Hi Alice,

I am twenty-nine-year-old male. I also am a crossdresser. The question I want to ask is this: I have been wanting to get on birth control pills. I have been wanting this since I was fourteen. I would like to know the danger of this before I see a doctor. I am not bothered about the female hormones. If I can, what are the things I need to ask, and what doctor do I see for getting birth control pills? I would feel more feminine and better about myself if I was on the pill. Thank you for your time.


Dear Maryan,

Seeking the advice of health care professionals is recommended when you are considering a new medication. It sounds like your main goal for taking birth control pills is to feel more feminine, and you have been thinking about taking birth control for some time now with that aim in mind. Kudos to you for consulting a trusted source as you gather more information and explore your options. Prior to seeking medical advice, however, you may also want to consider other ways you can enhance feeling feminine in your day-to-day life and achieve a similar result without the potential side effects of a new medication.

First, if your interest in taking birth control pills is to begin hormone therapy, below is some information about birth control and medical options for feminization that you might discuss with your health care provider:

There are many forms of birth control, but not all kinds work the same way in the body or contain estrogen. Hormonal birth control pills contain varying levels of the synthetic hormones estrogen and/or progestin to regulate a woman’s menstrual cycle. These types of medications are not typically prescribed to induce a feminizing effect on the body. Additionally, the use of birth control pills is not without risks and should be monitored by a health care provider. Serious side effects of birth control pills exist, but be aware that these were found in women — not enough information is available to know what side effects could occur in men.

Some forms of estrogen can be prescribed for hormonal therapy. Many people begin a combination of estrogen therapy with a prescription anti-androgen, which blocks the effects of testosterone, when they want to increase feminization and reduce testosterone levels. Regular physical exams and blood tests are especially important when on hormone therapy because your health care provider will want to monitor kidney and liver functioning, cholesterol levels, and other aspects of your health that can be impacted by hormone use. Estrogen therapy is also associated with increased risk of high blood pressure, blood clots, liver problems, stroke, and diabetes. Research is lacking in specific side effects of estrogen use by men. That said, it bears repeating that this type of therapy is best when paired with the supervision of a health care provider.

The Center of Excellence for Transgender Health at the University of California, San Francisco has more information on hormone therapy protocol for balancing a person’s physical body with their gender identity. Additionally, Vancouver Coastal Health provides hormone and health information (see Hormone’s: A Guide for MTFs) for a wide spectrum of gender identities, including those who identify as trans and those who identify elsewhere on the gender spectrum.

If your interest in taking birth control pills is a means of feeling more feminine by adopting a feminine activity, here are some other non-medical options you might consider:

  • Physical expression. Clothing (shoes and accessories, too!), hairstyle, makeup, and body language are all ways people outwardly express their identity, whether feminine, masculine, or elsewhere on the spectrum of gender. Often a little experimentation will help narrow down what feels right for your self-expression.
  • Community involvement. Talking and spending time with others who also identify similarly may also be a way to embrace and explore gender expression and identity. Clubs, social outings, community classes, online groups, or local organizations with like-minded members can provide a supportive setting to be yourself. Some people find that the more time they spend in the company of people where they feel safe to be themselves, the more their self-confidence improves. Many LGBT centers will offer events that specify safe space guidelines for gender non-conforming expression.
  • Hobbies, pastimes, and personal interests. Some people affirm their identity by investing more time and energy in themselves and their interests. What other habits or hobbies might you adopt to feel more feminine? Reading books or articles that explore femininity, watching movies, listening to music, or beginning a new hobby that allows you to embrace and express your feminine self are just a few ideas.

Speaking with a therapist may be another option to help you affirm and fully articulate your reasons for exploring your feminine self, no matter what route(s) you take. Regular therapy may also be a source of support as you continue your journey. Some health care providers may require or recommend meeting with a counselor or therapist before beginning hormone therapy. Columbia students can make an appointment to speak with a mental health professional at Counseling and Psychological Services (Morningside) or the Mental Health Services (CUMC). Additionally, if you are a Columbia student and want to set up an appointment to discuss anything from beginning to explore your gender to more specific medical options, you can see a health care provider at Medical Services (Morningside) or the Student Health Service (CUMC).

Other knowledgeable and sensitive providers can also be found through the Gay and Lesbian Medical Association or World Professional Association for Transgender Health. Community based clinics like Callen-Lorde (in NYC) and Lyon-Martin Health Services (in San Francisco) offer services specifically for individuals exploring their gender. When choosing a health care provider or mental health provider, make sure you can be honest with about your concerns and experiences.

Gender identity and expression exist on a spectrum, unique to each person. There are lots of ways to continue to explore and understand your feminine side, both on your own and with the support of others. Try to find the ideas and options that resonate most with you. Best of luck as you continue on your journey.


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