Ryusuta
Smash Master
Link to original post: [drupal=3066]MtF - The Transition Story (Part 2: Transitioning, body and mind)[/drupal]
In the second "Chapter" of this blog, I thought I would discuss exactly what the male-to-female transition is, since a great many people don't know anything beyond what we see on network sitcoms.
I think the best way for me to begin describing what this transition IS is by explaining what it's NOT. It's not a bird or a rabbit.
In all seriousness, though, there are quite a few preconceived notions that people often have regarding transitioning, and I'd like to do my best to address those things.
First, transitioning isn't a "before and after" sort of thing. It's certainly not a matter of saying "This day I was male, but the next day, or week, or year, I became female." That's not even close to the reality of the situation. There really is no set point at which one can definitively decide that one's "made it," because this transition is basically a lifelong goal.
In reality, most trans people will tell you that they've always been female in one form or another, and wish to bring that out. While I REALLY abhor the old cliche "woman trapped in a man's body," there is at least a kernel of truth in it. It's not to say that ******** think they've always been female. Most are very realistic about the situation, knowing that what they're pursuing is a desire rather than a reality. It's just a matter of trying to find the right point in time when you can say "This part of me is feminine." And I think I can very safely say that there isn't a single transperson alive that didn't feel a small leap in their heart the first couple of times someone addressed them with a female pronoun.
I honestly and truthfully can't remember the exact moment I began to think of myself as "her" rather than "he," but I think I can fairly safely say that it didn't happen all at once.
The next thing transitioning isn't is a sex change operation. Although SRS is a large goal and desire of transpeople, it isn't the only goal and certainly not the ultimate goal. I think the biggest misconception people have about this issue is that a transwoman is a man before surgery and a woman afterward (assuming that they're not the sort to simply call that person a man all the way through their life). It simply doesn't work that way. I'll go over the standards and requirements for surgery as I go on, but for now suffice it to say that it's not the key component to transitioning.
Transitioning is not something you can just decide on a whim. Even if you had no friends and family and a kajillion greenbacks to your name, no reputable medical professional is going to do anything to help you transition to the opposite gender unless you go through the paces. And although this idea frustrated me when I was a teenager, I've come to understand and even agree with this. One obvious thing no one will tell you starting out is that even if you look and sound totally feminine right out of the gate, there are so many subtle mannerisms and nuances in your behavior that might seem a bit off to the people around you. It takes a lot of time and work to acclimate to a female lifestyle.
Transitioning isn't a thing for homosexuals to do to date men. This might be surprising to a good many people that don't know any better, but gender identity isn't the same as sexuality. Nor is it directly influenced by it. (Though obviously the inner workings of our collective subconscious are so complex that it's impossible to say what functions and thoughts are completely individual of other ones.) Trans people can be straight, gay, or bi, same as normal people. And in just about the same ratio.
Basically, I didn't want to become a girl because I thought it would make it easier to date men. The very thought of that idea is actually extremely funny to me, in a tragic way. Tragic, because it's just such an unrealistic idea. It's not a stretch to say that the average Joe Schmoe on the streets is more likely to be transphobic than homophobic. People in general have a much EASIER time accepting gay people, because they don't have the idea that they're trying to hide something. I think in the back of everyone's mind, every transperson is a "Crying Game" waiting to happen. Look it up.
Transitioning isn't wearing a dress, or being fruity, or wanting to parade yourself and "look pretty." I'm extremely conservative about my female appearance. The LAST thing I want to be is a drag queen. Transvestites dress like girls for entertainment and/or sexual value. Transsexuals have a desire to BE female rather than just dress that way.
So, those are the basic things that are assumed about transgenderism, but aren't the case. What IS the case? To be honest, I don't know. I know my parents are likely to call me by my male name for the rest of their lives. And while that is unfair and hurtful of them, it's also not entirely wrong. I'll never be a birth female. I'll never have all of the female parts exactly as a birth female would. The first couple decades of my life were spent as a male, and I would no more deny that than I'd deny that the sun rises in the east and sets to the west. It's just reality.
What I feel transitioning does is puts me as close as I can possibly come to the form that allows me to engage in the sociological imperatives I find desirable in a way that is understandable to the people around me.
