You
may be thinking, "Now what?" The road to becoming your
true self can have pot holes and nice roadside stops where
you can enjoy a hot fudge sundae, but it's seldom boring! Some
describe it as a rollercoaster ride and I agree!
How
well your transition goes can be based on several factors: such
as where you live, age, trans resources in your area, how your
family and friends accept you, being married or in a relationship
and the potential for transitioning at a job. There are some basic
steps most of us have taken.
Gender
Identity Therapy
Finding
a gender identity therapist can be easy to impossible depending
on where you live. Most large cities have them. Some alternative
and gay & lesbian publications have listings of therapists
or check the Yellow Pages under gay & lesbian. Networking
with other trans people will often get you leads to therapists
in your area. If you have several therapists to choose from pick
the one you feel most comfortable with.
Like
many things in transition, therapy can be expensive. Try to have
your therapy, and hormones, covered by insurance.
You can sometimes have your therapy covered, even if your insurance
has exclusions for gender identity, if your therapist uses an
anxiety or adjustment disorder as a diagnosis, and likewise
your hormones covered if your doctor uses hormone imbalance
as the diagnosis. If you have to pay out-of-pocket some therapists
charge on a sliding scale, i.e. the cost is proportional to your
income.
I
got Blue Cross/Blue Shield to cover my mones for a year by using
"hormone imbalance" as the reason. When they discovered
that wasn't exactly right and tried to get me to pay them back
I said take a hike! They didn't get a penny!
Most
surgeons require 6 months of gender identity therapy before
SRS. Avoid going to a therapist or doctor who doesn't have
gender identity experience. Though you can sometimes educate
an unknowledgable therapist, or doctor, it's best to avoid them.
They sometimes do more harm than good by misdiagnosing you,
not knowing how to prescribe medications, etc.
Starting HRT (Hormone Replacement
Therapy) is usually done through a gender therapist who refers
you to a knowledgeable doctor. The sooner you start hormones
the better, as the body ages it becomes less receptive to hormonal
changes. The ideal time to start is in one's teens to early
20s. This age range produces dramatic results - some nearly
indistinguishable from their genetic counterparts. But it's
never too late to start!
You
can start HRT and still work as a guy (or woman for the FTM)
for a while, but eventually the changes will be noticed by your
co-workers and customers, like a deeper voice in the FTM (that
happens fairly rapidly on testosterone), breasts and other physical
changes if you're MTF. If you can dress causally at work loose
clothes can hide breasts. FTMs use a binder before a bilateral
mastectomy to conceal the breasts.
If there are no therapists in your area who will refer you for
hormones (or make you live full-time pre-hormones), or you just
want to do-it-yourself, you can order hormones
from overseas pharmacies. This is usually safe unless you take
higher than recommended dosages
or jeopardize your health by taking them when you have a medical
condition such as high blood pressure, cancer or liver damage.
Then you should only take them after seeing a doctor. Most surgeons
require a year on hormones before SRS.
A support group is a safe place to meet for support and camaraderie
and make new friends. If you're in, or close to, a major city
there are probably one, or more, trans support groups. They may
be harder to find in small towns and less liberal areas. As with
therapists, alternative and gay & lesbian publications can
have listings of support groups. You can sometimes get info about
support groups from a GLBT-friendly doctor or therapist and trans
friends. Avoid going to an exclusively crossdresser group, their
issues are different from our's.
Usually
most of us outgrow support groups, but they can be great for support
and camaraderie during your transition.
Personal
Support Network
This
ties into the preceding Support Group. Transition can sometimes
be difficult and lonely. Having a support network of friends and
allies is important, especially if you're currently in a relationship
and your partner is unaccepting or you're having family problems.
Women are generally more accepting (other than spouses) of MTFs
and easier to approach. Finding a GG
(genetic girl) who befriends and helps you is a gem!
Of
course, if your current friends accept the new you they
become your support network. You'll find out who your real
friends are by coming out! Trans-friendly bars, or night clubs,
are another source for finding supportive friends, but be careful
as some people's motives may not be as they appear. There are
many online TS / TG support groups and communities (IRC, AOL,
website chat rooms, etc). They can be a great source for internet
friends and networking, especially if you're in an isolated or
transphobic area.
Hair
Removal (MTF)
If you haven't already you'll need to start electrolysis
or laser ASAP. Electrolysis is still the only FDA recognized
permanent hair removal method. Laser has been approved for permanent
hair reduction by the FDA. Whether there's a significant
difference between removal and reduction is debatable.
