▶ 日本語

We are committed to providing an LGBTQ+-inclusive healthcare environment. In June 2023, we established a Transgender Clinic to offer specialized support for individuals experiencing Gender Dysphoria (GD) and Gender Incongruence (GI).

Dr. Shin Ikebukuro, a certified specialist in gender-affirming care (recognized by the Gender Incongruence (GI) Society), leads the clinic. We welcome all individuals seeking support—please feel free to visit us.

 

Medical Services

Counseling

We begin by listening to your concerns and providing guidance on available options and how to begin your transition journey.

Our gender clinic is led by a physician who is both a Gender Incongruence (GI) certified specialist and an OB/GYN specialist, allowing us to offer professional advice on treatment plans.

We provide consultations on:

・Gender incongruence (formerly known as gender identity disorder)

・Hormone therapy

・Surgical options

For those considering surgical procedures, we can provide referrals to appropriate hospitals. If you are pursuing legal gender recognition, we also offer guidance and assistance in preparing for gender-affirming surgery (GAS).

⚠ Please note: Our clinic does not provide psychiatric services and therefore does not issue gender incongruence diagnoses.

 

Gender Clinic Treatments

Our treatment options include hormone therapy and surgical referrals.

If, after careful consideration, both you and the physician determine that medical intervention is appropriate, you may proceed to the next step: hormone therapy.

If you are considering chest masculinization surgery (top surgery) or other gender-affirming procedures (e.g., bottom surgery), we will assist you in selecting a suitable clinic and provide referrals when possible.

 

Hormone Therapy

Hormone therapy can help align your physical characteristics with your gender identity. However, it may have potential side effects.

At our clinic, we ensure safe and monitored hormone therapy through regular check-ups and blood tests under physician supervision.

⚠ Warning: Self-administering hormone therapy without medical guidance can be dangerous. Please consult us before starting any treatment.

 

Gender-Affirming Hormone Therapy

【Masculinizing Hormone Therapy】

Testosterone Hormone Therapy

Testosterone Gender-Affirming Therapy (T-GHAT)

Applicable for:

・Transgender individuals assigned female at birth (AFAB)

・Transmasculine individuals

・FTM (Female-to-Male)

・Non-binary individuals

 

＜Injection (Parenteral) Options:＞

【Short-acting】

Testoviron Depot (100mg, 250mg)

・Active ingredient: Testosterone enanthate

 

【Medium-acting】

Sustanon 250mg

・Active ingredients: A combination of testosterone ester

・Each 1 mL of Sustanon 250 contains:

○ Testosterone propionate: 30 mg

○ Testosterone phenylpropionate: 60 mg

○ Testosterone isocaproate: 60 mg

○ Testosterone decanoate: 100 mg

・Other ingredients:

○ Arachis (peanut) oil (base)

○ Benzyl alcohol (preservative)

 

【Long-acting】

Cernos Depot (Nebido Generic)

・Active ingredient: Testosterone undecanoate

・Cernos contains the same active ingredient as Nebido.

＜Transdermal Options＞

・Gromin (1% testosterone cream)

・1UP Formula (5% testosterone gel)

＜Oral Options＞

・Cernos Capsules

○Active ingredient: Testosterone undecanoate

 

Primary Effects of Testosterone Therapy:

・Redistribution of body fat

・Increased muscle strength

・Growth of facial and body hair

・Deepening of voice

・Cessation of menstruation

・Clitoral enlargement

・Vaginal atrophy

・Oily skin & acne

・Androgenetic alopecia ; Hair Loss

＊Our clinic prescribes finasteride for hair loss associated with testosterone therapy.

Hair loss may begin shortly after starting hormone therapy and varies based on genetic factors. Transgender men may experience frontal and temporal recession or male-pattern baldness (thinning at the crown and receding hairline).
Management is similar to non-transgender men and includes minoxidil, 5-alpha reductase inhibitors (such as finasteride), and surgical options.
Finasteride 1mg daily (Propecia) is FDA-approved for male-pattern baldness and generally has minimal sexual side effects.

👉 For more details, click here.

 

Primary Side Effects of Testosterone Therapy:

・Polycythemia (high red blood cell count)

・Liver function abnormalities

・Cardiovascular diseases

・Hypertension

 

【Feminizing Hormone Therapy】

Estrogen Hormone Therapy

Estrogen Gender-Affirming Therapy (E-GHAT)

Anti-Androgen Therapy (Testosterone Blocker)

Applicable for:

・Transgender individuals assigned male at birth (AMAB)

・Transfeminine individuals

・MTF (Male-to-Female)

・Non-binary individuals

Hormone therapy consists of a combination of estrogen therapy and anti-androgen therapy, which reduces testosterone levels.

