in your body and increases your testosterone levels.

This allows your body to develop masculine characteristics. These are some of the physical changes you can expect with testosterone therapy:


  • Increase in facial and body hair
  • Increase in hair density


  • Increase in oil production and possible acne


  • Decrease in breast tissue

Reproductive system and sexual health

  • Cessation of menstruation
  • Permanent increase in clitoral size
  • Increase in sexual desire


  • Permanent lowered pitch

Body mass

  • Increase in lean body mass
  • Increase in body weight
  • Increase in grip strength

Depending on your goals and expectations, testosterone therapy alone may help you achieve the masculinizing characteristics you desire.

If you’re looking for additional gender-affirming treatment options, Rush offers other nonsurgical gender-affirming therapies and gender affirmation surgery. Your provider can connect you with the right specialist for your needs and goals. 

Types of Masculinizing Hormone Therapy

There are several ways to take testosterone:

  • Testosterone patches or gels
  • Intramuscular injections, using a long needle to inject testosterone into your muscle
  • Subcutaneous injections, using a short needle to inject testosterone under your skin

Your provider will discuss the best method for testosterone therapy for you.

Testosterone Risks

Taking testosterone as part of your gender-affirming care is safe and effective if you regularly follow up with your provider.

Research about the safety of testosterone therapy for transgender and gender non-conforming people is underway. This is what current research has shown:

  • Bone health: While more research is needed, studies show there is no significant bone density loss in transgender people on testosterone therapy.
  • Heart health: Testosterone does not increase your risk for heart conditions like heart attack or stroke. But you should talk to your provider if you have underlying risk factors (e.g., personal or family history, smoking).
  • Blood clots: Testosterone does not cause blood clots in healthy people. But you should talk to your provider if you have a personal or family history of blood clots or if you smoke.
  • Cancer: While more research is needed, you do not have an increased risk for cancer if you’re on testosterone. You should, however, talk to your doctor if you have a family history of breast cancer, ovarian cancer or prostate cancer.

Follow-up Care

When you begin testosterone therapy, it’s important to maintain a regular follow-up schedule with your provider.

You will follow up with your provider every three months in the first year after you start hormone therapy. At your appointments, you and your provider will discuss your progress, questions or concerns, and your overall health.

Depending on your needs and goals, your provider may order additional lab tests or adjust your medications. They can also refer you to other specialists like gender-affirming surgeons, behavioral health specialists and others.

Testosterone therapy and puberty

We also work with transgender youth to provide hormone therapy.

If you have not started puberty yet, you can take puberty blockers, also called hormone blockers, to suppress puberty. Then you can start testosterone therapy when puberty is naturally expected.

If you are transitioning after you’ve gone through puberty, you can start testosterone therapy immediately.

Family planning and testosterone

At Rush, we recognize there are multiple ways to have a family. There are ways that you can start or grow your family when you’re on or starting masculinizing hormone therapy.

Your provider can discuss your options with you and connect you to affirming fertility services at Rush.