HRT: Difference between revisions

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Note: after around a month on HRT some of your ranges in your [[Blood Testing|blood test (γενική αίματος)]] should be in the ranges of the sex you are transitioning into.
Note: after around a month on HRT some of your ranges in your [[Blood Testing|blood test]] should be in the ranges of the sex you are transitioning into.


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If you are a transfem: no, its not anemia
If you are a transfem: no, its not anemia


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== MTF ==
== Transfem ==
THERE IS NO GOOD REASON TO TAKE ONLY PUBERTY BLOCKERS ([[HRT#Αντιανδρογόνα και GNRH ανταγωνιστές|GNRH agonists]], eg: Arvekap) OR ANY ANTIANDROGEN WITHOUT ESTROGEN (i say this about youth transitioners, not nb ppl)
THERE IS NO GOOD REASON TO TAKE ONLY PUBERTY BLOCKERS ([[HRT#Antiandrogens and GNRH agonists|GNRH agonists]], e.g: Arvekap) OR ANY ANTIANDROGEN WITHOUT ESTROGEN (I say this about youth transitioners, not nb ppl)


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=== Μονοθεραπεία ===
=== Monotherapy ===
{| class="wikitable"
{| class="wikitable"
|+
|+
!Είδος
!Type
!Εμπορικά Ονόματα
!Commercial Names
!Δοσολογία
!Dosage
!Notes
!Notes
|-
|-
|
|
====== Υπογλώσσια/Sublingual (E Valerate/Βαλεριανική ή Hemihydrate/Ημιένυδρη) ======
====== Sublingual (E Valerate or Hemihydrate) ======
|Cyclacur (EV), Estrofem (EH)
|Cyclacur (EV), Estrofem (EH, imported), Trisequens (12 pills 2mg EH, 10 pills norgestrel, 6 pills 1mg EH)
|>=8-12mg/μέρα
|>=8-12mg/day
|Ενώ είναι εφικτό και με μικρότερη δοσολογία ('''τουλάχιστον 6mg'''), δεν είναι τόσο σύνηθες. Καλό είναι οι εξετάσεις αίματος ως σημείο αναφοράς για αυξομειώσεις (το γνωστό "'''Minmaxing'''")
|While it is possible, even with a smaller dosage ('''at least 6mg'''), it's not that common. Ideally, use your blood tests to '''minmax''' your doses.
|-
|-
|
|
====== Ενέσιμη Βαλεριανική (EV) ======
====== Injectable Estradiol Valerate (EV) ======
|Delestrogen (Φιαλίδιο), Progynon Depot (Αμπούλες), [[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|Neofollin (can be ordered from pharmacies near Czechia, not tested in Greece), Delestrogen (Vial, unavailable), Progynon Depot (Ampules, unavailable), [[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|5-7mg/5 μέρες
|5-7mg/5 days
|
|
* Λόγω των μεγάλων spikes που προκαλεί στα επίπεδα σε συνδιασμό με την μικρή [https://el.wikipedia.org/wiki/%CE%A7%CF%81%CF%8C%CE%BD%CE%BF%CF%82_%CE%B7%CE%BC%CE%B9%CE%B6%CF%89%CE%AE%CF%82 ημιζωή] δεν προτείνεται το διάστημα των δόσεων να ξεπερνάει τις 5 ημέρες διότι μπορεί να προκαλέσει συμπτώματα εμμηνόπαυσης.
* Due to the large spikes in levels combined with the short [https://en.wikipedia.org/wiki/Biological_half-life half-life] it is not recommended for dosages to surpass the 5 day mark because it may cause menopause symptoms.
* Τα επώνυμα φάρμακα δεν είναι διαθέσιμα στην Ελλάδα.
* Branded versions of this medication are not available in greece.
* Οι αμπούλες περιέχουν συγκεκριμένα mg η καθέ μία οπότε δεν υπάρχει μεγάλη ελευθερία στη δοσολογία και δεν επαναχρησιμοποιούνται. Προτείνεται η χρήση φιαλιδίου που έχει πώμα.
* The ampules contain a certain mg and do not allow for larger dosages, they are not re-usable. It is recommended to use a vial with a cap.
* Βλέπε '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space](*)''', π.χ. αν μένει '''0.05mL''', βγάλε '''+0.05mL''' απο το φιαλίδιο.
* Look for '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space](*)''', e.g. if there's '''0.05mL''' remaining after injecting, draw '''+0.05mL''' from the vial.
|-
|-
|
|
====== Ενέσιμη Ενανθική (EEn) ======
====== Injectable Estradiol Enanthate (EEn) ======
|[[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|[[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|4-7mg/Εβδομάδα
|4-7mg/Week
7-10mg/10 μέρες (7.2mg συνήθως, αναλόγως το φιαλίδιο, βολεύει διότι οι εκατοντάδες των mL είναι δύσκολες να βγούν ακριβώς)
7-10mg/10 days (7.2mg usually, depending on the vial, it's optimal because drawing cents of mL are hard to get right)
|
|
* Γίνεται να διπλασιαστεί η δοσολογία για έως και 14 μέρες (τόσο επιτρέπει η [https://el.wikipedia.org/wiki/%CE%A7%CF%81%CF%8C%CE%BD%CE%BF%CF%82_%CE%B7%CE%BC%CE%B9%CE%B6%CF%89%CE%AE%CF%82 Ημιζωή] της Ενανθικής)
* You can multiply the weekly dosage by 2, which lasts up to 14 days (as much as the [https://en.wikipedia.org/wiki/Biological_half-life half-life] of Enanthate)
* Βλέπε '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space](*)''', π.χ. αν μένει '''0.05mL''', βγάλε '''+0.05mL''' απο το φιαλίδιο.
* Look for '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space](*)''', e.g. if there's '''0.05mL''' remaining after injecting, draw '''+0.05mL''' from the vial.
|-
|-
|
|
====== Ενέσιμη Ενδεκυλική (EU/EUn) ======
====== Injectable Estradiol Undecylate (EU/EUn) ======
|[[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|[[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|Δεν υπάρχουν αρκετές πληροφορίες για τις δοσολογίες. Η συχνότητα των διαφέρει ανάλογα το λάδι (MCT/καστορέλαιο). Ενδεικτικές δοσολογίες:
|There's not enough information on dosage. The frequency of those may differ according to the oil used (MCT/Castor oil). Indicative Dosages:
15-20mg/2 εβδομάδες
15-20mg/2 weeks


