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!
well you transition can be based on many 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.
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.
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. Likewise hormones may
be covered if your doctor uses hormone imbalance as a 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).
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
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 and is permanent!), 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 of HRT 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. 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, or your trans friends. Avoid
going to an exclusively crossdresser grouptheir issues are
different from ours.
ties into the preceding support groups. 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 and easier to approach. Finding
a GG (genetic girl) who befriends,
and helps, you is a gem!
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 (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
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.
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.
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.
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 to fire someone
just for being transgender.
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
bathroom issue can be touchy. It's probably a good idea to get your
fellow employee's thoughts about the restrooms and 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 better to start over at a new job (especially if you're very
passable) and avoiding potential harassment, wrong pronoun usage
IDs and other personal identities
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 have undergone SRS to change the sex on your birth certificate.
It may seem trivial changing your email address if it has a male
name, but getting an email from bruce[at]yahoo.com signed Barbara
doesn't sound quite right. :)
voice and mannerisms
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.
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, i.e. it's a biological
condition and not a choice. 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.
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.
is necessarily a self-centered process. You have to put yourself
first if you're going to do it right.