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So You Want To Transition?

A Few Things To Reflect On First

Oh the bane of existence for every transperson; transition.  Should I? How far should I go? It seems that every one of us is under the mistaken impression that transition is a cure for our situation.  It is not a cure; there is no "cure".  What transition does for us is make it easier for us to live with our gender and sex.

We are transsexuals for life although for those of us who do transition we feel more like the female (or male) that we are.  My personal take on this is that it is a matter of body image first.  We hate what we see in the mirror because it doesn't fit.  This is probably why I refuse  to shave in front of a mirror.  I hate it.  I know of transitioned t-girls who still consider themselves transsexuals.  They are the smart ones.

There are alternatives of course and all too often we overlook those because of this need to transition.  I often wonder how much of this is need and how much is conditioning.

Anyone who believes that transition is the key to their happiness is far from being ready for it.  The key to your happiness is within; your self esteem.  Without that you will never acquire happiness because you have to live with yourself and in the world around you.  You are a transsexual and always will be.  Surgery will not change that fact.  Dont believe it?  Consider you meet a new lover.  You will have to come out to him or her.  If you fail to do that then your journey to transition was a lie.  Surgery may make you happier and more comfortable with yourself but it will not make you happy; only you can do that.

You will still face obstacles to your happiness.  Even if you spent tens of thousands of dollars on FFS, standing next to a genetic woman YOU will always know and feel the difference even if others cant tell that you are post op.  Maybe you couldn't afford the FFS, you still have to live with your face and body in the world.  You will still need the support of others to help you maintain your self esteem.

This doesn't mean everyone has to go full route.  It means you go as far as you want and need in order to fulfill your life as a woman.  That may be living full time or even nothing.  The real part of this however is living full time.  That is what it is all about and nothing else.  Any surgical work is after the fact.  The fact is you are female and you HAVE to live in that gender.

Living full time means exactly that.  There is no waffling here.  This means living, working, playing all as the female you are.  It is a difficult period of transition but it it the actual transition; transition before surgery.  It is that simple.  If you fail here, surgery is not going to change things.  It may make it easier but it wont change things.  Your life as a female depends entirely upon the depth you undertake to live that role. 

The first step to this is self acceptance.  This is simply understanding what and who you are and the effects of being a transsexual on your life as well as future possibilities.

The Transgendered Defined.

While to this point the term transgendered has been a generic term to describe all people with gender issues, in the context of transsexualism, it takes on an entirely different connotation.

In this context, the term Transgendered refers to a transsexual who has not or is not transitioned.  I know this seems a bit confusing but not all transsexuals completely transition.  Some make no body modifications at all.  It isn't the degree of transition that makes a transsexual but rather the feelings they harbour inside.  In the past, thinking that anything less than a need for full transition did not qualify one as a transsexual has definitely been reconsidered due to the number of TS's coming forward and opting to not transition.  There are valid reasons for this of course.  However the common thread is that their "brain sex" and their physical gender are at odds.  The other commonality is that if everything was equal, and there were no impediments would they transition and the answer is yes.

The Androgyne

Probably the least considered as a transsexual these people are still TS.  Their position is that they can live their lives as presenting neither as a distinctly female or male person.  With this view of the world around them they prefer to express themselves as having no particular preference to either of the binary genders.  They will dress in accordance with these beliefs and may or may not make very insignificant body modifications.  Some of the less flattering terms used are Genderqueer or Gender Bender.

Non OP.

In this "category" we find people who opt to do nothing except live their lives as best they can in their biological gender, others who proceed to hormonal treatment, those who will undergo HRT and some surgical body modification, and those living 24/7 in their true gender.

This last group can include those on HRT, those who are undergoing some body modification and those awaiting full SRS.

Transitioned TS.

These people undergo SRS to align their gender and sexual characteristics.  The surgical procedures can also include breast augmentation, tracheal shave, and facial feminization.  Other procedures less often performed such as vocal chord surgery can also be done but most surgeons refuse to do anything in this area.

HRT.

I am starting here because this seems to be everyone's goal.  "Oh, oh, gotta get on HRT."  To do so requires recommendation from your pdoc and possibly a supporting second opinion.  HRT is normally started during the Real Life Experience.  That is the protocol of the HBSOC.

I will not go into any detail here simply because I do not in any way want to be a part of someone self medicating.  I am totally opposed to this practice and want to state outright that only a fool would pursue this avenue.  Proper transitioning requires active involvement and supervision by the medical community.  Period.  To not have this is extremely dangerous.  I will not provide any links to websites that do give information about the drugs or their dosages.  Dont even think to ask.