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<!--T:45-->
20-40mg+/4 εβδομάδες
20-40mg+/4 weeks
|
|
* Δεν υπάρχουν αρκετές πληροφορίες για την [https://el.wikipedia.org/wiki/%CE%A7%CF%81%CF%8C%CE%BD%CE%BF%CF%82_%CE%B7%CE%BC%CE%B9%CE%B6%CF%89%CE%AE%CF%82 ημιζωή], γίνεται να δωθεί και αρκετά υψηλή δοσολογία που διαρκεί 20-30 ημέρες.
* There's not enough information on its [https://en.wikipedia.org/wiki/Biological_half-life half-life], a higher dosage can be administered that can last up to 20-30 days.
* Οι [https://el.wikipedia.org/wiki/%CE%95%CE%BD%CE%B4%CE%BF%CE%BC%CF%85%CF%8A%CE%BA%CE%AE_%CE%AD%CE%BD%CE%B5%CF%83%CE%B7 ενδομυϊκές ένεσεις] διαρκούν για περισσότερο διάστημα οπότε δίνουν και καλύτερα επίπεδα για το ίδιο διάστημα ανά ένεση.
* [https://en.wikipedia.org/wiki/Intramuscular_injection IM injections] last longer so they give better levels during the same period of time per injection.
* Χρειάζεται τουλάχιστον 90 μέρες για να φτάσει σε σταθερά επίπεδα.
* Needs at least 90 days to reach stable levels.
* Βλέπε '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space](*)''', π.χ. αν μένει '''0.05mL''', βγάλε '''+0.05mL''' απο το φιαλίδιο.
* Look for '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space](*)''', e.g. if there's '''0.05mL''' remaining after injecting, draw '''+0.05mL''' from the vial.
|}
|}
'''*''' = Έχει αναφερθεί πως οι σύριγγες υπολογίζουν το dead space, αλλά δεν είναι 100% σίγουρο αυτό.
'''*''' = It has been mentioned that syringes account for dead space, although that is not 100% certain.


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=== Sublingual vs oral ===
=== Sublingual vs Oral ===
{| class="wikitable"
{| class="wikitable"
|+
|+
!Μέθοδος
!Method
!Ουσία
!Substance
!Δοσολογία
!Dosage
!Παρατηρήσεις
!Observations
|-
|-
|
|
====== Oral (Κατάποση) ======
====== Oral ======
|Estradiol Valerate σε μορφή χαπιού (πχ Cyclacur)
|Estradiol Valerate in pill form (e.g. Cyclacur)
|>=6mg/μέρα
|>=6mg/day
(max 10mg as per Dr. Powers)
(max 10mg as per Dr. Powers)
|Οι δόσεις συνιστάται να γίνονται ξεχωριστά ανά τακτά χρονικά διαστήματα εντός της μέρας για πιο σταθερά επίπεδα οιστραδιόλης, πχ για δοσολογία 6mg παίρνουμε 2mg ανά 8 ώρες. Με την oral δίοδο η δραστική ουσία μεταβολίζεται από το συκώτι και ένα τμήμα της μετατρέπεται σε εστρόνη (Ε1), η οπoία έχει πολύ μικρότερα feminizing effects από την οιστραδιόλη (Ε2) οπότε εμποδίζεται ουσιαστικά το επιθυμητό αποτέλεσμα. Η βιοδιαθεσιμότητα της οιστραδιόλης με oral χορήγηση είναι πολύ μικρή (~5%) και συνήθως παρατηρούνται χαμηλότερα επίπεδα Ε2 σε εξετάσεις αίματος από τις υπόλοιπες μεθόδους χορήγησης. [anecdotal apo to server, wikipedia kai tttt - correct/expand?] Χρειάζεται παράλληλα να γίνεται χορήγηση αντιανδρογόνων για να μειωθούν τα επίπεδα τεστοστερόνης σε female range.
|It is recommended that doses are taken separately on set time intervals during the day for more stable estradiol levels, e.g. for a 6mg dose you would take 2mg per 8 hours. By the oral route the active substance is metabolized by the liver and part of it is converted to estrone (E1), which has much less feminizing effects than estradiol (E2) so the desired effect is essentially prevented. The bioavailability of estradiol by oral administration is very low (~5%) and usually lower levels of E2 are observed in blood tests than other methods of administration. [anecdotal apo to server, wikipedia kai tttt - correct/expand?] It is also necessary to administer anti-androgens to reduce testosterone levels to the female range.
|-
|-
|
|
====== Sublingual (Υπογλώσσια) ======
====== Sublingual ======
|Estradiol Valerate σε μορφή χαπιού (πχ Cyclacur)
|Estradiol Valerate in pill form (e.g. Cyclacur)
|>=4mg/μέρα
|>=4mg/day
|Οι δόσεις συνιστάται να γίνονται ξεχωριστά ανά τακτά χρονικά διαστήματα εντός της μέρας για πιο σταθερά επίπεδα οιστραδιόλης, πχ για δοσολογία 6mg παίρνουμε 2mg ανά 8 ώρες. Η υπογλώσσια δίοδος παρακάμπτει τον μεταβολισμό της οιστραδιόλης από το συκώτι και έχει περίπου 5 φορές τη βιοδιαθεσιμότητα οιστραδιόλης από την oral δίοδο. Με την υπογλώσσια μέθοδο τα επίπεδα οιστραδιόλης έχουν μεγαλύτερη διακύμανση από orally (higher peak lower bottom), με oral παραμένουν αυξημένα για ~12 ώρες ενώ με sublingual υποχωρούν μετά από 3-4 ώρες [idk if honscience to study einai apo to 2005 se cis gynaikes]
|It is recommended that doses are taken separately on set time intervals during the day for more stable estradiol levels, e.g. for a 6mg dose you would take 2mg per 8 hours. The sublingual way bypasses estradiol metabolism by the liver and has about 5 times the estradiol bioavailability of the oral way. This way, estradiol levels have greater range than orally (higher peak lower bottom), in oral they remain higher for ~12 hours while sublingually they go away after 3-4 hours [idk if honscience the study is from 2005 on cis women]
|}
|}


=== Vial info === <!--T:7-->
=== Vial info === <!--T:47-->


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=== Medications ===
=== Medications ===
For cyclacur: '''take only the white pills, the brown pills are Norgestrel which has an androgenic effect and may also cause other side effects'''.
For cyclacur: '''take only the white pills, the brown pills are Norgestrel which have 0.5mg of estradiol but has an androgenic effect and may also cause other side effects'''.


