Transfeminine HRT
Transfeminine HRT aims to lower testosterone and raise estrogen, producing a more feminine body. It combines estradiol (which causes feminization) with, in most cases, an anti-androgen (which blocks testosterone).
Medical disclaimer
This page summarises community guidance for educational purposes only. It is not medical advice. Dosing and monitoring should ideally be supervised by a qualified provider. See the source guides linked at the bottom.
Expected effects and timelines
According to the DIY HRT Directory, changes include body-fat redistribution, decreased muscle mass, reduced acne, softer skin, slowed body-hair growth, reduced erectile function and sperm production, and breast development.
- Changes typically begin within days to weeks, though for some it may take up to a month.
- Breast development usually plateaus at around 1–2 years and is mostly irreversible.
- Body-fat redistribution may also take years to reach a plateau.
- Most other changes are reversible if HRT is stopped.
Estradiol (injectable esters)
Injectable estradiol is common in DIY regimens because it is effective and easy to monitor. The DIY HRT Directory lists the following esters and example doses (monotherapy dose / dose alongside an anti-androgen):
| Ester | Monotherapy | With anti-androgen |
|---|---|---|
| Estradiol Valerate (EV) | 4 mg every 5 days | 2 mg every 5 days |
| Estradiol Cypionate (EC) | 4 mg every 7 days | 2 mg every 7 days |
| Estradiol Enanthate (EEn) | 4 mg / 7 days or 7 mg / 10 days | 2 mg / 7 days or 3 mg / 10 days |
| Estradiol Undecylate (EUn) | 24 mg every 21 days or 32 mg monthly | 12 mg every 21 days or 16 mg monthly |
Routes. Injections can be given subcutaneously (subq) — into the fat under the skin — or intramuscularly (IM) — deep into muscle. Absorption is essentially identical between the two, except for undecylate, which is highly recommended to be injected IM.
Non-injectable estradiol (sublingual tablets, transdermal patches/gel) also exists; consult the source guides for details.
Anti-androgens
Anti-androgens suppress testosterone so estrogen can do its work. Common options and example daily doses from the dosing guide:
- Cyproterone acetate — 6.25–12.5 mg daily
- Bicalutamide — 50 mg daily
- Spironolactone — 200 mg daily
Others such as relugolix and buserelin (GnRH modulators) are also documented.
Bicalutamide and your liver
If you take bicalutamide, the DIY HRT Directory strongly recommends liver-function tests (ALT/AST) every 3 months because of a very low but real risk of severe liver toxicity.
Target blood levels
"The most essential component of transfeminine HRT is to get total testosterone (T) below 50 ng/dL and estradiol (E2) above 100 pg/mL." — DIY HRT Directory
See Blood Testing for how and when to test.
Sourcing HRT when it's not medically available
In much of the MENA region, a doctor will not prescribe feminizing HRT, and importing it yourself may be the only realistic option. valerie.vg (formerly diyhrt.market) is a community-maintained directory of HRT vendors built for exactly this situation. It does not sell anything itself — it lists and vets suppliers so you can find estradiol and anti-androgens.
What it lists. Sources for every form of estradiol — pills, patches, injections, gels, and sprays — as well as anti-androgens such as bicalutamide. See the Transfeminine HRT guide on valerie.vg and its medication listings.
Two kinds of source:
- Pharmaceutical-grade — genuine medication made by licensed, regulated pharmaceutical companies, the same quality as a local pharmacy's. It can often be ordered without a prescription from companies in countries that permit legal export (the directory lists, for example, long-running pharmacies based in Hong Kong, India, Turkey, and Portugal).
- Homebrew — medication compounded by individuals from raw powder. Some community homebrewers make high-quality product, but homebrew carries more inherent risk; pharmaceutical-grade is the safer default when available.
How vetting works. Reputable directories like this one screen suppliers — requiring months of satisfactory customer feedback before a vendor is listed — and valerie.vg states its guidance was reviewed by a professional in the biomedical industry. Listing is not a guarantee: still read recent reviews and start cautiously.
Before you order
- Check your local laws. Importing medication may be restricted or illegal where you live, and customs can seize packages. Understand the personal and legal risk first.
- Protect your privacy. Consider a discreet delivery address and privacy-preserving payment — see Cryptocurrency.
- Verify what you receive. Confirm the medication and, above all, get Blood Testing done so you know your regimen is working and safe.
- Beware scams. Only use vendors with a solid, recent track record; never send money to an unvetted seller.
Sources: DIY HRT Directory — Transfem guide, valerie.vg (formerly diyhrt.market), hrt.info.