 

Estrogen Therapy Options:

＜Transdermal＞

・Gel: L’Estrogel 0.06%, Divigel

・Patches: Estrana Tape

○ Active ingredient: Estradiol

＜Oral＞

・Progynova (2mg)

○ Active ingredient: Estradiol valerate

＜Injections (Parenteral)＞

・Progynon Depot (10mg)

○ Active ingredient: Estradiol valerate

 

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Primary Effects of Estrogen Therapy:

・Breast development

・Redistribution of body fat (feminine body shape)

・Decreased muscle mass

・Softer skin & reduced sebum production

・Decreased libido & erectile function

・Testicular atrophy & loss of sperm production

Primary Side Effects of Estrogen Therapy:

・Thrombosis (blood clots)

・Cardiovascular diseases

・Gallstones

・Hyperprolactinemia

・Dyslipidemia

・Breast cancer

 

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Anti-Androgen Therapy (Testosterone Blockers)

Oral Options:

・Spironolactone

At our clinic, spironolactone is the most commonly used androgen blocker. It is a potassium-sparing diuretic that, at higher doses, blocks androgen receptors and reduces testosterone production.The main risk is hyperkalemia, though it is rare with proper monitoring, especially in patients with kidney issues or those on ACE inhibitors/ARBs. Due to its diuretic effect, some may experience increased urination, thirst, or dizziness.

・5-alpha reductase inhibitors

5-alpha reductase inhibitors, such as finasteride and dutasteride, reduce the conversion of testosterone to dihydrotestosterone (DHT).
Finasteride 1mg is FDA-approved for male pattern baldness.Dutasteride 0.5mg more effectively blocks type 1 5-alpha reductase, which may enhance feminization.
These medications provide partial antiandrogen effects but do not block testosterone production or action. They may be suitable for those unable to tolerate spironolactone, seeking partial feminization, or experiencing persistent virilization or hair loss after full androgen blockade or orchiectomy.

 

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Blood Tests & Hormone Monitoring

🔸 General Blood Tests
We conduct regular tests to monitor your health, including:

・Complete blood count (CBC)

・Liver & kidney function

・Electrolytes

・Uric acid & creatine kinase (CK)

・Lipid profile (TG, LDL, HDL)

・Blood glucose & HbA1c

🔸 Hormone Tests
We can measure:

・Estrogen

・Total testosterone & free testosterone

・Progesterone

・Prolactin

・Luteinizing hormone (LH)

・Follicle-stimulating hormone (FSH)

 

 

Pricing

◆ Testosterone  Hormone Therapy

【Testosterone Gender Affirming Therapy (T-GHAT)】

 

Injections

・Short-acting testosterone injection

▶Testoviron 100 mg: ¥2,500 (tax included)

      250 mg: ¥3,500 (tax included)

・Medium-acting testosterone injection

▶Sustanon 250 mg: ¥3,500 (tax included)

・Long-acting testosterone injection

▶Nebido generic – (Cernos Injection): ¥16,500 (tax included)

※ Initial testing is required before starting testosterone injections (Testosterone: ¥1,500 + General blood test: ¥3,000 = Total ¥4,500). Further tests may be required as needed.

※ A generic version of Nebido is also available in oral form: Cernos Capsules▶ More details here

 

Creams and Gels

・Gromin: ¥4,100 (tax included)

・1UP Formula – Prescription issuance fee: ¥2,200 (tax included)
※ For 1UP Formula, patients must pay for the medication separately at the All-in-One Pharmacy at a later date.
(Estimated cost: ¥12,100 tax included)

 

◆ Estrogen  Hormone Therapy

【Estrogen Gender Affirming Therapy (E-GHAT)】

 

Gels

・L’Estrogel

○ 1 bottle: ¥4,300 (tax included)

○ 2 bottles: ¥6,200 (tax included)

○ 3 bottles: ¥8,100 (tax included)

 

・Divigel

○ 14 sachets: ¥1,400 (tax included)

○ 28 sachets: ¥2,500 (tax included)

○ 56 sachets: ¥4,500 (tax included)

○ 84 sachets: ¥6,500 (tax included)

○ 168 sachets: ¥12,000 (tax included)

○ 336 sachets: ¥22,000 (tax included)

 

Oral

・Progynova

○ 28 tablets: ¥4,000 (tax included)

○ 84 tablets: ¥10,500 (tax included)

○ 168 tablets: ¥18,000 (tax included)

Injections

・Progynon Depot 10 mg: ¥2,000 (tax included)

20 mg: ¥3,000 (tax included)

 

◆Anti-Androgen Therapy（Testosterone blocker）

・Spironolactone

○ 50 mg (30 tablets): ¥3,000 (tax included)

○ 100 mg (30 tablets): ¥6,000 (tax included)

○ 150 mg (30 tablets): ¥9,000 (tax included)

○ 200 mg (30 tablets): ¥12,000 (tax included)

 

・Finasteride (Propecia Generic) 1mg

28 tablets per box (approximately 1-month supply) – Domestic certified product

○ 1 box: ¥4,000 (tax included)

○ 3 boxes (approx. 3-month supply): ¥10,500 (tax included)

○ 6 boxes (approx. 6-month supply): ¥18,000 (tax included)

