Case study—The Transmasculine Survival Guide to HRT

September 2018–April 2019

Project Type
Book Design

RGD's 2019 Student Awards Finalist

Photoshop, Illustrator, Indesign


The goal was to provide a personal and accessible source of information for trans-masculine patients pursuing hormone replacement therapy in Ontario. I wanted to strengthen the relationship between doctor and patient, provide understandable resources, and discourage online inquiries to anonymous sources. To accomplish this, I created a self help/reflection journal that acts as a personal guidebook to transition. The Journal provides resources that use more accessible language than what is currently given to patients, and space to track their transition in a private and safe way. The journal can be used to help trans individuals form questions and start more meaningful conversations with their doctor.

* Based on personal experience pursuing HRT with my family doctor as well as emails to the LGBTQ Health, Systems Navigator at Sherbourne Health Centre

*Based on personal experience pursuing HRT with my family doctor as well as emails to the LGBTQ Health, Systems Navigator at Sherbourne Health Centre

The Problem

The current process of pursuing hormone replacement therapy in Ontario* is quite straightforward on the surface. When you are transgender and want to start your transition, you will most likely approach your family doctor to inquire about HRT. Depending on what your doctor is comfortable with treating in their practice they will approach this subject in a few ways. You can be sent to a psychiatrist to receive a gender dysphoria diagnosis, be referred to a specialist, or be treated using the informed consent model to start right away. After completing any one of these processes and signing the consent form from your doctor you can then start HRT.

What is the problem with this process?

Your doctor will at most provide you with a chart that breaks down the changes you will expect on HRT and when they will most likely occur. They will also tell you of some resources you can pursue that will help you along with the process.

Why does this seem like it’s not enough?, Why am I being sent elsewhere when my doctor is the first person I should go to for questions about my transition? And is this why I’ve found many trans individuals rely on anonymous forum users for their health information?


I conducted a literature review of currently practiced Standards of Care for transgender patients in North America and found:

  • The amount of resources available to patients was small.

  • In these resources the language used was inaccessible to anyone that is not a medical professional.

  • There are some discrepancies in information provided, for example charts show conflicting timelines.

Literature reviewed, Sherbourne Health Center Guidelines & WPATH Standards of Care

I participated in forum discussion on trans male sub Reddits asking questions about other patients experiences pursuing HRT:

  • Found that discrepancies in information is common.

  • Doctors fail to discuss solutions to key concerns although they are informed to do so in the standard’s of care.

  • Emphasis of individual experiences is ignored in the majority of cases. Causing many to be extremely impatient about their changes, and obsessively compare themselves to others online.


The result of my research is a more personal resource rather than another website link or printout. The journal uses easy to understand language, friendly and approachable art direction, and is portable.