Bioidenticals or herbals are a waste of time and money.  The amount of hormones released by this methodology is so miniscule as to be moot.  Additionally herbals are drugs and they can be contraindicated with prescription drugs you may already be taking.  There has not been a single definitive double blind scientific study that shows they have any effect on transitioning.  Any evidence to the contrary has been anecdotal.

Okay, now that we have that bit of business out of the way let's move on.

Esthetics Changes.

For any TS, either M2F or F2M this is always the first place to start.  Hair length and cuts are altered, ear piercings are performed or grown over, beard removal is done or hair growth is done.  Eyebrow shaping is begun, nails and skin care regimens are changed.  In short the M2F adopts esthetics practices of the genetic female and the F2M does likewise of the genetic male.

Beard removal can be done either by laser or electrolysis.  It is worthy of note that laser beard removal has not been proven to be permanent and in fact can only be used under certain hair and skin types.  Its use is limited even though there have been advances in the field.

Electrolysis uses a mild electric current at the root of the hair to destroy the follicle.  There are three methods to this but the blended method is best.  If performed by a doctor it can be tax deductable.  This process can take a couple of years and is expensive in the long run but on a treatment by treatment basis is reasonable in cost.  It is usually very uncomfortable if not painful for the patient.  Someone undergoing this process usually has access to topical anesthetics and/or painkillers.

Surgical Options.

Surgical procedures for sex change are mutilating to the body, major surgery and not without risk, some of it significant.  It should never be taken lightly.  It involves reconstruction of existing physiology to correct sexual appearance and function.

Female to Male

For the F2M mastectomy is usually the first procedure sought.  Breast removal gives the F2M the desired appearance of a "flat" male chest.

The next procedure usually looked at by the F2M is hysterectomy where the ovaries, fallopian tubes and uterus are removed.  The cervix is sewn closed.

The last surgical procedure for the F2M is to have a penis constructed and vagina closed.  This is perhaps the most complex of any SRS procedure and many SRS surgeons refuse to do it.  The results are often disappointing to the patient.  This may change with time but for now is not often performed primarily because of the extremely high cost and the unpredictable results.

Male to Female

There are a number of options available here from orchiectomy (castration) to full vaginoplasty (construction of the clitoris, labia and vagina).  This surgery is performed routinely all over the world.  It can be very expensive or reasonable if the patient is willing to travel to Asia.  It is still buyer beware though.

Tracheal shave removes the Adams Apple on the neck of the M2F.

Breast augmentation is the same for the M2F as it is for the genetic female.  Other cosmetic procedures include the usual tummy tuck, Botox, liposuction and facial feminization.

None of this is cheap and is not covered by most health plans.  It can run up a price tag of as much as $100,000.  Again, foreign travel does make it much less expensive but still it is costly.

Things to Consider.

Botched surgery is botched and repair, if possible is costly and painful of course.  Maybe you went to Thailand and things didn't quite work out the way they were supposed to after you got home.  The surgeon says come back and we will fix it for free.  Okay but how about the $2000 to $4000 air fare you are going to have to pay plus expenses for your "partner" while you are healing?  What if you get there and the problem cant be repaired?

Okay that is the easy one.  Here are the tougher questions.

Let's start with a reality check.

You are going to begin to transition.  You talked to your HR department and they are non committal but apparently supportive.  Your company now finds that your performance is sub standard and after building a case, let's you go.  Oh sure you can sue them for unfair or constructive dismissal but how much is that going to cost, and after winning how much are you going to get after the lawyers take their cuts of 33% or more?  Is it going to be enough to support you until you can find another job?  That is assuming you can find one.  Remember, you are partly transitioned, your legal status is still with your biological gender, and you need to support yourself in an apartment, furnish it, pay for food and utilities, and still put money away for your surgery.  Divorce settlement?  How far is that going to go?  Maybe you are going to get hooked for alimony and child support too.

How about your partner?  You know the one you married.  Is s/he going to live with a gay relationship?  Remember they are cisgendered and straight.  Maybe the partner you thought could accept you really cant and leaves.

How about the other support systems?  Extended family and friends.  How are they going to accept you or will they?  Church on Sunday?  Okay then what about going out with your friends and the maitre d' announces he made a mistake and your table isn't available and wont be for the rest of the night?

That health insurance plan you paid for is suddenly cancelled.  Want to try to sue the insurance industry?

Then there is the whole safety factor.  Read that one here.

What about love?  Can you live without it if a partner doesn't materialize in your life?  You could be both lonely and alone.  If one does materialize will you be able to disclose?  You will have to of course but remember the world is not friendly to trans people no matter how passable.

The point I am making here is that this isn't all hearts and flowers on a website.  This is a very serious choice and you need to think about this beyond your "need".  Sure you can get your letters and you have managed your RLE but that is only a year and you have the rest of your life to consider.