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==== Οιστρογόνα ====
==== Estrogens ====
{| class="wikitable"
{| class="wikitable"
|+
|+
!Εμπορικό Όνομα
!Brand Name(s)
!Ουσία
!Substance
!Μορφή
!Form
!Μέθοδος Χορήγησης
!Method of Administration
!Κόστος
!Cost
!Κόστος με ασφάλιση
!Cost with Healthcare Coverage
!Δοσολογία
!Dosage
!Safety
!Safety
!Notes
!Notes
|-
|-
|
|
====== Cyclacur ======
====== [https://www.galinos.gr/web/drugs/main/drugs/Cyclacur Cyclacur] ======
|Βαλεριανική Οιστραδιόλη - Estradiol Valerate (EV)
|Estradiol Valerate (EV)
|Χάπι ταμπλέτα
|Pill tablet
|Από το στόμα ή υπογλώσσια
|Orally or sublingually
|1.69€ για 11 χάπια
|2.01€ for 11 pills
~111-277€/έτος
~130.8-328.€/year


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<!--T:50-->
~9.3-23.1€/μήνα
~10.9-27.4€/month


<!--T:11-->
<!--T:51-->
Οι τιμές είναι ενδεικτικές, το κόστος εξαρτάται από τη δοσολογία.
Prices are indicative, the cost depends on the dosage.
| -
| -
|6mg-10mg/μέρα (σύμφωνα με τον Dr. Will Powers)
|6mg-10mg/day (according to Dr. Will Powers)
4mg-8mg/μέρα (από Έλληνες ενδοκρινολόγους)
4mg-8mg/day (according to Greek Endocrinologists)
|A
|A
|
|
* '''Μόνο τα λευκά χάπια χρησιμοποιούνται.''' Τα καφέ δεν είναι οιστραδιόλη και δεν έχουν κανένα αποτέλεσμα στη φυλομετάβαση.
* '''Only white pills are used.''' Brown pills do have a bit of estradiol but arent taken due to other side effects.
* Χρειάζεται αντιανδρογόνα ή GNRH ανταγωνιστές αν το άτομο δεν έχει γίνει ορχεκτομή.
* You need antiandrogens or GNRH antagonists if you haven't had an orchiectomy.
|-
|-
|
|
====== Progynova ======
====== Progynova ======
|Βαλεριανική Οιστραδιόλη - Estradiol Valerate (EV)
|Estradiol Valerate (EV)
|Χάπι ταμπλέτα
|Pill tablet
|Από το στόμα
|Orally or sublingually
|~22€ για 72 χάπια του 1 mg ή ~32€ για 72 χάπια των 2 mg
|~22€ for 72 pills of 1 mg or ~32€ for 72 pills of 2 mg
Οι τιμές είναι ενδεικτικές, το κόστος εξαρτάται από τη δοσολογία.
Prices are indicative, the cost depends on the dosage.
| -
| -
|4mg-8mg/μέρα
|4mg-8mg/day
|A
|A
|
|
* Δεν υπάρχει λόγος να χρησιμοποιηθεί στην Ελλάδα εφόσον το Cyclacur είναι διαθέσιμο στα ελληνικά φαρμακεία.
* There is no reason to use it in Greece since Cyclacur is available in Greek pharmacies.
* Χρειάζεται αντιανδρογόνα ή GNRH ανταγωνιστές αν το άτομο δεν έχει γίνει ορχεκτομή.
* You need antiandrogens or GNRH antagonists if you haven't had an orchiectomy.
|-
|-
|
|
====== Estrofem, Estrifam (γερμανικό εμπορικό όνομα) ======
====== Estrofem, Estrifam (german brand name), Trisequens ======
|Ημιένυδρη Οιστραδιόλη - Estradiol Hemihydrate
|Estradiol Hemihydrate
|Χάπι ταμπλέτα
|Pill tablet
|Από το στόμα ή υπογλώσσια
|Orally or sublingually
|~30€ για 28 χάπια των 2 mg χωρίς τα έξοδα αποστολής.
|~30€ for 28 pills of 2 mg without shipping costs.
Οι τιμές είναι ενδεικτικές, το κόστος εξαρτάται από τη δοσολογία.
Prices are indicative, the cost depends on the dosage.
| -
| -
|4mg-8mg/μέρα
|4mg-8mg/day
|A
|A
|
|
* Δεν υπάρχει λόγος να χρησιμοποιηθεί στην Ελλάδα εφόσον το Cyclacur είναι διαθέσιμο στα ελληνικά φαρμακεία.
* There is no reason to use it in Greece since Cyclacur is available in Greek pharmacies.
* Χρειάζεται αντιανδρογόνα ή GNRH ανταγωνιστές αν το άτομο δεν έχει γίνει ορχεκτομή.
* You need antiandrogens or GNRH antagonists if you haven't had an orchiectomy.
* Trisequens, while being available in Greece, is odd to take with 12 pills being 2mg EH, 10 norgestrel, and 6 1mg EH, for a much higher price than [[HRT#Cyclacur|Cyclacur]].
|-
|-
|
|
====== Delestrogen (Φιαλίδιο), Progynon Depot (Αμπούλες) ======
====== [https://www.galinos.gr/web/drugs/main/drugs/Dermestril Dermestril] ======
|Βαλεριανική Οιστραδιόλη - Estradiol Valerate (EV)
|Estradiol Hemihydrate
|Ενέσιμο
|Patch
|Υποδόρια (subcutaneous) ή ενδομυϊκά (intramuscular)
|Trans-dermally
|80€/έτος (συμπεραλαμβανομένων των εξόδων μεταφοράς, συριγγών και αλκοολούχων μαντηλακιών)
|44€ for 24 patches of 100mcg
~15€ for 8 patches of 50mcg
| -
| -
|5-7mg/5 μέρες (μονοθεραπεία)
|50mcg/3.5 days (when starting off)
4-5mg/7 μέρες (μόνο σε συνδυασμό κάποιου αντιανδρογόνου ή GRNH ανταγωνιστή)
100mcg/3.5 days (whenever your e2 levels are stable)
|A
|
* '''If you have no idea how to apply patches watch this:''' [https://youtu.be/tXGIYWPqdpI?si=O0dlE19pq0ic0PZP Demonstrational Video]
* You need antiandrogens or GNRH antagonists if you haven't had an orchiectomy.
* 100mcg patches can be cut into 2 if needed.
|-
|Neofollin (can be ordered from pharmacies near Czechia, not tested in Greece), Delestrogen (Vial, unavailable), Progynon Depot (Ampules, unavailable)
|
====== Estradiol Valerate (EV) ======
|Injectable
|Subcutaneous or Intramuscular
|80€/year (including shipping costs, syringes and alcohol swabs)
| -
|5-7mg/5 days (monotherapy)
4-5mg/7 days (only in combination with an antiandrogen or GNRH agonist)
|A+
|A+
|
|
* Μπορεί να χρησιμοποιηθεί και χωρίς αντιανδρογόνα ή GRNH ανταγωνιστή ([[HRT#Μονοθεραπεία|μονοθεραπεία]]) αυξάνοντας τη δόση.
* It can be used without antiandrogens or GNRH agonists in ([[HRT#Μονοθεραπεία|Monotherapy]]) by increasing the dosage.
|-
|-
| -
| -
|
|
====== Οιστραδιόλη Ενανθική - Estradiol Enanthate (EEn) ======
====== Estradiol Enanthate (EEn) ======
|Ενέσιμο
|Injectable
|Υποδόρια (subcutaneous) ή ενδομυϊκά (intramuscular)
|Subcutaneous or Intramuscular
|80€/έτος (συμπεραλαμβανομένων των εξόδων μεταφοράς, συριγγών και αλκοολούχων μαντηλακιών)
|80€/year (including shipping costs, syringes and alcohol swabs)
| -
| -
|2.5mg-7mg/7 μέρες
|2.5mg-7mg/7 days
(συνήθης δοσολογία: 4mg/7days)
(usual dosage: 4mg/7days)
|A+
|A+
|
|
* Μπορεί να χρησιμοποιηθεί και χωρίς αντιανδρογόνα ή GRNH ανταγωνιστή ([[HRT#Μονοθεραπεία|μονοθεραπεία]]) αυξάνοντας τη δόση.
* It can be used without antiandrogens or GNRH agonists in ([[HRT#Μονοθεραπεία|Monotherapy]]) by increasing the dosage.
|-
|-
| -
| -
|
|
====== Οιστραδιόλη Ενδεκυλική - Estradiol Undecylate (EU, EUn) ======
====== Estradiol Undecylate (EU, EUn) ======
|Ενέσιμο
|Injectable
|Υποδόρια (subcutaneous) ή ενδομυϊκά (intramuscular)
|Subcutaneous or Intramuscular
|130€/έτος (συμπεραλαμβανομένων των εξόδων μεταφοράς, συριγγών και αλκοολούχων μαντηλακιών)
|130€/year (including shipping costs, syringes and alcohol swabs)
| -
| -
|15-20mg/2 εβδομάδες
|15-20mg/2 weeks
20-40mg+/4 εβδομάδες
20-40mg+/4 weeks
|A+
|A+
|
|
* Δεν υπάρχουν αρκετές πληροφορίες για δοσολογίες, συνήθως χρησιμοποιείται για [[HRT#Μονοθεραπεία|μονοθεραπεία]].
* There's not much info on dosages, usually seen in [[HRT#Μονοθεραπεία|monotherapy]].
|}
|}


