Questions:
1. Are body altering hormone treatments recommended at such a young age?
2. What would be the effects of testosterone shots?

Both sister and niece seems to feel this is a way to have her “fit in” better socially, but I disagree and am very concerned.

A: There is something known as the “Harry Benjamin Standards of Care” for people who wish to undergo sex reassignment. You can read more about them on the University of Minnesota site Under the Standards of Care, the treatment of adolescents is usually not done until age 18. This is because by this age, most adolescents are done with puberty and the hormone treatments will interfere less with their development. It does mention some cases in which hormones may be started earlier, usually at age 16. You can read in this document about the criteria doctors use when deciding whether a particular person is a good candidate to begin hormone therapy before age 18.

Shots given in this instance would have a few different effects: the first sets of hormones given suppress the menstrual cycle, then after some time taking these hormones, testosterone shots would be given. These shots have effects very similar to male puberty: deepening of the voice, growth of facial and body hair, increase in muscle mass, and development of other masculine characteristics.

We hear you are concerned about your niece; you may want to ask her as well as her doctor about the Standards of Care and how they are following them. You may also want to look at some resources about transgender issues. We would recommend Trans-health and TransGenderCare.

A: Sexual Reassignment Surgery is something many transgender people consider. It is possible for M2F transsexuals to achieve sexual pleasure with their new vagina and clitoris. The ability to be satisfied is something transsexuals may have to re-learn and become comfortable with – it does not generally happen automatically. Losing the ability to achieve pleasure and satisfaction is definitely a risk of the surgery. Request that your surgeon go over these risks before operating.

Here is a resource of many medical articles about the procedure, some with photos, that may clear up confusion.

As for the libido it would depend on many factors. The testicles are removed but many M2F transsexuals take hormones that would affect libido. It’s something you would need to find out from a medical source.