It's not hormone replacement therapy in the same sense as is used for relief of menopausal symptoms in women or symptoms of testosterone deficiency in men. The

It's not hormone replacement therapy in the same sense as is used for relief of menopausal symptoms in women or symptoms of testosterone deficiency in men. They don't have any actual hormone deficiency. Instead, they are using hormones for cosmetic purposes, to give themselves an artificially masculinized or feminized appearance in accordance with how they desire to look. It's more akin to people with anorexia starving themselves because they hold a belief that they are obese and must be thinner.