Body fat redistribution typically begins within the first 3-6 months of therapy and will plateau after 2-3 years. While under the influence of testosterone, your body tends to hold on to less fat than under the influence of estrogen. During hormone therapy, you will notice your subcutaneous fat thickens over time, especially in your face and cheeks, and will collect throughout the rest of your body. As this occurs, you will notice your muscle definition soften as your skin becomes smoother.
These changes should finalize between 2-3 years of therapy. Changes in body fat distribution will reverse if estrogen therapy is stopped.
Without androgen suppression, your body will collect fat in the android region, or your “gut”. This area is represented in blue on the figures to the right. Over time as your body adjusts to the lack of testosterone in conjunction with increased estrogen, your body fat will migrate from the android region to your gynoid region: the region near your lower stomach and around the hips, thighs and buttocks. This area is represented in magenta on the figures to the right.
As your weight fluctuates naturally, you will find that your body lets go of fat in the android region and holds onto fat in your gynoid region, giving you an “pear shape” body fat distribution as opposed to the “apple shape” that occurs under the influence of testosterone.
Subcutaneous fat is the fat that exists directly under your skin. This is the same type of fat that will collect in your face, allowing you to have more feminine facial appearance.
Body Fat Areas
Fat Redistribution Along a Timeline
Android Fat Collection
Increased Muscle Mass
Fat Migration to Gynoid Region
Less Muscle Definition
Gynoid Fat Collection
Increased Hip Diameter
Although your body will be holding onto more fat, you may gain or lose weight while undergoing hormone therapy. Since it will be easier to maintain a higher fat percentage, it is important to prioritize maintaining a healthy weight through regular diet and exercise. The CDC recommends 150-300 minutes of aerobic activity per week with 1-2 days of strength training. The Physical Activity Guidelines for Americans (2nd Edition) from the CDC can be found here.