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Masculinising Hormone Therapy
Information Sheet &
Informed Consent

Adapted from: Gender Aﬃrming Hormones Prescribers Guide, Version 2, August 2019, Dr Michelle Guttman-Jones

Informed consent model of care

The informed consent model of care respects your fundamental human right to self-determination and bodily autonomy. The purpose of this document is to indicate, in writing, that you consent to masculinising hormone therapy as part of a gender aﬃrmation process. This form may be signed by any person of sound mind over the age of 18, or over the age of 16 with the co-signatures of all primary legal guardians. 

This document relates to the hormone testosterone. Your doctor will discuss with you all of the information relating to starting hormone therapy. Please read and understand the following information, and raise any questions you have with your doctor.

Patient information sheet: expected changes on masculinising hormone therapy 

Typical changes from Testosterone (varies from person to person) 
Average timeline | Eﬀect of Testosterone

1–3 months after starting testosterone

• decreased oestrogen in the body 
• increased sex drive 
• vaginal dryness 
• growth of the clitoris - typically 1–3 cm 
• increased growth, coarseness, and thickness of hairs on arms, legs, chest, back, & abdomen 
• oilier skin and increased acne 
• increased muscle mass and upper body strength 
• redistribution of body fat to the waist, less around the hips

1–6 months after starting testosterone | • menstrual periods stop
3–6 months after starting testosterone | • voice starts to crack and drop within first 3–6 months, but can take a year to finish changing

1 year or more after starting testosterone

• gradual growth of facial hair (usually 1–4 years) 
• possible male-pattern balding

Consent Form: Masculinising Hormone Therapy 

I, <PtFullName>, acknowledge that I have read and understood the following information in consultation with my doctor, <DrName>:

Tick the boxes to acknowledge the following:

• Permanent changes expected whilst on masculinising hormone therapy:
	• Increased facial and body hair 
	• Deepened voice 
	• Enlargement of erectile genital tissue (phallus / clitoris) 
	• Possible male pattern balding 
	• Possible permanent infertility. I have been advised to consider storing eggs before starting hormone therapy. I have been given the opportunity to delay starting in order to store eggs.

• Reversible changes expected whilst on masculinising hormone therapy:
	• Increased libido 
	• Body fat redistribution 
	• Coarser and oilier skin 
	• Acne of face, chest and back 
	• Stopping of menstrual periods 
	• Vaginal dryness 
	• Raised cholesterol 
	• Increased blood pressure 
	• Mood changes - aggression, depression

• I acknowledge the following potential side effects and risks of masculinising hormone therapy. My doctor will continue to monitor my health and address any issues if and when they develop:
	• Polycythaemia - increased number of red blood cells, resulting in “thickened” blood 
	• Increased risk of cardiovascular disease 
	• Difficulty controlling blood sugars in people with diabetes
	• New or worsened obstructive sleep apnoea 
	• Osteoporosis 	
	• Liver damage 
	• Increased salt and water retention 
	• Increased risk of certain types of cancer, such as endometrial, ovarian and breast  cancer

• I understand that masculinising hormone therapy aﬀects everyone diﬀerently, and that there is no way to predict exactly how my body will change. Some of the long term eﬀects of masculinising hormone therapy are not yet known. 

• I have been informed that the use of masculinising hormones do not guarantee infertility, and that contraception should be used when having sex that puts me at risk of pregnancy. I have been advised that getting pregnant whilst taking testosterone could put the baby at serious risk of harm.

• I have been informed that the use of feminising hormones does not guarantee infertility, and that contraception should be used to avoid unwanted pregnancy if I have sex with someone who could become pregnant.

• It is my responsibility to educate myself about safe sex. I should take active steps to protect myself from getting HIV or other sexually transmitted infections. My doctor can guide me make the best choices.

• I understand that gender aﬃrming hormone therapy means that I will need to see my doctor and have blood tests at regular intervals throughout my life. Appointments will be more frequent at ﬁrst, and then every 6-12 months when my hormone levels are stable. I am ready to make this commitment to my health.

• I acknowledge that gender aﬃrming hormones are only a part of my overall health, and that a range of preventative health activities are recommended so that I remain happy and healthy in my aﬃrmed gender. These include but are not limited to:
	• Cervical screening tests at appropriate intervals, as recommended by my doctor 
	• Regularly checking my chest / breasts for lumps, even if I have had a mastectomy 
	• Regular breast mammograms from an appropriate age, in consultation with my doctor
	• Quitting smoking
	• Immunisations
	• Regular STI screening, depending on my level of risk
	• HIV prevention, depending on my level of risk
	• Regular physical activity, including resistance exercise for bone health
	• Healthy eating

I can choose to stop gender aﬃrming hormone therapy at any time. If I choose to stop taking hormones, it is best that I do this in consultation with my doctor, to ensure that I remain safe and healthy.

<PtFullName> | <DrName>
Signature: | Signature:
Date: | Date:

Masculinising hormone therapy information sheet & informed consent 
<PtFullName>, DOB: <PtDoB>

Masculinising hormone therapy information & informed consent
<PtFullName>, DOB <PtDoB>