This question has received a major rewrite and restructuring but is still the same original question.

  • Please see this meta-post, where I asked for advice on how to refocus this question. While I have taken everything mentioned onboard, all edit choices are obviously mine.
    • In the meta-post it was advised to focus on sex rather than gender.
  • I decided to still use the term transgender.
    • This was so that historical options, and previous answers are still relevant.

In the very far future, on a planet very far away...I have a human societal structure that, on the large part, accepts the concept of being transgender. As in several pre-modern Earth societies these transgender groups have been incorporated into society in various different ways to various different degrees of acceptance. It is in no way a Utopia, so for the purposes of this question, we can just assume no social or legal issues.

This society has the same knowledge as we do today including knowledge of genes/hormones/genetic traits/dna/chemistry/biology/pyschology/ even physics etc. However they are limited in that their technology is not as developed as ours. They are working on it, but physical infrastructure takes time to rebuild. At a push they could recreate ~1850 AD European Earth Tech.

Several of my characters wish for their body's sex-based characteristics to appear more like their opposite sex. They require various strong hormones (either synthetic or natural) as well as much weaker herbal supplements in order to change their outwards sexual appearance. However, would they even have access to these highly processed and synthetic drugs without modern technology and infrastructure?

If we knew in the past, what we know now, what strength of medicine could be made available?

  • Modern medical techniques such as plastic surgery & sexual reconstruction are not available.
  • they are limited to what changes they can bring about through drugs.
  • the changes they are after are about changing their 'superficial' physical appearance as much as possible to that of their desired sex. Such as:

    • reducing or limiting menstruation and PMS side effects (this can be useful for all women who may also suffer from painful or irregular menstruation)
    • increasing breast development or if started early enough, limiting breast development
    • increasing/decreasing the appearance of the adams apple
    • voice changes
    • facial hair growth
    • increased strength (steroids, which anyone could use), and even
    • reducing the effects of menopause (which affect 100% of the population at some time or another) etc.
  • Would there be natural, or easily recreated, hormone replacement therapy supplements that they could take, if my characters wished to make these hormone-based sex changes?

    • Note: the question is not about those particular examples but rather if we can create strong enough medication that could possibly affect those examples.

If this is not possible with today's knowledge, a well explained negative answer can be accepted. If this is possible, examples of good answers I am looking for would be focussed medically and on changing the human body's sexual characteristics.

The rest of the text is just some of my thoughts on the problem and is not necessary to be read, but I have kept as it may help.

I need to know how I can describe my characters, which is most definitely story-based. So I am trying to figure out what alternate medical options would be available to them, I am thinking mainly herbal. However, I do not know if herbal supplements would be strong enough to make such changes to the body. I doubt very much that it would be able to do anything close to what modern medicine can provide. I'm not so much looking for answers on if they should or would take this medicine. That would be an opinion and story-based answers.

Historical methods of how transgender people lived in the past are very useful but not exactly what I am after either. I am genuinely curious about taking our current medical knowledge of hormones and supplements and how the body works, into a historical setting. So for instance, if we didn't have modern equipment but still had the modern day knowledge of chemistry etc., could we partly/fully replicate the extraction, processing and concentration techniques that would be necessary to make use of natural hormone sources from various plant and animal products eg the horse urine of a pregnant mare that SudoSedWinifred mentioned in an earlier comment. I am assuming there is some pretty high precision machinery and chemistry involved.

Positive answers could (but don't have to be an exhaustive list) include methods of reducing/increasing the testosterone/estrogen and other related hormones, as well as mention how effective each solution could be. Probably not as completely as possible as in today's time but hopefully to some noticeable effect. Traditional practises of castration would be acceptable but I am hoping there are some non-invasive options available to reduce undesired hormones etc. For the most part, there are not many non-invasive options before the advent of modern medicine.

I used the pre-industrial tag purely to emphasise that the infrastructure level is lower than the knowledge base. Please limit any technology for any processing of medicine, to technology that could be created with a ~pre-1850 European infrastructure base.

I've edited further. Just incase.