<!--T:12-->
<!--T:52-->
==== Αντιανδρογόνα και GNRH ανταγωνιστές ====
==== Antiandrogens and GNRH agonists ====
These should '''not''' be taken sublingually.
These should '''not''' be taken sublingually.
{| class="wikitable"
{| class="wikitable"
|+
|+
!Εμπορικό Όνομα
!Brand Name(s)
!Ουσία
!Substance
!Κόστος
!Cost
!Κόστος με ασφάλιση
!Cost with Healthcare Coverage
!Δοσολογία
!Dosage
!Safety
!Safety
!Μορφή
!Form
!Τύπος
!Type
!Σημειώσεις
!Notes
|-
|-
|
|
====== Androcur ======
====== [https://www.galinos.gr/web/drugs/main/drugs/Androcur Androcur] ======
|Cyproterone Acetate - Οξεική Κυπροτερόνη (CPA) αναφέρεται και ως cypro
|Cyproterone Acetate (CPA) is also referred to as cypro
|23.10€/50mg * 50 χάπια
|23.10€/50mg * 50 pills
23.10-46.2€/έτος
21.1-33.7€/year
|?
|?
|6mg/2 μέρες - 12.5mg/μέρα
|12.5mg/2 days- 10mg/day
'''Μεγαλύτερες δόσεις δεν πρέπει να χορηγούνται'''
'''Larger doses shouldn't be administered'''
|C
|C
|Χάπι ταμπλέτα
|Pill tablet
|Προγεστίνη - Progestin (Steroidal antiandrogen)
|Progestin (Steroidal antiandrogen)
Σταματάει την παραγωγή τεστοστερόνης.
Stops testosterone production.
|Συνεχείς δόσεις μεγαλύτερες από 12.5mg/μέρα μπορούν να προκαλέσουν καλοήθη όγκο στον εγκέφαλο. Συνιστάται παρακολούθηση των επιπέδων προλακτίνης μέσω [[Blood Testing#MTF|αιματολογικών εξετάσεων]].
|The max recommended dosage is 10mg/day . Monitoring of prolactin levels is recommended through [[Blood Testing#MTF|blood testing]].
'''Πολλοί γιατροί χορηγούν υπερβολικές δόσεις της τάξως των 50 mg/μέρα. Η κυπροτερόνη είναι δυνατό αντιανδρογόνο και η καταστολή της τεστοστερόνης γίνεται και με μικρότερες δόσεις. Προτείνεται η αλλαγή γιατρού.'''
'''Many doctors give overdoses of 50 mg/day. Cyproterone is a strong anti-androgen and testosterone suppression is possible with lower doses. A change of doctor is recommended.'''


