: Basics of transition :
The transgender experience is as varied as the people who live it. Not everyone goes through the prescribed medical procedures that lead to SRS. Transsexuals can be as young or old, rich or poor, male or female. I know people who have transitioned as early as 14 years old; as late as in their 50s or even 60s. There are people who go from male to female (MTF) and female to male (FTM). And different people deal with the TG experience differently.
Some people are comfortable being part-time in their chosen gender for years, choosing simply to dress appropriately without taking hormones. Often the need to transition grows stronger over time, especially once the trans-person acknowledges and starts to accept it. Therapy is an important part of making sure that the person is fully aware of the irreversible effects of hormone treatments and that their transgender feelings are not masking other mental or emotional problems.
Once the person is diagnosed with gender identity dysphoria (GID) the therapist might refer the patient to an endocrinologist to prescribe hormone replacement therapy (HRT). For MTFs, this consists of taking large quantities of estrogen and progesterone, plus some kind of testosterone blocker. This can take the form of pills, injections or patches. For FTMs, this means getting regular injections of testosterone or other male androgens. Some effects of MTF HRT can be seen in a few months, such as loss of libido and breast growth, while other effects such as diminishment of body hair, fat redistribution from the waist to the hips and thinning of the skin can take several months or years. The effect of testosterone on FTMs is more dramatic and quicker - growth of muscle mass, increase of body hair, appearance of facial hair, changes in skin texture and deepening of the voice.
It should be noted that contrary to popular belief, female HRT does not cause the voice to change. Once a male has gone through puberty and started utilizing the full range of the larger male voicebox, the only way to change the voice is through speech training. There is a surgical procedure to raise the voice pitch, but it has a very low success rate. One of the biggest challenges for many MTF transitioners is developing a passable female voice.
Hormones affect all the soft tissues in the body, so the effects can be dramatic. However, there are certain things hormones will not change. They can't affect bone structures, so it can't make a tall person shorter, or turn a man's prominent brow bone and square jaw line into a soft, feminine face. Prolonged HRT renders the existing genital functions useless, but does not take away the organs themselves. Surgery is required to effect the changes that hormones cannot.
I am very lucky compared to many MTF transsexuals in many ways - I have soft facial features that only require minor surgical intervention. My voice pitch is naturally high for a male, although the difference between my male and female voice is still pretty dramatic. I had very little facial hair to deal with, having never grown a full beard. I have very little body hair, and even less on HRT. I haven't suffered male hair loss on my scalp as some males do. I don't have a great deal of muscle mass to rid myself of. My biggest handicap is my height - at 6' 1", I've always been considered tall even for an Asian male, so I feel positively gigantic as an Asian female. But the way I see it, everyone has something they don't like about their looks. It's just a matter of accepting yourself the way you are and being happy with your body.
How passable a person is can determine how far they are willing to transition. If a MTF is hopelessly masculine in appearance (think Arnold Schwarzenegger) and can't afford the extensive surgeries to correct her appearance, transition may not be possible because that person could not survive the inevitable discrimination she would have to face. Some people know they need to transition at a very early age. If they are able to obtain the support of their family and transition before puberty has done too much damage, these young transitioners often turn out to be completely indistinguishable from non-TG people, with the exception that they obviously cannot bear children. Older transitioners, or late-stage transitioners, have a harder time from a physical standpoint, but also have greater access to resources not available to younger TS people.
Some TS people believe that transition is something that should be avoided if at all possible, that it should only be something attempted if it's a choice between transition or death. Transition is hard, there's no argument about that. It's probably one of the hardest things that anyone can do in life. But I feel that once you realize that you have to transition, it's best to just get it done with and get on with your life.
Some people are comfortable being part-time in their chosen gender for years, choosing simply to dress appropriately without taking hormones. Often the need to transition grows stronger over time, especially once the trans-person acknowledges and starts to accept it. Therapy is an important part of making sure that the person is fully aware of the irreversible effects of hormone treatments and that their transgender feelings are not masking other mental or emotional problems.
Once the person is diagnosed with gender identity dysphoria (GID) the therapist might refer the patient to an endocrinologist to prescribe hormone replacement therapy (HRT). For MTFs, this consists of taking large quantities of estrogen and progesterone, plus some kind of testosterone blocker. This can take the form of pills, injections or patches. For FTMs, this means getting regular injections of testosterone or other male androgens. Some effects of MTF HRT can be seen in a few months, such as loss of libido and breast growth, while other effects such as diminishment of body hair, fat redistribution from the waist to the hips and thinning of the skin can take several months or years. The effect of testosterone on FTMs is more dramatic and quicker - growth of muscle mass, increase of body hair, appearance of facial hair, changes in skin texture and deepening of the voice.
It should be noted that contrary to popular belief, female HRT does not cause the voice to change. Once a male has gone through puberty and started utilizing the full range of the larger male voicebox, the only way to change the voice is through speech training. There is a surgical procedure to raise the voice pitch, but it has a very low success rate. One of the biggest challenges for many MTF transitioners is developing a passable female voice.
Hormones affect all the soft tissues in the body, so the effects can be dramatic. However, there are certain things hormones will not change. They can't affect bone structures, so it can't make a tall person shorter, or turn a man's prominent brow bone and square jaw line into a soft, feminine face. Prolonged HRT renders the existing genital functions useless, but does not take away the organs themselves. Surgery is required to effect the changes that hormones cannot.
I am very lucky compared to many MTF transsexuals in many ways - I have soft facial features that only require minor surgical intervention. My voice pitch is naturally high for a male, although the difference between my male and female voice is still pretty dramatic. I had very little facial hair to deal with, having never grown a full beard. I have very little body hair, and even less on HRT. I haven't suffered male hair loss on my scalp as some males do. I don't have a great deal of muscle mass to rid myself of. My biggest handicap is my height - at 6' 1", I've always been considered tall even for an Asian male, so I feel positively gigantic as an Asian female. But the way I see it, everyone has something they don't like about their looks. It's just a matter of accepting yourself the way you are and being happy with your body.
How passable a person is can determine how far they are willing to transition. If a MTF is hopelessly masculine in appearance (think Arnold Schwarzenegger) and can't afford the extensive surgeries to correct her appearance, transition may not be possible because that person could not survive the inevitable discrimination she would have to face. Some people know they need to transition at a very early age. If they are able to obtain the support of their family and transition before puberty has done too much damage, these young transitioners often turn out to be completely indistinguishable from non-TG people, with the exception that they obviously cannot bear children. Older transitioners, or late-stage transitioners, have a harder time from a physical standpoint, but also have greater access to resources not available to younger TS people.
Some TS people believe that transition is something that should be avoided if at all possible, that it should only be something attempted if it's a choice between transition or death. Transition is hard, there's no argument about that. It's probably one of the hardest things that anyone can do in life. But I feel that once you realize that you have to transition, it's best to just get it done with and get on with your life.