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    $\begingroup$ Im voting to close based on the nature of this question being primarily political and opinion based with little regard to world building. In addendum this is an open forum and telling people who disagree with you to "move along" adds a level of vitriol and angst to the community that I would like to not be seeing. $\endgroup$
    – TCAT117
    Commented Apr 4, 2018 at 21:41
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    $\begingroup$ @TCAT117 You can't close a question because the topic is controversial. The question is adequately scoped, about worldbuilding, and not rude or offensive. The question is about medicine and not current world politics. Even if the answer is 'there is no way to do it,' it is still a valid question. It should stay open. $\endgroup$
    – kingledion
    Commented Apr 4, 2018 at 22:04
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    $\begingroup$ Public service announcement: The B.A. thesis linked by @SudoSedWinifred attempts to cast a very modern light on an ancient religious cult. It uses non-traditional language and provides non-traditional views; it is highly recommended that would-be readers first make themselves acquainted with the traditional description and understanding of the cult of Cybele. After all, Cybele is no longer worshipped anywhere in the world, and the effect that her cult had on the Roman society was conditioned by how the Romans perceived it then, not by how it might have been perceived in the 21st century. $\endgroup$
    – AlexP
    Commented Apr 4, 2018 at 23:07
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    $\begingroup$ @EveryBitHelps --- I do have an issue with this statement: This society while having a modern, or slightly future, knowledge and understanding of transgender issues. It is no more or less "modern" to accept the "standard" two-gender system than it is to go along with the "everyone gets to make up their own gender" principle many people follow these days. The political bias really has no place in an otherwise interesting worldbuilding question. If you'd like the question itself to be less opinion based, simply edit out the political slant! $\endgroup$
    – elemtilas
    Commented Apr 5, 2018 at 0:55
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    $\begingroup$ I think you could duck all (reasonable) accusations of your question being overly political simply by removing everything below the first horizontal rule. It's really not necessary to your actual question, it's just defining terms that are already linked (and which anyone who ought to be offering up an answer should have no trouble with, anyhow) and throwing up guards at anticipated political difference. Your entire question is in the first part. Of course, it may not get reopened anyway, but this is a weird stack. $\endgroup$ Commented Apr 5, 2018 at 7:34

3 Answers 3


The history of transgender people is really interesting, I would recomend for you to give a good read about the ways the many ancient civilizations treated the subject.

Unfortunately, before the industrial age, most transition was a question of ritual and social standing.

There was never any plant capable of offering the same you can do these days with hormonal replacement.

If it's not too late, whoever there's a legend that could help you: Silphium.

This plant was known to be used by the romans as contraceptive, but we never managed to find what exactly this plant was and many believes it has been driven to extinction because of widespread roman use.

Depending on exactly when/where your story takes place it wouldn't be too hard to handwave a few sprouts surviving and being used.

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    $\begingroup$ Silphium was mostly used as a condiment. (That is, 99.9% of the production was sold as a condiment.) As any other garden plant, it was also used (with what effect, we don't know) to treat gout, rashes, warts, and what have you; it was also said to be an abortificient, or "next day" contraceptive (Wikipedia says that Pliny says it could induce menstruation). $\endgroup$
    – AlexP
    Commented Apr 11, 2018 at 8:14

The big thing to remember is that transgender people are a minority of a minority - as little as 0.2-0.3% of the population. Contrast being gay, which clocks in at one in ten. Most people in today's age of interconnectivity won't meet even a single transperson, let alone in pre-modern conditions. The most famous western example was the Marquis d'Eon, who effectively blackmailed the King of France into recognising her as a woman, and even she's pretty obscure (though transgenderism did come close to being named Eonism after her).

With that in mind even cheating in modern medical knowledge for the setting would make it pretty difficult for transgendered people - even those with significant means to go with their motivation.

But not impossible. Synthetic hormones are produced today using soybeans, which could be procured with effort. From there it wouldn't be outside possibility for a skilled chemist to develop a path to synthesise the appropriate hormone - whether for transition or something more pedestrian like menopause.