<!--T:13-->
<!--T:53-->
[[wikipedia:Side_effects_of_cyproterone_acetate|Παρενέργιες]]:
[[wikipedia:Side_effects_of_cyproterone_acetate|Side Effects]]:


<!--T:14-->
<!--T:54-->
* Καλοήθης όγκος στον εγκέφαλο.
* Benign brain tumor.
* Σε σπάνιες περιπτώσεις ηπατική βλάβη.
* In rare cases, liver damage.
* Ανεπάρκεια βιταμίνης B12.
* Vitamin B12 deficiency.
* Καρκίνος του μαστού.
* Breast cancer.


<!--T:15-->
<!--T:55-->
Η καταστολή της τεστοστερόνης μπορεί να επιτευχθεί και με ακόμη χαμηλότερες δόσεις, παρ' όλα αυτά ένα χάπι των 50 mg είναι δύσκολο να κοπεί σε κομμάτια μικρότερα των 6 mg ακόμη και με χαπακοκόπτη.
Testosterone suppression can be achieved with even lower doses, however a 50 mg pill is difficult to cut into pieces of less than 12.5 mg even with a pill cutter.
|-
|-
|
|
====== Bicalut ======
====== [https://www.galinos.gr/web/drugs/main/drugs/Bicalut Bicalut] ======
|Bicalutamide (aka: bica, Βικαλουταμίδη)
|Bicalutamide (aka: bica)
|29.10 euro/30 pills
|29.10 euro/30 pills
29.10/month
29.10/month


<!--T:16-->
<!--T:56-->
~350/year
~350/year
|6.77 euro/month (28 tabs)
|6.77 euro/month (28 tabs)
Line 255: Line 272:
'''Very rare''' chance for recoverable and non-fatal liver damage for people with a certain rare mutation.
'''Very rare''' chance for recoverable and non-fatal liver damage for people with a certain rare mutation.


<!--T:17-->
<!--T:57-->
Most of the effects listen in the instruction manual are scaremongering. (it lists a very high chance of liver issues when they are actually very rare, and also lists photosensitivity, which if it even occurs at all, it should be quite rare. We are aware of nobody who had a negative interction between alexandrite laser hair removal and bicalutamide).
Most of the effects listen in the instruction manual are scaremongering. (it lists a very high chance of liver issues when they are actually very rare, and also lists photosensitivity, which if it even occurs at all, it should be quite rare. We are aware of nobody who had a negative interction between alexandrite laser hair removal and bicalutamide).


<!--T:18-->
<!--T:58-->
Note that bicalutamide, unlike most other anti-androgens, '''does not''' lower testosterone levels, in fact they usually rise as the body responds to testosterone receptors being inhibited. Do not be alarmed if you notice an increase of testosterone in your blood tests.
Note that bicalutamide, unlike most other anti-androgens, '''does not''' lower testosterone levels, in fact they usually rise as the body responds to testosterone receptors being inhibited. Do not be alarmed if you notice an increase of testosterone in your blood tests.
|-
|-
|
|
====== Utrogestan ======
====== [https://www.galinos.gr/web/drugs/main/drugs/utrogestran Utrogestan] ======
|Progesterone - Προγεστερόνη (P4) αναφέρεται και ως prog
|Progesterone (P4) it is also referred to as prog
|6.56 euro/15 caps (200mg)
|6.56 euro/15 caps (200mg)
|?
|?
|200mg daily μέσω του ορθού (rectal administration)
|200mg daily (rectal administration)
|A
|A
|Κάπσουλα
|Capsule
|Σταματάει την παραγωγή τεστοστερόνης.
|Stops testosterone production.
|Δεν υπάρχουν πολλές επιβεβαιωμένες πληροφορίες για την προγεστερόνη.
|There is not much confirmed information about progesterone.
Μπορεί να χορηγηθεί και από το στόμα αλλά το ποσοστό απορρόφησης είναι πολύ χαμηλό.
It can also be taken orally but the absorption rate is very low.


<!--T:19-->
<!--T:59-->
Ανέκδοτοι ισχυρισμοί:
Anecdotal claims:


<!--T:20-->
<!--T:60-->
* Βοηθάει στην ανάπτυξη του στήθους και με τη θυληκοποίηση γενικότερα.
* Helps with breast development and with feminization in general.
* Μπορεί να χορηγηθεί μετά από ένα έτος οιστραδιόλης.
* Can be given after one year of estradiol.
* Προτείνεται να χορηγηθεί αφού το άτομο φτάσει στο Tanner στάδιο 3.
* Suggested to be given after the individual reaches Tanner stage 3.


<!--T:21-->
<!--T:61-->
Μπορεί να έχει ανδογόνα ή άλλα (μη-σοβαρά, ανακτήσημα) αποτελέσματα για μερικά άτομα - Συγκεκριμένα μπορεί να μετατραπεί σε DHT από το σώμα ακόμη και σε συνδιασμό με ντουταστερίδη ή βικαλουταμίδη.
It can have androgenic or other (non-serious, recoverable) effects for some individuals - in particular it can be converted to DHT by the body even in combination with dutasteride or bicalutamide.
|-
|-
|
|
====== Arvekap ======
====== [https://www.galinos.gr/web/drugs/main/drugs/Arvekap Arvekap] ======
|Triptorelin (Τριπτορελίνη)
|Triptorelin
| -
| -
|~200/year?
|~200/year?
Line 297: Line 314:
|-
|-
|
|
====== Aldactone ======
====== [https://www.galinos.gr/web/drugs/main/drugs/aldactone Aldactone] ======
|Spironolactone (Σπειρονολακτόνη)
|Spironolactone
|5.19 euro/20 tabs (100mg)
|5.19 euro/20 tabs (100mg)
|?
|?
Line 304: Line 321:
|B-C
|B-C
|Tablet
|Tablet
|
|Antimineralocorticoid/MCRA
|Very inefficient, makes you pee, it's a medication for blood pressure
|Very inefficient, makes you pee, it's a medication for blood pressure
|-
|-
|
|
|Flutamide (Φλουταμίδη)
|Flutamide
|
|
|
|
Line 318: Line 335:
|}
|}


