To a lot of trans people, HRT is the ultimate goal. It’s the Holy Grail, with a Philosopher’s Stone inside, sat atop Excalibur. It’s talked about in the transgender community with almost legendary status. It’s a solution, it’s a goal and it’s the answer. But in reality, it’s complicated.

For those unaware, HRT stands for hormone replacement therapy. For trans folk who choose to pursue it, HRT is often the first, and sometimes only, medical intervention taken to combat gender dysphoria.

What sparked this essay was a culmination of things, but primarily it was reading a claim that HRT is powerless. A dismissive statement which said HRT’s effectiveness is a dangerous myth, that before beginning transition we trans people should expect nothing and even warn those seeking to transition to do the same. Elsewhere, I read a call to mock trans people who wanted HRT “early”, before they had come out to their social circle, the implication being that they were naive and putting hope where it didn’t belong. They had to “earn” it and run the gauntlet first.

As a trans person myself, I entirely reject that mindset.

HRT does not do everything, no. But saying it does nothing is irresponsible and wrong. Meanwhile, anybody who wants it deserves to have it. There is nothing justifiable about withholding healthcare from a consenting individual who is aware of the risks and effects.

However, the idea that HRT has a set of guaranteed changes for everybody, is not something I agree with either. HRT is very personal. Different doses and methods work on different people at different speeds with different outcomes.

There’s a stereotype in the community that before deciding to transition, binary trans people will scroll through HRT timelines, photo diaries of those who’ve gone through it already. These days you could even just browse the video library of your favourite trans vlogger, bouncing around their channel to look for how their appearance has changed. There is no shortage of before/after comparisons, often focused around HRT.

But comparing ourselves to others’ transitions is not a wise idea, tempting as it can be. Just like a random group of cis teenagers going through puberty, you can’t expect them to have the same results in the same timeframe just by virtue of having the same hormones. Genetic diversity dictates results more than anything else.

Claiming that everybody who goes through HRT with a “good” outcome must somehow be expertly deceptive or a liar, is just a ridiculous. There’s being cautious and then there’s being relentlessly pessimistic. Are we guaranteed to look attractive based on cisnormative beauty standards once on HRT? No. Is there a chance we will? Sure! If someone wants to transition, is it worth them starting HRT with no guarantees on how they’ll look? Yes, of course.

I’ve argued it before, but basing your transition hopes entirely on your appearance isn’t something I believe is a good idea, but I understand why some people do it. Gender dysphoria is deeply personal, but can often cruelly suggest that if you just looked better, then you’d feel better too.

HRT isn’t just about changing how you look. Transition is not the journey to look pretty. Its effects go beyond surface changes. There can be mental and emotional effects too, they can push people to feel better about themselves. Perhaps feel the best they’ve felt in years by treating the root cause of dysphoria, not just the external effect of it. This is also why I can never agree with the gatekeeping mentality that people must “earn” HRT. The mental effects alone of starting it can be hugely worthwhile, it can even give someone the confidence and peace of mind they need to socially transition.

Before starting HRT, I hated taking any photo of myself. Post-HRT, I take photos of myself weekly, for fun. I can consciously look at my own reflection for the first time in my life. For months after beginning HRT, whenever I walked by the tall glass building on my way to work I would glance at my reflection and smile. The fact that I was able to look at myself and actually feel anything other than numb dissatisfaction, is still something I consider groundbreaking.

Was that change from the subtle physical changes to my body and face? Or was that mental effects of HRT lessening dysphoria? Both? Honestly, I think it doesn’t matter. Regardless of the source, the result is that I am happier. It worked. HRT helped usher in a large and positive impact to my life within weeks.

Obviously, HRT is not the only reason I’m happier, no. It would be wrong to praise it as the sole force behind my life improving. But it is an important part of it. It helped me feel like I was making progress by hitting a significant milestone. Most of all, it gave me hope.

The transgender community is a vulnerable one. Hope is important, it is vital. Hope saves lives.

I cannot stress that last part enough. Hope is the most valuable and precious thing we can pass on to the younger generation, they need it.

It’s not even about age either. I spoke to a trans woman recently who’s my age, she wants to transition but is scared her life will be too difficult and complicated if she does. But she’s miserable not transitioning. She’s trapped in a middle-zone, suffering from her own brand of dysphoria and unable to see a happy future.

I used to be in the exact same position, I delayed transitioning for years and years, thinking I couldn’t find happiness. My life was a sad shell. I assumed transitioning meant a difficult and terrifying life, while I knew not transitioning meant emptiness and regret.

The only thing that got me out of that slump was the hope that things just might work out okay. I dared to wonder, what if transition went well? What if HRT made me feel better about myself? What if I found acceptance?

It’s important that we spread that hope and show success. People need to see that you can be trans and happy. We have to fight the sensationalist media perception that trans people are spectacles for others, that we’re all miserable and crawling through life with nothing.

I reject the message that all trans people are miserable and ugly, that HRT is some fallacy. I reject that because I know it’s lethal to some of us to believe it, it’s dangerous to spread it. I also reject it because it’s bullshit.

My life is infinitely better for starting transition. Is it easy? No. But it’s sure as hell been worth it.

I don’t “pass”, I look trans, if I never look any more feminine than this? Fine. I still have no regrets. I will still take HRT. It allowed me to be a better, more confident, happier me. It helped me realise I don’t have to look or act a certain way, that my gender dysphoria was as much about what was going on in my head as what my body looked like.

Ultimately: HRT is personal. It won’t do everything on its own, you have to work on your own wellbeing too, but it can help, a lot.

As a community we should be realistic with what it does, but I believe we should also fight pessimism and cultivate hope. We should do that for the sake of the most vulnerable of us, who are only still here because of the hope that they can one day be happy. To some trans people HRT is nothing, but to others it’s a goal to keep fighting for, a reason to hold on, it’s everything.


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