Which hormones and which dose?
For each aspects of hormone treatment exists a large array of (semi) synthetic sex steroids. There are no solid literature data to prove certain hormonal drugs superior in efficacy to others. Only two published studies give an indication of the value of different hormone schedules in the treatment of transsexuals, but the results are far from conclusive (Meyer et al., 1981 & 1986).
The choice of hormonal drugs in the treatment of transsexualism depends on availability (national regulations, pharmaceutical marketing), local traditions, side effects, route of administration, cost and folk belief (in particular from the side of the transsexual subject and his/her peer group, but also from the physician).
Optimal dosages of these drugs have not yet been established. The first effects of the cross-gender sex hormones appear already after 6 to 8 weeks (Futterweit, 1980). Voice changes in female-to-male transsexuals and the development of painful breast noduli in male-to-female transsexuals are the first manifestations. Thereafter the changes take over 6 to 24 months and even longer before they are complete (beard growth may take 4 to 5 years in androgen-treated female-to-male transsexuals).