For every individual, there is a variation on the process of transitioning. However, the generally practiced guidelines in the United States are as follows:
-First, you make the decision to address the feelings of gender disphoria you've experienced. For the majority of transpeople (though not QUITE all of them), these feelings start very early on and grow as time passes. This step isn't easy at all, and as such a lot of transpeople have a bunch of false starts, in which they decide to transition, and maybe even take a couple of steps, but then they panic and hold back, fearing repercussions.
-The second step is to meet up with a dedicated practitioner, able to diagnose you with GID (gender identity disorder). Though there are no hard-and-fast outlines for this, many therapists desire at least a couple of weeks to a month of knowing the patient before they're willing to make this diagnosis.
-The next step really varies depending on age, marital status, appearance, and financial situation. The person can begin attempting to gain RLE (real-life experience) by trying to dress in public as the target gender. This is NOT a realistic goal in many cases, especially for older people, people who have family, friends, or coworkers that can't hear about their transition yet, and people that look TOO much like their original gender to even hope to pass.
What will often happen if a person is prepared to amass real-life experience is that they will be given a letter from their therapist, which is a legal documentation proclaiming you to be of sound mental health and not a threat to yourself or others. This letter (often called "The letter," or "The note") is actually a very important thing to have when starting out, because if you get pulled over by a cop or carded someplace and you're obviously presenting as female, there can often be severe misunderstandings as to your intentions.
Oh, and one other thing about this part. Because this is a question that often comes up, as well. When you're presenting yourself as a certain gender, you go to the restrooms of that gender. If I'm dressed female and go into a male restroom, I'm putting myself in SEVERE risk of bodily harm, while I know I pose no risk to other women. This is a VERY important thing to know because this isn't always made readily apparent.
-Generally speaking, after some time of therapy, the doctor will write you a note to see a specialist able to give you a physical examination and bloodwork in order to prescribe you with hormones. Generally these hormones include a form of estrogen (estradiol is common) and an antiandrogen (such as spirolactone). The antiandrogen is given to block testosterone from being produced in the body, while the estrogen alters the body (and yes, certainly the mind, as well), giving it more female characteristics. Sometimes progesterone is included to aid in breast growth, but experts are divided as to just how much of an effect this has. Sometimes a transwoman can begin by just taking the antiandrogens to see how much of an impact there is and ensure that this is their desire before beginning estrogen. (Obviously female-to-male transitions take different hormones to replicate male hormone output.)
Hormone replacement therapy is, short of actual surgery (and possibly not even that), the biggest step in transitioning between genders. It should be noted that the effects are extremely subtle, and happen over a long period of time. As you go through HRT, chances are you'll hardly notice any differences in your facial appearance or body structure as they happen, but a year or two down the road, when you look back at how you looked before, the changes really are quite staggering.
Some changes you are likely to notice relatively quickly, however, are changes to your skin, for instance, and possibly some changes to your mood. After a relatively short amount of time on hormone treatments, you'll likely notice that your skin has become softer and more sensitive. And many people feel calmer and more... bah, it's hard to pinpoint the word... but more at ease after taking pills. Though whether this is due to the hormones themselves, or just the simple fact that you've taken the step of using them (or both) is open for conjecture.
As time goes by, you might find yourself getting a bit softer in the belly and growing in the hips. Actually, this is pretty much certain. And then, of course, there's the breast growth. To be honest, I didn't really know exactly what point mine began to come in. It wasn't a drastic noticeable change, but I found myself just noticing that my chest was kind of sticking out a bit more.
In some cases (such as my own), there's often a loss in height and shoe size. This actually is quite desirable for many of us (again, such as me). When I first came out, I could only wear a size 11 women's shoe. Now I'm down to a size 10. BELIEVE me, that makes a difference.
Really the HRT treatments are like enacting a second puberty upon yourself. You don't notice everything all at once, but you know something is going on, and when you look back, you know that you're nowhere near the same as when you started.
-While HRT is going on and occasional real life experience might be accumulated, the vast majority of transwomen require a form of permanent facial hair removal. This is becase although HRT absolutely changes body hair to nominal female levels, it perplexingly has no effect on facial hair. As such, a form of hair removal such as electrolysis or laser hair removal is usually required. Some people with certain Native American or Asian backgrounds find themselves incapable of growing facial hair anyway, and are therefore the lucky ones.