 

・Dutasteride (Zagallo Generic) 0.5mg

30 tablets per box (approximately 1-month supply) – Domestic certified product

○ 1 box: ¥5,000 (tax included)

○ 3 boxes (approx. 3-month supply): ¥13,500 (tax included)

○ 6 boxes (approx. 6-month supply): ¥24,000 (tax included)

 

◆ Blood Tests

・General blood test for hormone therapy: ¥3,000 (tax included)

・Testosterone: ¥1,500 (tax included)

・Free testosterone: ¥1,500 (tax included)

・Estrogen: ¥1,500 (tax included)

・Testosterone + Estrogen: ¥2,000 (tax included)

・D-dimer: ¥1,500 (tax included)

・Progesterone: ¥1,500 (tax included)

・Prolactin: ¥1,500 (tax included)

・Luteinizing hormone (LH): ¥1,500 (tax included)

・Follicle-stimulating hormone (FSH): ¥1,500 (tax included)

・Prostate-specific antigen (PSA): ¥2,000 (tax included)

 

◆ Consultation Fees

・Initial consultation : ¥2,500 (tax included)

・Follow-up consultation : ¥1,000 (tax included)

・Initial online consultation: ¥2,500 (tax included)

・Follow-up online consultation: ¥1,000 (tax included)

 

Final Notes:

・Availability & pricing of medications are subject to change without notice.

・All prices include tax.

・Prolactin

・Luteinizing hormone (LH)

・Follicle-stimulating hormone (FSH)

 

Cost

◆ Testosterone  Hormone Therapy

【Testosterone Gender Affirming Therapy (T-GHAT)】

 

Injections

・Short-acting testosterone injection

▶Testoviron 100 mg: ¥2,500 (tax included)

　　　　　　250 mg: ¥3,500 (tax included)

・Medium-acting testosterone injection

▶Sustanon 250 mg: ¥3,500 (tax included)

・Long-acting testosterone injection

▶Nebido generic – (Cernos Injection): ¥16,500 (tax included)

※ Initial testing is required before starting testosterone injections (Testosterone: ¥1,500 + General blood test: ¥3,000 = Total ¥4,500). Further tests may be required as needed.

※ A generic version of Nebido is also available in oral form: Cernos Capsules ▶ More details here

 

Creams and Gels

・Gromin: ¥4,100 (tax included)

・1UP Formula – Prescription issuance fee: ¥2,200 (tax included)
※ For 1UP Formula, patients must pay for the medication separately at the All-in-One Pharmacy at a later date.
(Estimated cost: ¥12,100 tax included)

◆ Estrogen  Hormone Therapy

【Estrogen Gender Affirming Therapy (E-GHAT)】

 

Gels

・L’Estrogel

○ 1 bottle: ¥4,300 (tax included)

○ 2 bottles: ¥6,200 (tax included)

○ 3 bottles: ¥8,100 (tax included)

 

・Divigel

○ 14 sachets: ¥1,400 (tax included)

○ 28 sachets: ¥2,500 (tax included)

○ 56 sachets: ¥4,500 (tax included)

○ 84 sachets: ¥6,500 (tax included)

○ 168 sachets: ¥12,000 (tax included)

○ 336 sachets: ¥22,000 (tax included)

 

Oral

・Progynova

○ 28 tablets: ¥4,000 (tax included)

○ 84 tablets: ¥10,500 (tax included)

○ 168 tablets: ¥18,000 (tax included)

Injections

・Progynon Depot 10 mg: ¥2,000 (tax included)

         20 mg: ¥3,000 (tax included)

 

◆Anti-Androgen Therapy（Testosterone blocker）

・Spironolactone 

○ 50 mg (30 tablets): ¥3,000 (tax included)

○ 100 mg (30 tablets): ¥6,000 (tax included)

○ 150 mg (30 tablets): ¥9,000 (tax included)

○ 200 mg (30 tablets): ¥12,000 (tax included)

 

◆ Blood Tests

・General blood test for hormone therapy: ¥3,000 (tax included)

・Testosterone: ¥1,500 (tax included)

・Free testosterone: ¥1,500 (tax included)

・Estrogen: ¥1,500 (tax included)

・Testosterone + Estrogen: ¥2,000 (tax included)

・D-dimer: ¥1,500 (tax included)

・Progesterone: ¥1,500 (tax included)

・Prolactin: ¥1,500 (tax included)

・Luteinizing hormone (LH): ¥1,500 (tax included)

・Follicle-stimulating hormone (FSH): ¥1,500 (tax included)

・Prostate-specific antigen (PSA): ¥2,000 (tax included)

 

◆ Consultation Fees

・Initial consultation : ¥2,500 (tax included)

・Follow-up consultation : ¥1,000 (tax included)

・Initial online consultation: ¥2,500 (tax included)

・Follow-up online consultation: ¥1,000 (tax included)

※ The availability and pricing of medications are subject to change without notice.