Laser is reportedly faster, less painful and can cover larger
areas than electrolysis. Some trans women clear their faces with
laser then clean up with electro. Electrologists and laser
methods and technicians vary in price, type, skill and technique.
It may take a bit to find ones you like.
In
the beginning you'll need to have some beard growth for the electrologist,
or laser technician, to work on. This can make living full-time
difficult, especially if you have a dark beard. You can have electro/laser
done while still working in guy mode or living part-time.
The
decision to transition at your current job, or start fresh at a
new employer, is an important one. Some of the more progressive
companies, like Intel, Microsoft, IBM, etc, have policies regarding
transitioning. Check your employer's anti-discrimination policy.
Also, check your local anti-discrimination laws to find out if gender
identity is included. Even at supposedly liberal companies you can
have problems with co-workers and management.
Where
you live and how well trans people are accepted in your community
effects how you're treated. You may encounter discrimination and
harassment on the job in a conservative area and even some liberal
areas. Unfortunately, it's still legal in most states (US) to
fire someone just for being transgender.
If
you want to transition at your current job, I recommend writing
a letter to your employer stating you've been diagnosed with GID
and "as required by the Harry Benjamin SOC
(Standards of Care) will be transitoning to the female/male gender."
Explain it's a medical condition and you're following the standard
procedures (i.e. hormones, electrolysis, living full-time, etc)
in preparation for your SRS. A letter from your therapist should
be included.
The
bathroom issue can be touchy. It's important to get your fellow
employees thoughts about the restrooms and find out if there are
any company policies in place regarding them. Some employers offer
unisex bathrooms or other accommodations, but there's a fine line
between reasonable accommodation and discrimination. Once SRS has
been performed it's normally accepted that you can use the restroom
congruent with your self-identified gender.
It's
sometimes better to start over at a new job, especially if you're
very passable and avoiding possible harassment, wrong pronoun usage
or termination, though if you have a good job that pays well it
might be better to transition OTJ (on the job).
Changing
IDs and other Personal Identities
Once
you're close to living full-time it's time to change your IDs to
your new name and gender. Usually the first step is getting a court-ordered
legal name change. The procedures differ by state, but typically
you file a form with your state civil court, pay a fee and are given
a court date. Changing your driver's license also varies by state.
Sometimes a letter from a therapist is required - this can be useful
for other ID changes as well. Some states will let you change the
sex on your driver's license before SRS, others require you to have
completed surgery. For Social Security, call your local SS office
for details on changing name and gender. Bank accounts, credit cards,
etc. are relatively easy as long as you have a court-ordered name
change and / or letter from a therapist. For birth certificates
contact the Department of Vital Statistics, or Records, in the state
(USA) you were born to find out what's required. Usually you will
have to undergone SRS to change the sex on your birth certificate.
E-mail:
It may seem trivial changing your email address if it has a male
name, but somehow getting an email from bruce@yahoo.com signed Barbara
doesn't sound quite right. :-)
Deportment:
Voice and Mannerisms
Since
we've lived some, or most, of our lives as the wrong gender we usually
need to unlearn the traits we developed growing up. This comes naturally
to some, others have to learn it. A good way is to study female's
(or male's if you're FTM) mannerisms and imitating them until they
come naturally. Either vocal surgery, or voice
training, is usually necessary (except FTMs, their voices
become deeper with testosterone). Unless you started in your teens,
before you voice changed, estrogen has little effect on voice.
Most
marriages don't last through transition. This is an unfortunate,
but common, consequence of transitioning. A few do, it helps if
your partner is bi or has bi / lesbian tendencies. I recommend giving
your partner accurate information about GID, so he / she can become
educated and realize it's a biological condition and not a choice.
Keep communication open as much as possible. Many people have misunderstandings
about us, think we're being selfish and "destroying the family"
without any regard for them. We can be saddled with guilt and your
spouse, or partner, may compound this by trying to make it your
fault. Couples counseling with a gender therapist may help, but
most marriages end in separation and divorce. Sometimes a partner
may be supportive, or neutral, at first, but as the physical changes
become more pronounced and the reality sets in, he or she may become
unaccepting, even hostile.
Once
you've made the decision to transition and it's obvious your partner
won't accept the new you you'll need to start thinking about
the logistics of separation, how to handle shared properties, belongings,
child support, visitation, etc. It's a necessary step, as painful
as it may be. My advice is try to make it as amicable as possible.
Spouses can be vindictive. Having a support network can be
helpful during this period.
Transition
is necessarily a self-centered process. You have to put yourself
first if you're going to do it right.