Laser hair removal is undeniably the quicker of the two methods. Using a beam of light (you know... a LASER), they essentially zap and burn the hair follicles under your skin, causing the hairs to fall out and eventually rendering them unable to grow back. Because hair grows in cycles, this often requires about 6 full treatments, rekilling the hair follicles, to have permanent effect. And then on occasion, there might be a slight resurgence after half a decade or so.
The problem with laser hair removal is that it often has trouble working for people with a skin tone close to their hair tone. And worse, the laser can't "see" red hairs, light blonde hairs, or gray ones.
An individual full-beard treatment of laser costs about 100 dollars.
On the other end of the spectrum, electrolysis is a method that permanently removes hair as well. Unlike laser, it can be done on any hair color or skin tone. Electrolysis is a method by which a needle is inserted directly into the hair follicle and a current of electricity is sent through the needle, zapping the follicle and rendering it dormant. Te hair is then blocked out by the root. Sounds good, right?
The problem is that electrolysis is painfully (literally) inefficient. You see, electrolysis has to be done to EACH INDIVIDUAL HAIR for it to work. A needle is inserted into one hair, the shock is given, a pair of tweezers are used to pluck the hair out. Then the process goes to the next hair, then the next, then the next... you get the idea.
Worse yet... although electrolysis IS more potent than laser, hair follicles still grow in cycles, and therefore an area killed before will often need to be treated at least once more. As such, electrolysis is best used for "clean-up" work in combination with laser hair removal.
A generally reasonable price for electrolysis is about a dollar a minute.
If you hadn't guessed already transitioning is EXPENSIVE.
-At some point, you need to come out to loved ones and tell them about yourself. I did this right away... but others need to wait for one reason or another.
The only thing that I can say about these revelations is that they are NEVER predictable. Everyone's reaction to knowing their friend/coworker/family member is trans can be very different from each others'. In my next part, I'll discuss these revelations in great detail.
-One of the next steps is often a legal change of name. For some people with "neutral" names, this sort of thing isn't necessary. Depending on the state/city/province you live in, the gender marker on your ID can also be changed after receiving a special notation from your endo.
These changes should NOT be done until you are ready start going full-time. Because once you change your name from Stan to Alice, you can't go around legally proclaiming yourself to be Stan. Especially once your gender marker has been changed.
-So, the next step is living full-time. Basically, the point of no return. You live ONLY as female in your public and private lives, and that includes your job. This can often only be accomplished after at least a year or two (often longer) of real transitioning.
And after you start going full-time, you finally come to the step everyone knows about...
-Sexual reassignment surgery. Also known as SRS. Formerly known as a "sex change operation," though this term is NOT used in common medical parlance anymore.
In order to get SRS, you have to have completed ALL of the above steps. Every last one of them. In most cases, you must also legally divorce your spouse if you have not done so already.
In order for a doctor to even CONSIDER looking at you, you have to have lived as your target gender full-time for at least a year. And that's just to get a surgeon to even take a look at you, to get your foot in the door. Often surgeons are extremely specific about the cases they'll take and have additional requirements for you to complete before they'll agree to operate.
There's not much to mention about this part, because everyone already knows about it. Additional surgeries are often taken on by transwomen, such as breast augmentation, facial feminization surgery, and in certain cases, a very technical operation that reduces the size of the Adam's Apple. Unless there's a very apparent one, this last surgery is something I don't think should be recommended.
So... that's it. That's what goes into becoming female. Factoring in wardrobe costs, hormones, hair removal, surgery, name change documentation, psychiatric visits, and other expenses... the lifetime expense of transitioning can easily measure in the hundreds of thousands possibly even more.
I've already spent way longer than I meant to (again) on this part, so I'll save more for the next "exciting" chapter. See you then!
In the second "Chapter" of this blog, I thought I would discuss exactly what the male-to-female transition is, since a great many people don't know anything beyond what we see on network sitcoms.
I think the best way for me to begin describing what this transition IS is by explaining what it's NOT. It's not a bird or a rabbit.
