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The Effects of Hormones

Transsexuals most often report being excited about the secondary sex characteristics that accompany the hormone treatment, which may serve to improve their self-esteem and, consequently, their willingness to consider participating in sexual situations. (Ramsey 1996:49-50).

It is beyond the scope of this paper to summarize thoroughly the physical effects of hormone replacement therapy (HRT) for trans individuals, and their ramifications for sexual life. It must suffice to say that for MTFs, effects generally include breast development, redistribution of body fat to give the hips, face, etc. a more "female" appearance, eventual diminution of body hair; effects on sexual functioning include decrease in fertility, decreased erectile functioning, decreased sex drive (for some) and, especially if sexual activity is sparse or absent, eventual atrophy and shrinking of the genitals. For FTMs, typical effects include facial and body hair development, deepening of the voice, and fat redistribution; effects on sexual functioning include decrease in fertility, elongation of the clitoris, increase in sex drive, and sometimes decrease in vaginal lubrication. The degree or even the presence of all these effects varies significantly among individuals. The implications of these changes for one's sex life also, of course, vary to a considerable degree.

For many individuals, it appears that undergoing HRT may lead to increased comfort with and participation in sexual activities. As the body comes somewhat closer to aligning with the individual's identity, body dysphoria may decrease markedly and with it anxiety about sharing it with partner and experiencing sexual pleasure.

For others, however, the initiation of HRT is precisely the point at which they enter the much less sexual, if not totally asexual "cocoon" stage discussed above. While HRT is a positive and life-enriching choice for practically all of these individuals, hormone-induced changes in their secondary sex characteristics in combination with their unaltered natal genitals may cause them to be more self-conscious and hesitant to risk sharing their increasingly nonstandard body configuration with a partner. Unsurprisingly, this attitude appears to be particularly common among those who intend to eventually undergo SRS.

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Part II: My Study

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