Starting estrogen in March 2023 was one of the most exciting and terrifying decisions of my life. Like so many trans women, I had high hopes, cautious expectations, and an emotional roadmap built from Reddit threads, YouTube transition diaries, and medical handouts that felt more like disclaimers than guidance.
The first year was intense. Emotionally volatile, physically transformative, and deeply affirming. My skin softened. My face changed shape a bit. My emotions came alive in ways that made me feel connected to myself for the first time. I cried, I laughed, and I found peace in the mirror on some days, at least.
But now, in August 2025, things feel like they are slowing down.
Welcome to the second puberty plateau.
What Is the Second Puberty Plateau?
The “second puberty” is what many of us call the early stages of HRT. It mirrors the rapid-fire changes of adolescent puberty, only this time you likely know how to pay bills and have developed a complicated relationship with skincare routines.
During the first 12 to 18 months of HRT, many trans women experience significant physical and emotional shifts:
- Breast development
- Fat redistribution
- Skin softening
- Emotional regulation changes
- Libido shifts
- Muscle loss or changes in strength
Then the changes slow, and many of us are left wondering: Is that it?
The answer depends on how you frame it. Some changes taper off. Others continue quietly beneath the surface. But you are not done. Not by a long shot.
Why It Happens: The Science Behind the Slowdown
Hormone therapy, especially estrogen combined with testosterone blockers, is powerful. But it does not keep producing visible changes at the same rate forever.
According to endocrinologists and clinical research, the majority of visible physical changes from HRT occur during the first two years. After that, many changes become slower, more subtle, and sometimes harder to detect without a keen eye or regular journaling.
Here are some reasons why things feel slower now:
- Receptor saturation: Your cells adjust to estrogen and may become less reactive over time.
- Fat redistribution slows: You may still gain fat in more feminine patterns, but the dramatic shifts have mostly settled.
- Bone and muscle shifts stabilize: Most muscle mass and strength changes occur early, and then level off.
- Breast development plateaus: While full development can take 3 to 5 years, the most noticeable growth happens in the first 18 months.
- Skin and hair changes become maintenance-based: These continue but usually require intentional upkeep rather than spontaneous improvement.
This plateau is part of the normal HRT process. It is not a sign of failure or something being wrong. It simply means your body has reached a new equilibrium.
Emotionally Managing the Plateau
For many trans women, this slower phase triggers a new wave of dysphoria or confusion. When the early euphoria fades, it can feel like you are standing still. But you are still changing, even if it is less dramatic.
Some common emotional reactions include:
- Feeling disappointed that visible changes have slowed
- Becoming impatient or restless
- Comparing yourself to other trans or cis women
- Questioning whether your body is still evolving
These reactions are valid. I have felt all of them myself. Here are some things that helped me cope:
Recognize Your Progress
It is easy to forget how far you have come when your focus is stuck on the future. Take time to look at old photos or revisit your early journal entries. Talk to someone who knew you before you started HRT. You are not the same person anymore.
Validate Mixed Emotions
It is okay to feel both pride and frustration. You can love your reflection one day and feel disconnected the next. That does not mean your transition is failing. It means you are human.
Take Breaks From the Mirror
The mirror often becomes a battleground during this phase. You start searching for confirmation that you are still progressing, which can make even good days feel uncertain. Step back and focus on how you feel in your body, not just how you look.
Talk to Your Doctor
If you feel like something might be off, whether it is physical symptoms, changes in mood, or energy levels, check in with your healthcare provider. Sometimes a simple blood test or dosage adjustment can offer clarity and reassurance.
The Hidden Work of This Phase
Even if the surface looks calm, your body is still working. The second puberty plateau is less about flash and more about slow, meaningful integration. Think of it as the period when your body gets used to its new normal.
Here are some of the ways that transformation continues quietly:
Breast Tissue Still Matures
Breast development does not stop at 18 months. Tissue density, shape, and nipple sensitivity often continue evolving for years. You may notice small changes well into your third or fourth year.
Skin and Hair Texture Can Keep Shifting
For some, body hair continues to thin or soften, especially with consistent shaving or hair removal. Skin may retain more moisture and become even smoother with time.
Emotional Regulation Improves
As hormone levels stabilize, so does your emotional landscape. You may find it easier to recognize emotional triggers, communicate clearly, or manage stress in healthier ways.
Your Identity Becomes More Grounded
Many of us enter HRT hoping for a specific outcome. But during this plateau, you may begin to let go of the need to “arrive” at a perfect version of yourself. Instead, you learn to live in your identity with more self-awareness and confidence.
When Dysphoria Returns
Unfortunately, a slowing of physical change can bring dysphoria back to the surface. Maybe you feel stuck between worlds. Maybe you still do not see the woman you hoped to become. That pain is real. But it does not mean you are back at square one.
Here are a few ways to deal with dysphoria during the plateau:
- Engage in body-neutral movement like yoga, dance, or long walks
- Journal regularly and include small affirmations or gratitude notes
- Seek out therapy or support groups that include other mid-transition women
- Explore creative outlets like makeup, clothing, art, or writing
- Focus on community to remind yourself that you are not alone
Some people also begin exploring non-hormonal options during this time, such as laser hair removal, electrolysis, facial feminization, or voice training. Others focus on internal development, choosing to heal relationships, pursue new careers, or reconnect with themselves in deeper ways.
Should You Adjust Your Hormones?
This is a decision that should always involve a doctor. There are valid medical reasons to re-evaluate your dose, such as:
- Changes in mood, fatigue, or libido
- Bloodwork that shows hormone levels outside the target range
- A return of unwanted testosterone effects (if you are using blockers)
However, if your labs are stable and you feel generally well, there is no reason to chase further changes by increasing your dosage. More estrogen is not always better. Sometimes the healthiest path forward is to maintain your current regimen and focus on emotional or lifestyle goals instead.
Reframing the Plateau
The plateau does not mean your transition is over. It means your body has reached a place of greater balance. That gives you space to focus on other parts of your life and identity.
Here are some ways to reframe this time:
- Create a visual timeline that shows your physical and emotional growth
- Celebrate milestones you may have overlooked, like wardrobe changes or social shifts
- Reflect on what parts of transition feel complete, and what still feels open
- Recognize that beauty, femininity, and gender are not measured in months or dosage levels
You are not frozen. You are integrating. This is the part where you become the person you imagined, not through change, but through being.
The Bottom Line
If you started hormones in early 2023, you are now standing at a critical point in your transition. The whirlwind of early change has passed. The next phase is less visible, but no less important.
The second puberty plateau is not the end. It is the beginning of embodiment.
You are not failing because you are not transforming as quickly as before. You are not less valid because your changes feel small. You are simply entering the part of your journey that teaches you how to live, rather than just evolve.
Your body is still yours. Your path is still unfolding. And your story is still worth telling.
