The following steps are those taken by other male-to-female transgenders who have completed transition. Because every transition has it’s own unique twists, it’s best to consider this a checklist of things to do, rather than a rigid plan. That means that although each of the following steps is numbered, your situation might require you to follow a different order. Or you may do some steps simultaneously.
The list assumes that you have given a lot of thought to your transgendered feelings and are at the point where you want to proceed. Remember, that you should take each step only when you feel ready for it. And as you take each step, you can tread water for a while before going on. This is important so that you can assess how you are doing. You can even discontinue the process at any time, although you may not be able to undo whatever physical changes have taken place.
Here, then, are the 10 steps to changing your gender:
1) Go to a transgender-friendly medical centre
You will need a GP to monitor your physical progress through transition and to refer you to other medical services. You may also want to arrange regular counselling to help you deal with turbulent emotional stretches.
2) Seek professional assessment
You have several options. You can ask your GP for a referral to a gender identity clinic, or you can be referred to a psychologist and psychiatrist in private practice. Either way, the doctors may want to see you periodically over a period of a year or two. They must be satisfied that you are ready for surgery before they will okay it. For more information on the assessment, see the Harry Benjamin standards.
3) Network with other MTFs
Transistion can be emotionally challenging. It’s easier if you can share the journey with others who are also experiencing it. Try to hook up with a local support group. If there isn’t one, check with your counsellors to see if there is at least one other person you can meet for coffee and to share the good times as well as the not-so-good times. There is also the Internet. You can contact other MTFs in groups around the world.
4) Begin electrolysis on your face
Removing a beard can take 100 to 300 hours. So you will have to budget for the time as well as the money. It’s easier to undergo electrolysis while you are still working as a male. That’s because you must let the hair grow for a few days before each treatment and you will likely have some redness or swelling after. Few people will question a man whose face looks a little battered from time to time, but they will certainly notice it in a woman. After you have done your face, you will likely want to do other parts of your body.
5) Go to an endocrinologist
Your GP or psychologist can refer you to an endocrinologist who will assess you, prescribe hormone therapy and monitor your progress. Don’t try to self-medicate by using someone else’s prescription or by buying hormones through the black market or from other countries. You can actually do more harm than good. With hormones, time is the most important factor, not mega-doses. In fact, mega-doses can cause the opposite effect that you desire. It will take months before you see physical changes on a safe dosage. But there will be more changes over the years and after surgery. Don’t be impatient.
6) Tell family, friends and your employer
This is one of the most difficult steps for most people. Only do it when you are ready and you are sure you are going on to have surgery. A counsellor or psychologist can help you develop a clear plan for explaining your situation to others. You can also talk to other transgendered folk to see how they handled this period. Your employer and friends are more likely to take it in stride than your family. Be prepared for an emotional roller-coaster. But also be aware that whatever pain or embarrassment you experience is a necessary yet relatively short-lived phase of transition.
7) Start living in your new gender role
Many transgendered folk experiment with cross-dressing long before they decide to transition. Transition is different. It’s not fantasy, it’s real life. Now you will start living the full experience, at first in the privacy of your home, then in some carefully chosen social situations with understanding friends, then out in public and finally at work. All surgeons require that you live at least one year in the new role before they will perform surgery. Everyone finds this terrifying at first, but it settles into a routine quickly enough.
8) Change your name
This part is easy. driver’s licence, passport, health records, social insurance, etc. You may also want to get in touch with your former schools and change the name on your records. And don’t forget to contact banks, gas companies, phone companies, cable and credit-rating agencies. Your magazine and club subscriptions only require a letter or phone call to change the name on the label.
9) Choose a surgeon
Most surgeons skilled in doing gender-reassignment surgery will require you to book six months or more in advance. There are only a handful of surgeons to choose among in North America but there are also several in Europe, Thailand, Australia and New Zealand. As you research the available surgeons, you will want to consider, experience, technique, the before and after care, transportation and of course the cost. A good surgeon will willingly supply full details of his services, facilities and techniques. It’s also a good idea to talk to former patients of the surgeons you are considering. The surgeon’s office should be able to offer references.
10) Obtain a recommendation for surgery
Once you have successfully completed the real life experience, the doctors assessing you will send a letter of recommendation to the surgeon of your choice.