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.

A poster illustrating this concept with data found from a study produced by the Endocrine Society can be found here.


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

  • Masculine Silhouette

  • Fat Migration to Gynoid Region

  • Less Muscle Definition

  • Softer Skin

  • Gynoid Fat Collection

  • Slender Shoulders

  • Feminine Silhouette

  • Increased Hip Diameter

Before Therapy

3-6 Months

2-3 Years

Weight Management

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.

© 2019 Sam Nigro, Augusta University

Hormone therapy is not required for any transition or queer experience. Changes from hormone therapy that are outlined in this website are not guaranteed. All changes from hormone therapy are dependent on genetic makeup and can be different for everyone. 

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