Gender dysphoria plagues many of our friends. How we express ourselves through our gender is important to our mental health, and people who feel their body does not match their gender can struggle throughout their life. Herbs may be an ally many of our transgender and nonbinary friends can use to find gender euphoria.
Herbal Medicine for Gender Euphoria
Gender expression is a complex, intersectional, multifaceted issue and lived experience that many people grapple with on some level. Gender is a deeply ingrained performance in our society, and although we see trends towards dismantling the binaries of masculine & feminine, our modern world is an uncomfortable or downright dangerous place for folks who aren’t cis-gender.’
Being ‘cis-gender’ means that one’s sense of personal identity and gender corresponds with their birth sex, assigned based on genitalia. Whereas trans, non-binary, two-spirit, genderqueer, gender non-conforming and gender fluid folks (not an exhaustive list) do not identify with theirassigned birth sex. Since these folks must live in and interact with binary society, it’s common that they will experience ‘gender dysphoria,’ or feelings of discomfort, distress, or trauma in reaction to societal norms, perceptions, expectations, and triggers around gender expression.
Some trans and nonbinary folks will use gender-affirming pharmaceutical hormones and/or receive gender-affirming surgeries. Pharmaceutical hormones can block the formation of testosterone and androgens, increase estrogen or increase testosterone. Taking hormones can alter secondary sex characteristics like fat distribution, hair growth & location, voice timbre, and muscle mass. For many people, these medical interventions are life-saving. They do the magic work of helping one feel embodied. However, it must be said, trans and gender-nonconforming folks do not need or always desire medical interventions to be whole and valid in their expressions.
As a clinical herbalist, I work with people of all genders but tend to attract more folks on the trans spectrum. A significant portion of my clients are trans, and I’ve supported many of them herbally and energetically through gender-affirming surgeries, pharmaceutical hormone supplementation (and titrating on and off), and the emotional/physical/spiritualnavigation of choosing to radically love oneself. The herbal information shared in this article comes mostly from first- or second-hand experience rather than scientific studies, which largely, and tellingly, do not exist on this particular subject. It should be noted that I am not trans myself, and although I identify as queer and genderfluid, I have cis-passing privilege. This herbal information is presented through the lens of practitioner and ally.
I’ve seen herbs work in a multitude of ways in terms of helping folks to achieve ‘gender
euphoria’. Gender euphoria is the happy opposite of gender dysphoria, defined as feelings of satisfaction, joy, or ecstasy, with the congruence, or rightness, between one’s gender identity. For physical gender affirmation, herbs canbe used to create mild secondary sex characteristic shifting effects, or, they can support thebody to counteract unwanted side effects of synthetic hormones. Alternately, herbs can be used on an energetic level to help with the emotional and spiritual aspects of gender affirmation.
Note
Most herbs are unlikely to have a significant or immediate effect without any other
transition methods. If you are looking for marked physical effects, prescription hormones are the safest and easiest way to make that happen. The dosages you would need to take of herbs in order to get a physical effect can put too much stress on our organs. As always, do not start an herbal protocol without consulting an informed, trusted herbalist. Each body is unique, with its own energetic constitution that must be considered. Never combine herbs with your pharmaceutical medications without first discussing with a trusted herbalist and your healthcare provider.
Fortifying the Foundation
Herbal medicine works most effectively when we start from a place of nourishment and rest. It’s important to take care of our bodies so they can handle the changes and stress that canaccompany shifting in gender expression. All hormones are made of fat, so it’s important to eat good fats (omega 3s especially) to help the body form and transform hormones and coat nerve cells. Fats form the boundaries of our cells, so we need good fats in our bodies to have solid building blocks and physical and emotional boundaries!
All bodies make the same hormones, just in different amounts. Our bodies also use different amounts of hormones; this is where we can change how our bodies utilize the hormones we already have. Everybody makes progesterone from cholesterol, and that progesterone can turn into either estrogen or testosterone. The estrogen and testosterone in our bodies can also convert back and forth. This is the reason we need to be very precise with both synthetic hormone dosages and the use of herbal medicine. Our bodies want to maintain balance. If we disturb that balance too much, our bodies can convert the desired hormone into the undesirable hormone to maintain balance in our systems, countering the effects we seek.
Herbs to Support Feeling Embodied
Damiana
Largely considered an aphrodisiac herb, Damiana helps us to feel good in our
bodies by increasing sensory capability, helping to regulate the nervous system , and creating a pleasurable embodied experience. Damiana can also reduce pain and tension and elevate mood. This herb is quite popular among my trans clients, as it can help folks feel comfortableand experience pleasure in their physical form. It combines well with other herbs in tincture orelixir form or makes a really lovely tea when combined with herbs like Chamomile and Milky Oats.