In all seriousness, though, there are quite a few preconceived notions that people often have regarding transitioning, and I'd like to do my best to address those things.
First, transitioning isn't a "before and after" sort of thing. It's certainly not a matter of saying "This day I was male, but the next day, or week, or year, I became female." That's not even close to the reality of the situation. There really is no set point at which one can definitively decide that one's "made it," because this transition is basically a lifelong goal.
In reality, most trans people will tell you that they've always been female in one form or another, and wish to bring that out. While I REALLY abhor the old cliche "woman trapped in a man's body," there is at least a kernel of truth in it. It's not to say that ******** think they've always been female. Most are very realistic about the situation, knowing that what they're pursuing is a desire rather than a reality. It's just a matter of trying to find the right point in time when you can say "This part of me is feminine." And I think I can very safely say that there isn't a single transperson alive that didn't feel a small leap in their heart the first couple of times someone addressed them with a female pronoun.
I honestly and truthfully can't remember the exact moment I began to think of myself as "her" rather than "he," but I think I can fairly safely say that it didn't happen all at once.
The next thing transitioning isn't is a sex change operation. Although SRS is a large goal and desire of transpeople, it isn't the only goal and certainly not the ultimate goal. I think the biggest misconception people have about this issue is that a transwoman is a man before surgery and a woman afterward (assuming that they're not the sort to simply call that person a man all the way through their life). It simply doesn't work that way. I'll go over the standards and requirements for surgery as I go on, but for now suffice it to say that it's not the key component to transitioning.
Transitioning is not something you can just decide on a whim. Even if you had no friends and family and a kajillion greenbacks to your name, no reputable medical professional is going to do anything to help you transition to the opposite gender unless you go through the paces. And although this idea frustrated me when I was a teenager, I've come to understand and even agree with this. One obvious thing no one will tell you starting out is that even if you look and sound totally feminine right out of the gate, there are so many subtle mannerisms and nuances in your behavior that might seem a bit off to the people around you. It takes a lot of time and work to acclimate to a female lifestyle.
Transitioning isn't a thing for homosexuals to do to date men. This might be surprising to a good many people that don't know any better, but gender identity isn't the same as sexuality. Nor is it directly influenced by it. (Though obviously the inner workings of our collective subconscious are so complex that it's impossible to say what functions and thoughts are completely individual of other ones.) Trans people can be straight, gay, or bi, same as normal people. And in just about the same ratio.
Basically, I didn't want to become a girl because I thought it would make it easier to date men. The very thought of that idea is actually extremely funny to me, in a tragic way. Tragic, because it's just such an unrealistic idea. It's not a stretch to say that the average Joe Schmoe on the streets is more likely to be transphobic than homophobic. People in general have a much EASIER time accepting gay people, because they don't have the idea that they're trying to hide something. I think in the back of everyone's mind, every transperson is a "Crying Game" waiting to happen. Look it up.
Transitioning isn't wearing a dress, or being fruity, or wanting to parade yourself and "look pretty." I'm extremely conservative about my female appearance. The LAST thing I want to be is a drag queen. Transvestites dress like girls for entertainment and/or sexual value. Transsexuals have a desire to BE female rather than just dress that way.
So, those are the basic things that are assumed about transgenderism, but aren't the case. What IS the case? To be honest, I don't know. I know my parents are likely to call me by my male name for the rest of their lives. And while that is unfair and hurtful of them, it's also not entirely wrong. I'll never be a birth female. I'll never have all of the female parts exactly as a birth female would. The first couple decades of my life were spent as a male, and I would no more deny that than I'd deny that the sun rises in the east and sets to the west. It's just reality.
What I feel transitioning does is puts me as close as I can possibly come to the form that allows me to engage in the sociological imperatives I find desirable in a way that is understandable to the people around me.
For every individual, there is a variation on the process of transitioning. However, the generally practiced guidelines in the United States are as follows:
-First, you make the decision to address the feelings of gender disphoria you've experienced. For the majority of transpeople (though not QUITE all of them), these feelings start very early on and grow as time passes. This step isn't easy at all, and as such a lot of transpeople have a bunch of false starts, in which they decide to transition, and maybe even take a couple of steps, but then they panic and hold back, fearing repercussions.
