Target Ranges (Total T, Free T, E2, HCT)
Primary Targets
| Marker | Target Range | Why |
|---|---|---|
| Total T (trough) | 300–1,000 ng/dL (10.4–34.7 nmol/L) | Male range |
| Free T | 50–200 pg/mL | Active fraction |
| E2 | < 50 pg/mL (< 184 pmol/L) | Suppress feminising effects |
| Hematocrit | < 54% | Prevent polycythemia |
What the Numbers Mean
Total T
| Level | Interpretation |
|---|---|
| < 300 ng/dL | Too low; increase dose |
| 300–1,000 ng/dL | ✅ Target |
| > 1,000 ng/dL (trough) | High; reduce dose |
E2
| Level | Interpretation |
|---|---|
| < 50 pg/mL | Well-suppressed |
| 50–100 pg/mL | Borderline |
| > 100 pg/mL | Elevated; consider aromatase inhibitor |
Hematocrit
| HCT | Action |
|---|---|
| < 50% | Normal |
| 50–54% | Monitor; consider blood donation |
| > 54% | Reduce T dose or phlebotomy |
References
Hembree WC, et al. (2017). Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. JCEM, 102(11):3869–3903. https://academic.oup.com/jcem/article/102/11/3869/4157558
Coleman E, et al. (2022). Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. International Journal of Transgender Health, 23(S1). https://www.tandfonline.com/doi/full/10.1080/26895269.2022.2100644
UCSF Transgender Care. Masculinising hormone therapy — monitoring. https://transcare.ucsf.edu/guidelines