Bearing in mind the combined rarity of the condition, the difficulty in procuring the raw materials (both base and any reagents needed for production), and the need to retain a personal chemist of no small skill, the whole process of transition, while possible, would be difficult in the extreme.

Definitely only for wealthy monarchs or high ranking aristocrats.

(Surgery? Sink me, no. The only thing you'd get that way, in those conditions, is another victim of infection.)

  • $\begingroup$ "transgender people are a minority of a minority" This needs to be emphasized, since the percentage of transgendered people in the US is only 1/3 of 1%. $\endgroup$
    – RonJohn
    Commented Apr 13, 2018 at 20:31
  • $\begingroup$ @RonJohn Yeah, the number is around 0.2-0.3% or so, it's pretty rare $\endgroup$
    – Pingcode
    Commented Apr 13, 2018 at 22:41

You actually answered your own question. You say this society has no advanced medical technology or science as of yet ("...does not have the medical infrastructure/technology to fully transition on a physical level"). Modern techniques such as hormone therapies and reassignment surgery are all very much out of reach for your society I deem. And it's really a kind of bizarrely lucky happenstance it's available to people in the 21st century at all. Without the massive strides taken in plastic surgery between the 1860s (US Civil War) and the 1920s (WWI), our society simply would not be able to turn the male body into a reasonable simulacrum of the female body (and vice versa).

Leaving aside all the politics and social uproar over this particular issue, biologically speaking, if the people of your society are like humans (of if they are humans), then they come in two basic forms: female and male. There's really just no getting around that, regardless of what activists would like us to believe.

Barring magic (whatever that might mean to your society), there are no "herbs" or "diets" or "behaviours" or "rituals" or "concoctions" of any kind that will transform a male into a female.

Your best bet will be to look at how various societies here on Earth have dealt with the very few who really are different: use of clothing, language, cosmetics / adornments, social status change, name change, etc.

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    $\begingroup$ Simply wrong on a few accounts. For one, castration, even including penectomy was available to the ancients and practiced occasionally even by free adolescents and adults, not just those too young or otherwise not free to object. Mastectomy was also practiced, though as far as I know usually for reasons of sexual renunciation rather than gender transition. $\endgroup$ Commented Apr 5, 2018 at 5:34
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    $\begingroup$ Also, intersex conditions have been a reality in human populations throughout human history. It may be that our age of industrial and medical waste has increased the incidence of intersex births and they are now more common than previously, but they have always been with us in some proportion. $\endgroup$ Commented Apr 5, 2018 at 5:34
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    $\begingroup$ Finally, the asker is not asking a question just about the real world, but a world they're building. While in the real world no plants produce an estrogen or testosterone analogue that is effective in humans, there's absolutely no reason there can't be such a plant in everybithelps's world. There are some in the actual world that come quite close. The first commercial estrogen replacement drug was Premarin, which is derived from the urine of a pregnant mare, and is still in use. It wouldn't be contemporary lab-quality, but you could make a dirty conjugated estrogen with medieval equipment. $\endgroup$ Commented Apr 5, 2018 at 5:43
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    $\begingroup$ Thanks for the answer. I did stipulate that we wouldn't be able to do any of the surgical procedures & therefore I have no intention to "be able to turn the male body into a reasonable simulacrum of the female body (and vice versa)." Hormonally there's always the ancient surgical technique of castration which would reduce the amount of testosterone in a transgender female. So while it wouldn't be a full transition as we would consider it today, it's an available option from the past that would affect someone on a hormonal level. If they decide to go ahead, is up to them on an individual basis. $\endgroup$ Commented Apr 5, 2018 at 7:33
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    $\begingroup$ Omnibus: Castration is not & never has been a mode of gender reassignment. Intersex conditions: note that I am not denying the existence of such things. Nature of the question: OP doesn't specify anything upon which to base an answer other than one either based on the primary world or one that amounts to "dude, it's your world, you do what you want!" OP: yes, castration will reduce testosterone, but it will not increase estrogen, etc. Take a look at pictures of Alessandro Moreschi for the result of adolescent castration. $\endgroup$
    – elemtilas
    Commented Apr 6, 2018 at 0:45

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