I am often asked what we can expect in terms of breast development after starting estrogen therapy by a many of of my transgender patients. This is an area of very limited research and I will do our best to shed some light on this topic
Breast Development in Transgender Women
Normal breast development: breast development is a complicated process that starts at birth in biological females and then accelerates during puberty.
There are 5 stages of breast development in biological females and transgender women. The timeline of breast development in transgender woman can vary significantly depending upon the age, dose and duration of feminizing hormone therapy with estrogen. There can also be variation depending upon the type of estrogen modality used such as oral estradiol versus topical, estradiol injection or estradiol pellets.
| Stages | Timeline | Changes |
| Stage I | 3-6 months | Tip of the nipple is raised |
| Stage II | 6-12 months | Breast buds appear, both the breast and the nipple gets enlarged. A dark circle develops around the nipple which is called areola. |
| Stage III | 12-16 months | Further enlargement of the breast tissue |
| Stage IV | 2-3 years | Elevation of the nipple and the breast and increase in size of areola |
| Stage V | Transgender women are unlikely to achieve this stage. Surgical breast implants are required if a larger breast size is desired. |
Transgender women MTF Transition Pictures
We are sincerely thankful to our patients for allowing us to use their transition pictures to help guide others in their journey.
Progesterone therapy:
Progesterone therapy is recommended for transgender patients to decrease the negative side effects of estrogen. In my personal opinion, Progesterone supplementation does not significantly change the development of breast tissue.
Testosterone blockade:
Testosterone suppression with anti androgen such as spironolactone, bicalutamide, finasteride or additional medications are required to augment breast development. Elevated testosterone levels have a negative effect on breast tissue development and ideally should be maintained below 100 ng per dL.
have questions about gender affirming hormone therapy? Schedule a consultation with our transgender care doctors in Las Vegas.
Dr. Raj Singh MD, FACP, FASN
I am a transwoman and I have size 42C breasts. You through your site say no one can reach anything greater than a a or b.
Hi Joanna, Thanks for sharing your comments. Breast growth with GAHT is based on the available data and applies to majority of cases however, We are all unique individuals with different metabolism.
Dear; Doctor my question is I'am a male 68 years old, and I feel the urge to get in contact with a transgender male,the thing is that they have a body just like women everything looks real like a women body the only different is a penis hang in there, I'am turning gay? please answer me tank you very much.
Thanks for the comment. There is nothing abnormal in being curious about other genders. It is a part of human sexuality. My advice would be to seek a mental health professional who can help you navigate the anxiety that you are experiencing.
I'm actually just beginning the journey of MTF HRT and the one thing I've noticed and have found is that many who start have very little breast tissue if any at all and they all seem to end up at various cup sizes being A to a small C within 2-3 years of transition. The thing I'm wondering is where exactly id end up at least on paper for a general idea, since I'm actually beginning with natural 46C cups due to a mistake as a teenager that caused my body to develop breast tissue (long amusing story) I've been told that starting with actual breast tissue (at least where I'm starting) is a very solid foundation and can be very beneficial for increased breast growth over the course of the years being on HRT.