The Trans Directory

FTM HRT

5 min read

Testosterone hormone replacement therapy (HRT), also called masculinizing hormone therapy or gender-affirming hormone therapy (GAHT), is treatment with testosterone that produces typically masculine physical changes in people whose bodies don’t make much testosterone on their own. The testosterone used is bioidentical, the exact same molecule human testes make, not a synthetic anabolic steroid.12

Who it’s for

Trans men (men assigned female at birth) and transmasculine nonbinary people who want some degree of masculinization. Some people want full virilization (the complete set of masculine changes); others want slower or partial change, both are legitimate goals that we can work with (see FTM Low-Dose and Nonbinary).

What testosterone does

Testosterone shifts your hormone profile into the typical cis male range, driving changes such as a deeper voice, facial and body hair, increased muscle mass, redistributed body fat, stopping periods/amenorrhea (ceasing menses), and genital (bottom) growth. Some changes are permanent and some are reversible if you stop, knowing which is which is one of the most important things to understand before starting. See FTM Effects for the full timeline and FTM Target Ranges for what “male range” actually means in numbers.

Two things worth knowing on day one:

  • You can’t pick and choose effects. There is no regimen that reliably delivers only the changes you want; genetics, age, and your body’s sensitivity to hormones decide a lot (see FTM Effects).1
  • More is not faster. Once your level is in the normal male range, higher doses add side effects such as acne, high red blood cell counts(polycythaemia/high RBC), hair loss but not extra masculinization.1

How people start

Most people start testosterone through one of these routes:

  • GP / primary care clinician — in many countries (Australia, Canada, much of the US) a supportive GP can prescribe and manage HRT directly.
  • Endocrinologist (a hormone specialist) or gender clinic — the traditional specialist pathway; standard in the UK and much of Europe, often with long waits.
  • Informed-consent providers — the clinician explains effects, risks, and alternatives; if you understand and consent, you can be prescribed hormones without a therapist letter or mandatory counseling. This model is recognized by WPATH SOC8 for adults and is standard at many community health centers, Planned Parenthood clinics, and telehealth services.34
  • Telehealth — method of consulting doctors remotely over the phone or video call; prescribing rules for testosterone (a controlled substance — a legally restricted drug in some countries) vary and change fast. See FTM Access for country-by-country detail.
  • DIY — Accessing HRT through DIY methods for some can be their only viable or affordable way of accessing HRT depending on their location. ranging from 11% to 93%, depending on the region, relies on DIY HRT as a necessary harm-reduction strategy.

In Australia specifically (as of 2026): GPs can prescribe testosterone under an informed-consent model, but getting it subsidised through the PBS (Australia’s medicine-subsidy scheme) requires a one-time involvement of a specialist (an endocrinologist, sexual health physician, or urologist, even a phone/email consult counts). Subsidised testosterone then costs roughly A$7 with a concession card, up to about A$40 per month, and you don’t need to be registered with Medicare as male to access it.5 AusPATH, the Australian professional association for trans health, publishes a national position statement on hormonal care.6

Wherever you start, the usual shape of care is: a goals conversation → baseline blood tests → a starting dose → titration (gradually adjusting your dose) over months, guided by blood levels and how you feel (see FTM Dosages and FTM Blood Testing).

On this site

Testosterone HRT pages

  • FTM HRT this page: the overview and starting point
  • FTM forms of HRT injections, gels, patches, pellets, oral: what exists and how they compare
  • FTM Dosages standard clinical regimens, titration logic, and the underdosing problem
  • FTM Target Ranges what your testosterone (and estrogen) numbers should look like
  • FTM Effects what changes, when, and what’s permanent
  • FTM Blood Testing monitoring schedules, what’s tested, and how to read your results

Elsewhere on the site

FTM Resources * Standards of Care * Surgeries * Voice Training * Australian Legal * Research Papers * Genderal Resources

Further reading

One website shouldn’t be your only source, these are the places we’d send you next.

Footnotes

  1. UCSF Gender Affirming Health Program, “Overview of masculinizing hormone therapy” (Deutsch MB, ed., 2nd ed.) - https://transcare.ucsf.edu/guidelines/masculinizing-therapy ↩ ↩2 ↩3 ↩4

  2. Mayo Clinic, “Masculinizing hormone therapy” - https://www.mayoclinic.org/tests-procedures/masculinizing-hormone-therapy/about/pac-20385099 ↩

  3. WPATH Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 (Coleman E, et al., 2022), Int J Transgender Health 23(S1) - https://pmc.ncbi.nlm.nih.gov/articles/PMC9553112/ ↩

  4. UCSF patient document, “Information on Testosterone Hormone Therapy” (March 2025) - https://transcare.ucsf.edu/article/information-testosterone-hormone-therapy ↩

  5. TransHub (ACON, Australia), clinical guidance on PBS-listed testosterone access - https://www.transhub.org.au/clinicians/endocrinology/ ↩

  6. AusPATH / Cheung AS, et al. “Position statement on the hormonal management of adult transgender and gender diverse individuals,” Med J Aust 2019;211:127-133 - https://auspath.org.au/ ↩

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