Kava
This root, native to the Pacific Islands, has been used ceremonially and socially for
centuries for its pleasurable stimulating but relaxing effects. Kava works to modify GABA
receptors, blocking norepinephrine uptake, noticeably reducing feelings of overwhelm and stress. It can really help to soothe anxiety, circular thinking, and phobias. I find that Kava can show us the difference between dissociation and embodiment, leading us toward the latter. Kava combines well with Damiana to promote deeper social and personal communication and connection.
Note
Never combine Kava with alcohol. Kava can cause intoxicating effects; use it with caution. Those taking pharmaceuticals, recreational drugs, or those with liver imbalances should avoid Kava or speak with a trusted herbalist before consuming.
Herbs to Support Increased Estrogen Levels
Saw Palmetto
Saw Palmetto is a really interesting herb for hormonal effects, and I use it for clients on both ends of the gender-binary spectrum in different situations. Basically, Saw Palmetto helps to slow down the conversion of testosterone into another androgenic hormone called dihydrotestosterone, or DHT, which is partly responsible for masculine secondary sex characteristics. Supplementing with Saw Palmetto while not taking pharmaceutical hormone replacement therapy (HRT) can increase breast tissue, reduce “male-pattern baldness”, reduce some hormonal acne, and increase the appearance of smooth skin. It’s one of the most popular herbs among my clients looking for herbal feminizing effects.
Black Cohosh
Black Cohosh root contains several phytoestrogens compounds and can create similar effects to raised estrogen levels in the body, like increased breast tissue and sensitivity. Black Cohosh can potentially increase estrogen in progesterone.
Additionally, it can be used when titrating off of or on to pharmaceutical HRT to combat side effects like hot flashes. I’ve had many clients who have self-experimented with Balck Cohosh prior to seeing me, and most complained of undesirable effects like migraines. Please only use this herb under the supervision of a trusted herbalist. Red Clover is a gentler phytoestrogenic herb that’s much safer for self-experimentation (and makes a far tastier tea).
Maca
Maca root is known for its effects on fat distribution and is credited with helping to create or enhance breasts and hips. However, Maca also has aphrodisiac effects and can increase erectile capacity and sperm count, which is something to consider depending on personal goals. I sometimes recommend Maca to clients who are on Spironolactone, as it can help to combat osteoporosis, one side effect of that drug. For clients taking estrogen-dominant HRT, Maca can be a nice accompaniment herb that aids in curvedevelopment and maintaining libido.
Note
If you have had estrogen-sensitive breast cancer, you should use caution or avoid phytoestrogenic herbs.
Herbs to Support Increased Testosterone
Pine Pollen
Much like there are phytoestrogenic herbs, there are also herbs that contain phytoandrogenic compounds. Pine Pollen contains the most currently measurable and closest approximation to human androgens like testosterone, DHEA, and androstenedione. Pine Pollencan act like a natural steroid with androgenic effects and supports androgenic hormone production, resulting in masculinizing effects. My clients who supplement with Pine Pollen have reported increased facial hair growth, feelings of more dense muscle mass, and increased endurance/libido.
Ashwagandha
Ashwagandha is an adaptogenic herb that can be a hormonal precursor totestosterone. Several studies demonstrate that Ashwagandha supplementation led to a significant rise in measured testosterone levels in participants. Another double-blind study found that Ashwagandha supplementation decreased body fat percentage and increased muscle size and strength after 30 days. In addition to potentially masculinizing effects, I like Ashwagandha for clients who experience stress and anxiety, as this root also helps to ground, center, and strengthen resilience. My clients have reported feeling stronger, more robust, “more rugged,” and happier due to taking Ashwagandha.
He Shou Wu
This is another wonderful herb for increasing strength and muscle mass. I alsouse He Shou Wu for clients who are concerned about losing hair, as it can help to counteract “male-pattern baldness.” He Shou Wu has the added benefits of reducing oxidative stress in thebody, strengthening the blood by increasing red blood cell count, and improving circulation andenergy levels. There’s speculation that He Shou Wu increases testosterone, but there don’tseem to be any studies related to this fact.
Saw Palmetto
I mainly recommend Saw Palmetto supplementation for clients who are
currently taking testosterone-dominant HRT to prevent or curbside effects like “male-patternbaldness” and/or acne. I find it to be extremely effective for these side effects but I would adviseagainst taking Saw Palmetto if a person isn’t taking synthetic T. In this case, Saw Palmetto should be combined with a good quality B-complex vitamin and about 30 mg of Zinc.
Sources:
(1) Equi Institute, “Gender Affirming Hormone Therapy”
(2) Heart of Herbs Herbal School, “Herbs for Trans Women”
(3) Midnight, Dori. Holistic Health For Transgender & Gender Variant Folks.
(4) Prism Integrative Wellness, “Herbs for Transitioning”
(5) Trans Gender Care, “Phytoestrogens, Natural or Herbal Hormones.”