<!--T:22-->
<!--T:62-->
==== Other anti-androgens (optional) ====
==== Other anti-androgens (optional) ====
These are used to block conversion of other androgens to DHT (which causes hair loss (hair) and body hair growth). They aren't general use anti-androgens.
These are used to block conversion of other androgens to DHT (which causes hair loss (hair) and body hair growth). They aren't general use anti-androgens.
Line 335: Line 352:
|}
|}


<!--T:23-->
<!--T:63-->
=== Blood Levels ===
=== Blood Levels ===
  Additionally, refer to the [[Blood Testing]] page.
  Additionally, refer to the [[Blood Testing]] page.
PLEASE make sure that you are using the right measures
PLEASE make sure that you are using the right measures


<!--T:24-->
<!--T:64-->
Careful: biotin can mess with blood tests and make everything seem much higher
Careful: biotin can mess with blood tests and make everything seem much higher


<!--T:25-->
<!--T:65-->
Grapefruit fucks everything
Grapefruit fucks everything


<!--T:26-->
<!--T:66-->
Do the test JUST BEFORE your next dosage
Do the test JUST BEFORE your next dosage






<!--T:27-->
<!--T:67-->
E2: - pg/ml
E2: - pg/ml


<!--T:28-->
<!--T:68-->
Some doctors claim that it should be 100-200 pg/ml, this is not scientifically supported.
Some doctors claim that it should be 100-200 pg/ml, this is not scientifically supported.


<!--T:29-->
<!--T:69-->
T: <1.5nmol/L (ng/??)
T: <1.5nmol/L (ng/??)


<!--T:30-->
<!--T:70-->
DHT: <10? (High values signify an issue but low values don't signify lack of an issue, DHT is often created inside of tissues and doesn't leak to blood)
DHT: <10? (High values signify an issue but low values don't signify lack of an issue, DHT is often created inside of tissues and doesn't leak to blood)




<!--T:31-->
<!--T:71-->
If taking Androcur (Cyproterone acetate), also check: Prolactin
If taking Androcur (Cyproterone acetate), also check: Prolactin


<!--T:32-->
<!--T:72-->
If taking either Androcur (Cyproterone acetate) or Bicalutamide, also check: ALT, AST. As an extra if you feel like wasting money: Bilirubin, ???
If taking either Androcur (Cyproterone acetate) or Bicalutamide, also check: ALT, AST. As an extra if you feel like wasting money: Bilirubin, ???


== FTM == <!--T:33-->
<!--T:81-->
== Transmasc ==
{| class="wikitable"
|+
!Brand Name(s)
!Substance
!Form
!Method of Administration
!Cost
!Cost with Healthcare Coverage
!Dosage
!Safety
!Notes
|-
|[https://www.galinos.gr/web/drugs/main/packages/4929 Norma]
|Testosterone Enanthate
|Injection/Ampule
|Subcutaneous or Intramuscular
|17.67€/ampule
|?
|?
|A+
| -
|-
|[https://www.galinos.gr/web/drugs/main/packages/15739 Tostran]
|Testogel
|Gel
|Trans-dermally
|'''Starting dose'''
 
<!--T:82-->
* 35.54€/2 months
* 213.24€/year
 
<!--T:83-->
'''30 mg dose'''
 
<!--T:84-->
* 35.54€/40 days
* ~324.30€/year
 
<!--T:85-->
'''40 mg dose'''
 
<!--T:73-->
* 35.54€/30 days
* 426.48€/year
|35.54€ -> 8.89€
|20mg/day (starting dose)
30-40mg/day
|B-
|
* 1 pump of Tostran ('''0.5g''') delivers 10 mg of T.
* 2 pumps of Tostran are 1 pump of Testogel (20.25mg of T)
* Can cause skin reactions.
|}


<!--T:34-->
<!--T:74-->
== Legal ==
== Legal ==
It is legal to buy anything without a diagnosis or a prescription (off the counter - OTC) EXCEPT testosterone
It is legal to buy anything without a diagnosis or a prescription (off the counter - OTC), Testosterone can be hit or miss, look for [https://www.galinos.gr/web/drugs/main/packages/15739 Tostran] (Testogel) or [https://www.galinos.gr/web/drugs/main/packages/4929 TEn] (Testosterone Enanthate/Norma, injections). 
 
<!--T:86-->
You can also check the '''[https://diyon.top/map Trans-Friendly Pharmacies Map]''' for any pharmacies near you (this goes for both Transfem and Transmasc HRT).


<!--T:35-->
<!--T:75-->
There is no minimum or maximum legal age for someone to start HRT.  
There is no minimum or maximum legal age for someone to start HRT.  


<!--T:36-->
<!--T:76-->
It is not legally mandatory for someone to have a diagnosis by a psychiatrist in order to medically transition.
It is not legally mandatory for someone to have a diagnosis by a psychiatrist in order to medically transition.


<!--T:37-->
<!--T:77-->
There is no legally mandatory time restriction for a psychiatrist to monitor you before diagnosing you.
There is no legally mandatory time restriction for a psychiatrist to monitor you before diagnosing you.


<!--T:38-->
<!--T:78-->
You don't legally need to be on HRT in order to be exempt from the [[army]], change your [[Legal|legal sex]], or to have a [[surgery]].
You don't legally need to be on HRT in order to be exempt from the [[army]], change your [[Legal|legal sex]], or to have a [[surgery]].


== Other resources == <!--T:39-->
== Other resources == <!--T:79-->


<!--T:40-->
<!--T:80-->
* Simulator: https://www.estrannai.se/
* Simulator: https://www.estrannai.se/
* https://transfemscience.org/ (note, the authors of this site disagree with a lot of what they are saying, regardless, it is still interesting)
* https://transfemscience.org/ (note, the authors of this site disagree with a lot of what they are saying, regardless, it is still interesting)

Latest revision as of 16:45, 19 January 2025


Note: after around a month on HRT some of your ranges in your blood test should be in the ranges of the sex you are transitioning into.

