Hormone replacement therapy (HRT) is a cornerstone of gender-affirming medical care for transgender and gender-diverse individuals. The primary goal of HRT is to induce secondary sex characteristics that align with an individual's gender identity, while suppressing those associated with their sex assigned at birth. HRT protocols are highly individualized, reflecting patient goals, medical history, risk factors, and the evolving landscape of clinical evidence and patient-centered care.
This report is to compile and analyze the medications most commonly used in both feminizing and masculinizing HRT protocols, providing detailed information on each agent’s generic and brand names, primary use, routes of administration, typical dosages, notable side effects, and prescription status.
The report is structured to support the development of a searchable medication database for Bloom, a privacy-first wellness tracking app for trans individuals, and is designed to be accessible, accurate, and respectful to support informed decision-making.
This report is divided into two main sections:
Feminizing HRT and Masculinizing HRT.
Within each database, medications are grouped by their function (e.g., estrogens, anti-androgens, testosterone, progestogens, adjuncts). Each group is presented in a structured table, followed by in-depth paragraphs that elaborate on the clinical context, nuances, and considerations for each medication. Special attention is given to monitoring, safety, fertility, and patient-centered approaches, including protocols for nonbinary and partial transitions, as well as emerging therapies and ongoing controversies.
This reference list provides detailed, up-to-date (as of 2/11/26) information on the medications most commonly used in feminizing and masculinizing hormone replacement therapy for transgender and gender-diverse individuals. By organizing medications by function and providing clinical context, dosing, side effects, and patient-centered considerations, this report supports informed decision-making and the development of accessible, respectful resources for the transgender community. Ongoing research, individualized care, and shared decision-making remain essential to optimizing outcomes and supporting the diverse goals of transgender and nonbinary individuals seeking gender-affirming hormone therapy.