Gender Affirming Hormone Therapy

Your gender affirmation journey

Affirming who you are

The gender affirmation journey is a deeply personal process of aligning your gender expression with your inner identity. For many transgender and non-binary people, hormone therapy is an important, but not mandatory, step on this path.

There is no "right" or "wrong" way to transition. The important thing is to have access to accurate information and non-judgmental support to make informed decisions, at your own pace.

Is hormone therapy the right option for me?

This decision is entirely yours. Hormone therapy can greatly improve well-being and reduce gender dysphoria, but it is not a prerequisite to be trans or non-binary.

For adults

In Quebec, access to hormones is based on an informed consent model. Although support from a mental health professional can be a valuable asset in your journey, a psychological evaluation is no longer a requirement to start treatment. The essential part is having a transparent discussion with a healthcare professional about the expected effects and risks.

And for minors?

Access to gender-affirming care, including puberty blockers and hormone therapy, is also possible for adolescents in Quebec. The process, however, is different and requires:

The consent of parents or legal guardians.
A comprehensive assessment by a specialized pediatric medical team (such as those at major university health centers like CHU Sainte-Justine).

The goal is to ensure the youth is well-informed and supported in their journey. Organizations like Jeunesse Lambda and Gender Creative Kids Canada are invaluable resources for youth and their families.

The pharmacotherapy explained

Feminizing hormone therapy

The goal is to induce secondary female physical characteristics using estrogens and anti-androgens.

Available forms: Oral pills, transdermal patches, topical gels, and estrogen injections.
Expected effects and their timeline:
- Start (1-3 months): Decreased libido, skin softening.
- Development (3-6 months): Breast development begins, body fat redistribution.
- Ongoing effects (1-2+ years): Testicular atrophy, reduced body hair. Maximum breast growth can take several years.
- Permanent changes: Breast development is permanent. Infertility is possible and often permanent.

Masculinizing hormone therapy

The goal is to induce secondary male physical characteristics with testosterone.

Available forms: Mainly injections and topical gels.
Expected effects and their timeline:
- Start (1-6 months): Cessation of menses, oilier skin, increased libido, voice deepening begins.
- Development (6-12 months): Increased muscle mass, growth of facial and body hair.
- Permanent changes: Deeper voice, clitoral growth, facial hair, and potential scalp hair loss.

Beyond hormones: Other tools and sexual health

Gender-affirming gear

Tools like binders (for chest compression), packers (penile prostheses), or gaffs (for flattening the genital area) can be important allies in your daily life.

Prevention and contraception

This is a crucial point. Hormone therapy is not a method of contraception and does not protect against HIV and STIs. PrEP, condoms, and regular screening remain pillars of your sexual health.

Your pharmacist: a partner in your journey

Your pharmacist is an accessible and trained front-line healthcare professional who can support you. Our role is to:

Teach you safe injection techniques.
Discuss the pros and cons of each formulation with you.
Manage your renewals to ensure continuity of care.
Offer a confidential and safe space where you can ask questions without fear of being misgendered or judged.

Trusted resources

Community support

Aide aux Trans du Québec (ATQ): The reference organization in Quebec for support and advocacy.
Interligne: A 24/7 helpline and information service for LGBTQ+ people.
Jeunesse Lambda: An organization for LGBTQ+ youth aged 14 to 30.
Action Santé Travesti(e)s et Transexuel(le)s du Québec (ASTT(e)Q): Offers support to trans people, including sex workers.

Trans health information

Rainbow Health Ontario: A very comprehensive and reliable medical knowledge base.
CPATH: The Canadian Professional Association for Transgender Health.