The Dark Side of Transitioning

Transitioning has many benefits, but we must be well informed and mindful of the negative aspects of HRT and SRS before we go through with it.


If you are a transgender individual who has already transitioned, then you know some of the amazing changes you go through to be your authentic self. However, with everything good, there is also a downside. For those who haven’t transitioned yet, this information isn’t often presented to them, or they overlook it in favor of the positive effects. While it’s important to remain optimistic, there is a downside to transitioning, taking hormones, and having sex reassignment surgery. We will divide this up into three sections, one for the cons of a social transition, another for the side effects of hormone replacement therapy, and last one for the side effects of sex reassignment surgery.

Conceptual dark portrait of woman stretching the skin of her face in ugly grimace
© fotoyou

Social Transition

While there are many benefits of a social transition where others view you as what you’ve always felt you are, there are many things that inhibit your happiness and cause you to feel depressed and anxious. One is that the easier it is for other people to tell you’re trans, the more they will judge and make fun of you. People can be quite hurtful by nature, say awful things, and do things that will lower your self-esteem. However, you have the right to not take offense to what they’re saying and instead show how confident you actually are.

Gendering or misgendering symbol
© Dzmitry

Additionally, some people may not take you seriously. No matter how mature you are, and good advice you give, some people will view you as a mentally ill person who has clue what they’re saying and thus your words go in one ear and out the other. To them, you’re a fraud and phony and whatever comes out of your mouth cannot be trusted, even if you’re generally right about your advice. This can be upsetting since you see those around you struggling and know that if they just listened to you that they wouldn’t be in this situation. But, they didn’t listen since they saw you and your lifestyle as a joke. Don’t let this affect you too deeply since people will make their own choices, so if they don’t follow your advice, the decision is solely on them and if they suffer a bad outcome by not listening to you, then that is entirely on them. You did the right thing by speaking up, but that’s the most you can do.

Hormone Replacement Therapy

Hormone replacement therapy, or HRT, is considered the first major step at transitioning since it lowers the hormones the body naturally produces and replaces them with the hormones of the opposite sex. While this will cause significant changes to the physical body in ways that feel right, there is also a dark side that is overlooked. Anytime human intervention is involved in the natural ways the body functions, there will be consequences. By lowering the hormones that the body makes, you’ll be messing with the plethora of functions those hormones serve, which goes far beyond secondary sex characteristics.

Helps Pain & Anxiety
Delta-9 THC Gummies
Delta-9 THC Gummies
Save 15% By Using Code AUT15
samples of Blood for sexual hormones
© angellodeco

Hormones will definitely affect your sex drive, even completely getting rid of it. It will affect your ability to reproduce, which is why it’s important to plan ahead. Your energy levels may suffer, and some days you’ll be so weak and fatigued, you may experience extreme weight gain or loss, poor digestion, brain fog, and the inability to sleep. HRT may affect both your thyroid and hypothalamus which will cause a plethora of health problems.

Sex Reassignment Surgery

Sex reassignment surgery, or SRS, is often considered the final step in the transition process and involves removing and reconstructing the genitals the person was born with to appear more like the sex they’re transitioning to. Just like HRT, anytime human intervention is involved in the natural ways the body functions, there will be consequences. Since the body no longer produces the hormones that are natural to it, the individual no longer will need to take a blocker and can lower their hormone dosage considerably. While this is a plus, the effects from having too low of the natural hormones the body needs to function is a real issue.

Finding this article helpful?

Consider donating to help support my website and content. Your support makes a huge difference!
Sex-change operation
© adragan

Take the side effects from HRT and ramp it up by ten since severe thyroid and hypothalamus issues could occur, extreme weakness and tiredness, and even worse digestive issues, weight gain or loss, and little to no sex drive. Over time, the body will deplete its own resources to make up for the lack of birth sex hormones that it needs to function. The body will try to use the hormones the person is giving it, but it’s not the right ones since it needs the hormones that it’s designed to have, which are the ones it previously naturally produced.

On top of the hormonal issues, there are surgical issues that can leave the person unable to have a sex drive, be numb, have wounds that won’t heal, which also deplete the body of resources since it’s always trying to heal something that can never be healed. All of this makes SRS a high risk, high reward procedure for many trans individuals since there is no going back.

My Experience

Speaking from experience, while HRT has allowed me to present as a woman, the side effects over time have been devastating, especially after SRS. I have identified the following effects from estradiol specially, especially as the dosage increases:

  • Fatigue & Weakness
  • Coldness
  • Low sex drive and turn off from relationships
  • Low self-confidence
  • Extreme Dehydration
  • Poor digestion & extreme weight loss
  • Mucus & difficulty breathing
  • Brain fog
  • Poor sleep and no dreams
  • Lower bone density and tooth enamel
  • Slow wound healing

Many of these effects are considered to be a hypothalamus dysfunction which has been directly linked to my intake of estradiol, especially with a higher dosage. Pills were the most devastating since the standard dose is 4mg a day since 90%+ of it is filtered out by the liver. Patches were the lowest dose at just 0.3mg a day which remedied almost all the issues, but caused skin irritation and hot flashes over time from my estradiol levels being too low. Then injections are middle of the road by preventing my levels from being too low and causing menopausal systems, but also getting rid of my sex drive, causing dehydration, and extreme weight loss. It may be time to start adding some testosterone, but that may not correct what has been damaged.

Not All Hope is Lost

But, not all hope is lost. If you feel as though these negative effects are too much for you, then you have the choice to go as far with your transition as you’re comfortable with. No one should pressure you into taking the next step when you’re not ready. So, don’t be swayed by someone else’s demands, but instead listen to your intuition and what you’re comfortable with, weighing the pros and cons to determine if the side effects are worth the positive effects you may experience.

Let me know how this works for you. Have a great day!

Additional Info

I was in denial for many years about HRT causing my plethora of health problems. However, it caused me so much harm, making it hard to breathe since I had so much mucus in my lungs. This caused me to have brain fog and unable to think clearly. I was unable to sleep well, felt extremely weak, and had zero sex drive. Not to mention the dehydration that was absolutely insane. I would drink 14 cups of water a day and barely urinate, yet never feel hydrated. While the injections are far better, some of the problems are still there to a lesser degree. Testosterone may be the only way out of this mess.


LGBT / Transgender / TranssexualHormonesSRSTransgender / TranssexualTransition

About the Author

Autumn Asphodel
Autumn Asphodel helps others live a better life through natural means, hard work, and dedication.

Get my FREE eBook & New Videos!

Inline Feedbacks
View all comments