If you are a transfem: no, its not anemia

Transfem

THERE IS NO GOOD REASON TO TAKE ONLY PUBERTY BLOCKERS (GNRH agonists, e.g: Arvekap) OR ANY ANTIANDROGEN WITHOUT ESTROGEN (I say this about youth transitioners, not nb ppl)

Monotherapy

Type Commercial Names Dosage Notes
Sublingual (E Valerate or Hemihydrate)
Cyclacur (EV), Estrofem (EH, imported), Trisequens (12 pills 2mg EH, 10 pills norgestrel, 6 pills 1mg EH) >=8-12mg/day While it is possible, even with a smaller dosage (at least 6mg), it's not that common. Ideally, use your blood tests to minmax your doses.
Injectable Estradiol Valerate (EV)
Neofollin (can be ordered from pharmacies near Czechia, not tested in Greece), Delestrogen (Vial, unavailable), Progynon Depot (Ampules, unavailable),
my honest reaction
5-7mg/5 days
  • Due to the large spikes in levels combined with the short half-life it is not recommended for dosages to surpass the 5 day mark because it may cause menopause symptoms.
  • Branded versions of this medication are not available in greece.
  • The ampules contain a certain mg and do not allow for larger dosages, they are not re-usable. It is recommended to use a vial with a cap.
  • Look for syringe dead space(*), e.g. if there's 0.05mL remaining after injecting, draw +0.05mL from the vial.
Injectable Estradiol Enanthate (EEn)
my honest reaction
4-7mg/Week

7-10mg/10 days (7.2mg usually, depending on the vial, it's optimal because drawing cents of mL are hard to get right)

  • You can multiply the weekly dosage by 2, which lasts up to 14 days (as much as the half-life of Enanthate)
  • Look for syringe dead space(*), e.g. if there's 0.05mL remaining after injecting, draw +0.05mL from the vial.
Injectable Estradiol Undecylate (EU/EUn)
my honest reaction
There's not enough information on dosage. The frequency of those may differ according to the oil used (MCT/Castor oil). Indicative Dosages:

15-20mg/2 weeks

20-40mg+/4 weeks

  • There's not enough information on its half-life, a higher dosage can be administered that can last up to 20-30 days.
  • IM injections last longer so they give better levels during the same period of time per injection.
  • Needs at least 90 days to reach stable levels.
  • Look for syringe dead space(*), e.g. if there's 0.05mL remaining after injecting, draw +0.05mL from the vial.

* = It has been mentioned that syringes account for dead space, although that is not 100% certain.

Sublingual vs Oral

Method Substance Dosage Observations
Oral
Estradiol Valerate in pill form (e.g. Cyclacur) >=6mg/day

(max 10mg as per Dr. Powers)

It is recommended that doses are taken separately on set time intervals during the day for more stable estradiol levels, e.g. for a 6mg dose you would take 2mg per 8 hours. By the oral route the active substance is metabolized by the liver and part of it is converted to estrone (E1), which has much less feminizing effects than estradiol (E2) so the desired effect is essentially prevented. The bioavailability of estradiol by oral administration is very low (~5%) and usually lower levels of E2 are observed in blood tests than other methods of administration. [anecdotal apo to server, wikipedia kai tttt - correct/expand?] It is also necessary to administer anti-androgens to reduce testosterone levels to the female range.
Sublingual
Estradiol Valerate in pill form (e.g. Cyclacur) >=4mg/day It is recommended that doses are taken separately on set time intervals during the day for more stable estradiol levels, e.g. for a 6mg dose you would take 2mg per 8 hours. The sublingual way bypasses estradiol metabolism by the liver and has about 5 times the estradiol bioavailability of the oral way. This way, estradiol levels have greater range than orally (higher peak lower bottom), in oral they remain higher for ~12 hours while sublingually they go away after 3-4 hours [idk if honscience the study is from 2005 on cis women]

Vial info

Medications

For cyclacur: take only the white pills, the brown pills are Norgestrel which have 0.5mg of estradiol but has an androgenic effect and may also cause other side effects.

Estrogens

Brand Name(s) Substance Form Method of Administration Cost Cost with Healthcare Coverage Dosage Safety Notes
Cyclacur
Estradiol Valerate (EV) Pill tablet Orally or sublingually 2.01€ for 11 pills

~130.8-328.€/year

~10.9-27.4€/month

Prices are indicative, the cost depends on the dosage.

- 6mg-10mg/day (according to Dr. Will Powers)

4mg-8mg/day (according to Greek Endocrinologists)

A
  • Only white pills are used. Brown pills do have a bit of estradiol but arent taken due to other side effects.
  • You need antiandrogens or GNRH antagonists if you haven't had an orchiectomy.
Progynova
Estradiol Valerate (EV) Pill tablet Orally or sublingually ~22€ for 72 pills of 1 mg or ~32€ for 72 pills of 2 mg

Prices are indicative, the cost depends on the dosage.

- 4mg-8mg/day A
  • There is no reason to use it in Greece since Cyclacur is available in Greek pharmacies.
  • You need antiandrogens or GNRH antagonists if you haven't had an orchiectomy.
Estrofem, Estrifam (german brand name), Trisequens
Estradiol Hemihydrate Pill tablet Orally or sublingually ~30€ for 28 pills of 2 mg without shipping costs.

Prices are indicative, the cost depends on the dosage.

- 4mg-8mg/day A
  • There is no reason to use it in Greece since Cyclacur is available in Greek pharmacies.
  • You need antiandrogens or GNRH antagonists if you haven't had an orchiectomy.
  • Trisequens, while being available in Greece, is odd to take with 12 pills being 2mg EH, 10 norgestrel, and 6 1mg EH, for a much higher price than Cyclacur.
Dermestril
Estradiol Hemihydrate Patch Trans-dermally 44€ for 24 patches of 100mcg

~15€ for 8 patches of 50mcg

- 50mcg/3.5 days (when starting off)

100mcg/3.5 days (whenever your e2 levels are stable)

A
  • If you have no idea how to apply patches watch this: Demonstrational Video
  • You need antiandrogens or GNRH antagonists if you haven't had an orchiectomy.
  • 100mcg patches can be cut into 2 if needed.
Neofollin (can be ordered from pharmacies near Czechia, not tested in Greece), Delestrogen (Vial, unavailable), Progynon Depot (Ampules, unavailable)
Estradiol Valerate (EV)
Injectable Subcutaneous or Intramuscular 80€/year (including shipping costs, syringes and alcohol swabs) - 5-7mg/5 days (monotherapy)

4-5mg/7 days (only in combination with an antiandrogen or GNRH agonist)

A+
  • It can be used without antiandrogens or GNRH agonists in (Monotherapy) by increasing the dosage.
-
Estradiol Enanthate (EEn)
Injectable Subcutaneous or Intramuscular 80€/year (including shipping costs, syringes and alcohol swabs) - 2.5mg-7mg/7 days

(usual dosage: 4mg/7days)

A+
  • It can be used without antiandrogens or GNRH agonists in (Monotherapy) by increasing the dosage.
-
Estradiol Undecylate (EU, EUn)
Injectable Subcutaneous or Intramuscular 130€/year (including shipping costs, syringes and alcohol swabs) - 15-20mg/2 weeks

20-40mg+/4 weeks

A+
  • There's not much info on dosages, usually seen in monotherapy.

