At MCNYC MedSpa, we proudly offer a compassionate and all-inclusive experience for transgender and gender-diverse individuals seeking hormone optimization, gender-affirming care, and wellness support.
Our program is led by Dr. Nicolas Batty, MD — American Board Certified ×5 — providing safe, evidence-based, and affirming treatment aligned with the latest standards of care (WPATH, Endocrine Society, UCSF).
Understanding Gender-Affirming Hormone Therapy (GAHT)
Gender-affirming hormone therapy helps align a person’s physical characteristics with their gender identity. For transgender women (AMAB), therapy involves reducing testosterone and adding estrogen.
For transgender men (AFAB), therapy adds testosterone to promote masculinization. Every plan is individualized to your health, goals, and comfort level.
Hormone Therapy for Transgender Women (AMAB)
1. Estrogen (17-β Estradiol)
Estrogen promotes breast development, body fat redistribution to hips and thighs, softer skin, and reduced body hair and muscle mass.
Treatment forms include transdermal patches, oral tablets, and intramuscular injections. Transdermal forms are often preferred for patients with higher cardiovascular risk, as they have a lower risk of blood clots.
Target hormone ranges: Estradiol levels of approximately 100–200 pg/mL and testosterone levels under 50 ng/dL are often used to guide therapy.
Lab monitoring includes estradiol, testosterone, and electrolytes (if using spironolactone). Visits are typically every 3 months during the first year, then 6–12 months once stable.
2. Anti-Androgens
Anti-androgens reduce the effects of testosterone. The most commonly used are spironolactone, which blocks androgen receptors and reduces testosterone production, and finasteride or dutasteride, which help reduce scalp hair loss.
GnRH analogs (such as leuprolide) may also be used for complete testosterone suppression.
3. Progesterone (Optional)
Some patients may use micronized progesterone to aid in breast development or improve sleep, though evidence is mixed. This is considered optional and individualized.
Hormone Therapy for Transgender Men (AFAB)
1. Testosterone
Testosterone therapy promotes voice deepening, facial and body hair growth, muscle development, fat redistribution, and cessation of menses.
It can be administered as intramuscular or subcutaneous injections (cypionate, enanthate, or undecanoate) or topical gels/creams.
Target hormone ranges: Total testosterone between 300–1000 ng/dL is commonly used to mirror physiologic male levels.
Monitoring includes testosterone, hematocrit, hemoglobin, liver enzymes, and lipids. Labs are checked every 3 months during initiation, then every 6–12 months when stable.
2. Adjunct Therapies
Progestin therapy may be used to help manage breakthrough bleeding in early testosterone therapy.
5-α reductase inhibitors like finasteride can reduce scalp hair thinning if desired.
Fertility and Family Planning
Before starting hormone therapy, fertility preservation should be discussed.
Estrogen therapy may decrease sperm production, and testosterone therapy suppresses ovulation.
Options include sperm banking, egg freezing, or embryo cryopreservation before treatment begins.
Monitoring and Expected Timelines
- Visits every 3 months in the first year, then every 6–12 months once stable.
- Lab monitoring includes hormone levels, metabolic health, and safety screening.
- Physical changes typically begin within 3–6 months and progress for 2–5 years depending on the individual and dosage.
- Fertility effects may occur within months and can be long-lasting or irreversible.
Safety Considerations
- Transdermal estradiol is preferred over oral forms to minimize blood clot risk.
- Testosterone levels should remain within physiologic range to avoid excessive red blood cell production or liver strain.
- Regular cancer screenings (breast, cervical, prostate as appropriate) remain essential regardless of hormone use.
- Doses are always individualized to achieve safety and satisfaction.
An All-Inclusive Experience
At MCNYC MedSpa, inclusivity and medical excellence define our care. We honor every patient’s identity and journey.
Under the guidance of Dr. Nicolas Batty, MD — a five-time American Board Certified physician — we provide comprehensive, affirming, and confidential care in a safe and supportive environment.