Trans woman Zoei Montgomery, 25, administers a weekly estradiol injection at her home in Kitsap County, Washington (Photo by Annabel Clark for The Washington Post via Getty Images)
A newly published study has highlighted how hormone replacement therapy (HRT) improves the lives of trans women at a biological level.
As reported by IFLScience.com, researchers at the Murdoch Children’s Research Institute (MCRI) in Victoria, Australia, analysed the biological changes from prolonged gender-affirming hormone treatment.
Examining over 5,000 blood proteins from samples taken from 40 adult trans women both before and after beginning treatment, the team of biologists compared their findings with data from a long-running study of cisgender women.
The study, published in Nature Medicine, found that, after taking a daily dose of estradiol and anti-androgens for six months, protein changes among the patients began to more closely align with those of cisgender women.
Researchers discovered that feminising HRT significantly reduced protein biomarkers – molecules that act as indicators of a biological process – related to male fertility and reproduction, while driving those associated with body fat and breast development, similar to what is seen in menopausal women, who also receive HRT.
Remarkably, there were also signs that feminising hormones can also strengthen the immune system and improve heart health.
MCRI associate professor, Boris Novakovic, noted that the treatment “may go onto impact the risk of allergic and autoimmune diseases, which tend to affect more females,” but also noted it can widely diminish the risk of heart disease, which he said is “more commonly seen in males.”
“This highlights that human biology is malleable and that even in adulthood, our bodies respond to sex hormone changes.”
Researchers urge ‘personalised’ approach to HRT prescriptions
Novakovic said the findings likely mean medical professionals should undertake more nuanced health monitoring for patients depending on the hormone treatment they are undergoing, and should ensure that treatment is optimised to meet the needs of the individual.
The findings could have implications for medical treatment outside of trans healthcare, with professor Ada Cheung, co-author of the study, saying it could improve the development of health monitoring more broadly.
“Studying proteins could help with the development of personalised treatment approaches by monitoring the effectiveness of gender-affirming hormone therapy in trans women and help us with early detection of potential side-effects of heart health or immune function,” she said in a statement.
While the study give a remarkable glimpse into the immutable biological fact that HRT significantly improves trans people’s well-being, researchers said more work needs to be done to thoroughly understand personalised treatment as technology advances.
An array of studies have proved that regret rates among trans people undergoing HRT are incredibly low. Research published in the American Journal of Surgery in 2024 noted that transition-related regret is considerably lower than breast augmentation surgery, weight-loss surgeries, and even having children.
Another study published in 2023 noted that transition-related regret is more complex than trans people simply reverting back to their gender assigned at birth. 60 per cent of detransitioners shifted from a binary gender to non-binary, while the vast majority said they felt positive about exploring their gender identity.
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