Gender Affirming Procedures

How To Transition MTF Without Hormones?

Making a gender transition from male to female (MTF) often involves taking hormones. Hormone replacement therapy—sometimes called a chemical transition—can help suppress aspects of the body that present more masculinely and promote a more feminine appearance. For example, excess body and facial hair growth can slow and thin while taking MTF hormone replacement therapy.

However, not all transgender women find it necessary, easy, or possible to chemically transition. Can you transition without hormones?

MTF Transition Without Hormones

It is possible to transition without hormones. Some simply begin outwardly presenting as their true gender while never undergoing any aspect of a medical transition. However, for most people, this will not be adequate due to gender dysphoria. Yet, the extent of the gender dysphoria and whether certain aspects of transition are necessary will vary from patient to patient.

A patient who chooses not to transition using hormones chemically may determine that a physical transition via medical procedures is necessary. For example, there are several surgeries and procedures that a transgender woman may undergo to appear more feminine and improve their quality of life. One example is a brow bone reduction surgery female gender affirming procedure that reduces the size and protrusion of the brow bone. This particular surgery can also be part of a larger facial feminization surgery.

Other procedures a transgender woman may undergo as part of a physical transition:

  • Breast augmentation
  • Body contouring
  • Brazilian butt lift
  • Facial feminization
    • Rhinoplasty
    • Brow lift
    • Lip lift
    • Hairline feminization
    • Hair transplant
    • Jawline contouring
    • Tracheal shave
  • Laser hair removal
  • Filler injections

Patients may also seek out bottom surgery, but Dr. Sajan does not perform nor specialize in bottom surgery.

The Right Transition For You

Every patient has a unique gender transition experience. Identifying the procedures right for you can take time and therapy. It may even change over time and as you undergo other transitional procedures. A hormone transition can be started before or after a physical transition, so do not feel pressured to commit to it right away.

If a patient is ready to consider a physical transition, Dr. Sajan can help patients determine the procedures they qualify for. He does not push procedures on patients who do not want them, even if they would benefit. Dr. Sajan can discuss each procedure with you and give you an understanding of what each entails.

Additionally, some transgender people choose not to transition in anyway beyond socially. This is also perfectly valid and—should a patient change their mind—they can see hormones or physical transition throughout their lifetime. Therefore, hormones are not a necessary part of an MTF transition, but it is one frequently sought out.


Dr. Javad Sajan is one of Washington’s leading surgeons who specialize in gender affirming surgery. He has worked closely with the transgender community around the globe for his entire career. Dr. Sajan has also traveled to Spain to attend one of the world’s top facial feminization seminars. To learn more and schedule a consultation with Dr. Sajan, call us at 206-990-0060. Patients can also reach out online via chat or contact form.