Antiandrogens and GNRH agonists

These should not be taken sublingually.

Brand Name(s) Substance Cost Cost with Healthcare Coverage Dosage Safety Form Type Notes
Androcur
Cyproterone Acetate (CPA) is also referred to as cypro 23.10€/50mg * 50 pills

21.1-33.7€/year

? 12.5mg/2 days- 10mg/day

Larger doses shouldn't be administered

C Pill tablet Progestin (Steroidal antiandrogen)

Stops testosterone production.

The max recommended dosage is 10mg/day . Monitoring of prolactin levels is recommended through blood testing.

Many doctors give overdoses of 50 mg/day. Cyproterone is a strong anti-androgen and testosterone suppression is possible with lower doses. A change of doctor is recommended.

Side Effects:

  • Benign brain tumor.
  • In rare cases, liver damage.
  • Vitamin B12 deficiency.
  • Breast cancer.

Testosterone suppression can be achieved with even lower doses, however a 50 mg pill is difficult to cut into pieces of less than 12.5 mg even with a pill cutter.

Bicalut
Bicalutamide (aka: bica) 29.10 euro/30 pills

29.10/month

~350/year

6.77 euro/month (28 tabs)

~95/year

50mg/day A- Pill/Tablet Androgen receptor antagonist (Nonsteroidal antiandrogen)

Blocks absorption of all androgens (including testosterone)

Serious negative interactions can be noted if combined with other anti-androgens and GNRH agonists (except progesterone)

Very rare chance for recoverable and non-fatal liver damage for people with a certain rare mutation.

Most of the effects listen in the instruction manual are scaremongering. (it lists a very high chance of liver issues when they are actually very rare, and also lists photosensitivity, which if it even occurs at all, it should be quite rare. We are aware of nobody who had a negative interction between alexandrite laser hair removal and bicalutamide).

Note that bicalutamide, unlike most other anti-androgens, does not lower testosterone levels, in fact they usually rise as the body responds to testosterone receptors being inhibited. Do not be alarmed if you notice an increase of testosterone in your blood tests.

Utrogestan
Progesterone (P4) it is also referred to as prog 6.56 euro/15 caps (200mg) ? 200mg daily (rectal administration) A Capsule Stops testosterone production. There is not much confirmed information about progesterone.

It can also be taken orally but the absorption rate is very low.

Anecdotal claims:

  • Helps with breast development and with feminization in general.
  • Can be given after one year of estradiol.
  • Suggested to be given after the individual reaches Tanner stage 3.

It can have androgenic or other (non-serious, recoverable) effects for some individuals - in particular it can be converted to DHT by the body even in combination with dutasteride or bicalutamide.

Arvekap
Triptorelin - ~200/year? A? Injection GNRH Agonist

(indirectly) Stops testosterone AND estrogen production

Also a puberty blocker
Aldactone
Spironolactone 5.19 euro/20 tabs (100mg) ? 50mg-200mg/day B-C Tablet Antimineralocorticoid/MCRA Very inefficient, makes you pee, it's a medication for blood pressure
Flutamide F--- Only in this table as an example to avoid

Other anti-androgens (optional)

These are used to block conversion of other androgens to DHT (which causes hair loss (hair) and body hair growth). They aren't general use anti-androgens.

Name Effectiveness
Dutasteride
High
Finasteride
None to Medium (Please just take duta - will not stop conversion of progesterone to DHT)

Blood Levels

Additionally, refer to the Blood Testing page.

PLEASE make sure that you are using the right measures

Careful: biotin can mess with blood tests and make everything seem much higher

Grapefruit fucks everything

Do the test JUST BEFORE your next dosage


E2: - pg/ml

Some doctors claim that it should be 100-200 pg/ml, this is not scientifically supported.

T: <1.5nmol/L (ng/??)

DHT: <10? (High values signify an issue but low values don't signify lack of an issue, DHT is often created inside of tissues and doesn't leak to blood)


If taking Androcur (Cyproterone acetate), also check: Prolactin

If taking either Androcur (Cyproterone acetate) or Bicalutamide, also check: ALT, AST. As an extra if you feel like wasting money: Bilirubin, ???

Transmasc

Brand Name(s) Substance Form Method of Administration Cost Cost with Healthcare Coverage Dosage Safety Notes
Norma Testosterone Enanthate Injection/Ampule Subcutaneous or Intramuscular 17.67€/ampule ? ? A+ -
Tostran Testogel Gel Trans-dermally Starting dose
  • 35.54€/2 months
  • 213.24€/year

30 mg dose

  • 35.54€/40 days
  • ~324.30€/year

40 mg dose

  • 35.54€/30 days
  • 426.48€/year
35.54€ -> 8.89€ 20mg/day (starting dose)

30-40mg/day

B-
  • 1 pump of Tostran (0.5g) delivers 10 mg of T.
  • 2 pumps of Tostran are 1 pump of Testogel (20.25mg of T)
  • Can cause skin reactions.

Legal

It is legal to buy anything without a diagnosis or a prescription (off the counter - OTC), Testosterone can be hit or miss, look for Tostran (Testogel) or TEn (Testosterone Enanthate/Norma, injections).

You can also check the Trans-Friendly Pharmacies Map for any pharmacies near you (this goes for both Transfem and Transmasc HRT).

There is no minimum or maximum legal age for someone to start HRT.

It is not legally mandatory for someone to have a diagnosis by a psychiatrist in order to medically transition.

There is no legally mandatory time restriction for a psychiatrist to monitor you before diagnosing you.

You don't legally need to be on HRT in order to be exempt from the army, change your legal sex, or to have a surgery.

Other resources