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. Â
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). Â
Understanding Gender-Affirming Hormone Therapy (GAHT)Â
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. Â
For transgender men (AFAB), therapy adds testosterone to promote masculinization. Every plan is individualized to your health, goals, and comfort level. Â
Hormone Therapy for Transgender Women (AMAB)Â
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. Â
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. Â
Target hormone ranges: Estradiol levels of approximately 100–200 pg/mL and testosterone levels under 50 ng/dL are often used to guide therapy. Â
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. Â
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. Â
GnRH analogs (such as leuprolide) may also be used for complete testosterone suppression. Â
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. Â
Hormone Therapy for Transgender Men (AFAB)Â
1. Testosterone
Testosterone therapy promotes voice deepening, facial and body hair growth, muscle development, fat redistribution, and cessation of menses. Â
It can be administered as intramuscular or subcutaneous injections (cypionate, enanthate, or undecanoate) or topical gels/creams. Â
Target hormone ranges: Total testosterone between 300–1000 ng/dL is commonly used to mirror physiologic male levels. Â
Monitoring includes testosterone, hematocrit, hemoglobin, liver enzymes, and lipids. Labs are checked every 3 months during initiation, then every 6–12 months when stable. Â
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 PlanningÂ
Before starting hormone therapy, fertility preservation should be discussed. Â
Estrogen therapy may decrease sperm production, and testosterone therapy suppresses ovulation. Â
Options include sperm banking, egg freezing, or embryo cryopreservation before treatment begins. Â
Monitoring and Expected TimelinesÂ
- Visits every 3 months in the first year, then every 6–12 months once stable.Â
- Lab monitoring includes hormone levels, metabolic health, and safety screening.Â
- Physical changes typically begin within 3–6 months and progress for 2–5 years depending on the individual and dosage.Â
- Fertility effects may occur within months and can be long-lasting or irreversible.Â
Safety ConsiderationsÂ
- Transdermal estradiol is preferred over oral forms to minimize blood clot risk.Â
- Testosterone levels should remain within physiologic range to avoid excessive red blood cell production or liver strain.Â
- Regular cancer screenings (breast, cervical, prostate as appropriate) remain essential regardless of hormone use.Â
- Doses are always individualized to achieve safety and satisfaction. Â
An All-Inclusive ExperienceÂ
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.