What facial changes can trans people expect from HRT?

Yes, HRT does change your facial features – and a new study has actually measured this.

One of the most exciting aspects of HRT for trans people is seeing the physical changes in facial appearance, with trans women typically experiencing a reduction in masculine features while developing more prominent feminine features, and vice versa for trans men. It’s one of the topics most commonly asked about in support forums like Reddit’s AskTransgender: many trans people wait eagerly for the gradual changes in their face over months and years, and often wonder what the various details of their facial features will look like.

While individual appearance varies widely and trans people will obviously have widely varying results in terms of facial femininity or masculinity, several studies have examined how trans people perceive the changes induced by HRT. Medical transition is associated with improvements in body image, and trans women on HRT have shown significant improvement in positive perceptions of their eyes, arms, chest, and buttocks (Fisher et al., 2014).

A recent abstract by Tebbens et al. (2018) contributes new findings in this area. Participating trans women and trans men had their facial shape imaged with a 3D scanner before starting HRT and after three months of treatment. This detailed imaging revealed feminizing changes in trans women and masculinizing changes in trans men:

In transwomen the shifts implicate a rounding of the jaw and an increase in cheek tissue. In transmen the shift implicates a decrease in cheek tissue. These changes suggest that hormonal treatment induces facial feminization in transwomen and masculinization in transmen.

These findings also illustrate that visible changes in facial appearance can occur rapidly, within the first three months of starting HRT. Given that the Endocrine Society has described redistribution of body fat on cross-sex hormones as taking 3 to 5 years to complete, further 3D imaging studies over a longer period of time could help describe the additional and more dramatic changes that occur after long-term treatment. 

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About Zinnia Jones

My work focuses on insights to be found across transgender healthcare, public health, psychiatry, and history of medicine, integrating these many perspectives and guided by the lived experiences of trans people. I live in Orlando with my family, and work mainly in technical writing.
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