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When a transsexual woman starts taking hormones, a number of changes may occur. Muscle mass may decrease. Breast tissue will enlarge similarly to what girls experience during puberty. The skin may soften, and skin lesions may dry up or fall off. Beard growth might reduce slightly, and the fatty layer under the skin may thicken.

There may also be mental changes, though not all report these. Aggression may decrease. Certain types of abstract thought might diminish, possibly making it harder to work math problems or plot a driving route, though that can be overcome with effort. The sense of smell and hearing may intensify (though directionality of hearing may reduce), certain phobias might increase slightly, and anger may reduce. Some even report handwriting changes.

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