-The second step is to meet up with a dedicated practitioner, able to diagnose you with GID (gender identity disorder). Though there are no hard-and-fast outlines for this, many therapists desire at least a couple of weeks to a month of knowing the patient before they're willing to make this diagnosis.
-The next step really varies depending on age, marital status, appearance, and financial situation. The person can begin attempting to gain RLE (real-life experience) by trying to dress in public as the target gender. This is NOT a realistic goal in many cases, especially for older people, people who have family, friends, or coworkers that can't hear about their transition yet, and people that look TOO much like their original gender to even hope to pass.
What will often happen if a person is prepared to amass real-life experience is that they will be given a letter from their therapist, which is a legal documentation proclaiming you to be of sound mental health and not a threat to yourself or others. This letter (often called "The letter," or "The note") is actually a very important thing to have when starting out, because if you get pulled over by a cop or carded someplace and you're obviously presenting as female, there can often be severe misunderstandings as to your intentions.
Oh, and one other thing about this part. Because this is a question that often comes up, as well. When you're presenting yourself as a certain gender, you go to the restrooms of that gender. If I'm dressed female and go into a male restroom, I'm putting myself in SEVERE risk of bodily harm, while I know I pose no risk to other women. This is a VERY important thing to know because this isn't always made readily apparent.
-Generally speaking, after some time of therapy, the doctor will write you a note to see a specialist able to give you a physical examination and bloodwork in order to prescribe you with hormones. Generally these hormones include a form of estrogen (estradiol is common) and an antiandrogen (such as spirolactone). The antiandrogen is given to block testosterone from being produced in the body, while the estrogen alters the body (and yes, certainly the mind, as well), giving it more female characteristics. Sometimes progesterone is included to aid in breast growth, but experts are divided as to just how much of an effect this has. Sometimes a transwoman can begin by just taking the antiandrogens to see how much of an impact there is and ensure that this is their desire before beginning estrogen. (Obviously female-to-male transitions take different hormones to replicate male hormone output.)
Hormone replacement therapy is, short of actual surgery (and possibly not even that), the biggest step in transitioning between genders. It should be noted that the effects are extremely subtle, and happen over a long period of time. As you go through HRT, chances are you'll hardly notice any differences in your facial appearance or body structure as they happen, but a year or two down the road, when you look back at how you looked before, the changes really are quite staggering.
Some changes you are likely to notice relatively quickly, however, are changes to your skin, for instance, and possibly some changes to your mood. After a relatively short amount of time on hormone treatments, you'll likely notice that your skin has become softer and more sensitive. And many people feel calmer and more... bah, it's hard to pinpoint the word... but more at ease after taking pills. Though whether this is due to the hormones themselves, or just the simple fact that you've taken the step of using them (or both) is open for conjecture.
As time goes by, you might find yourself getting a bit softer in the belly and growing in the hips. Actually, this is pretty much certain. And then, of course, there's the breast growth. To be honest, I didn't really know exactly what point mine began to come in. It wasn't a drastic noticeable change, but I found myself just noticing that my chest was kind of sticking out a bit more.
In some cases (such as my own), there's often a loss in height and shoe size. This actually is quite desirable for many of us (again, such as me). When I first came out, I could only wear a size 11 women's shoe. Now I'm down to a size 10. BELIEVE me, that makes a difference.
Really the HRT treatments are like enacting a second puberty upon yourself. You don't notice everything all at once, but you know something is going on, and when you look back, you know that you're nowhere near the same as when you started.
-While HRT is going on and occasional real life experience might be accumulated, the vast majority of transwomen require a form of permanent facial hair removal. This is becase although HRT absolutely changes body hair to nominal female levels, it perplexingly has no effect on facial hair. As such, a form of hair removal such as electrolysis or laser hair removal is usually required. Some people with certain Native American or Asian backgrounds find themselves incapable of growing facial hair anyway, and are therefore the lucky ones.
Laser hair removal is undeniably the quicker of the two methods. Using a beam of light (you know... a LASER), they essentially zap and burn the hair follicles under your skin, causing the hairs to fall out and eventually rendering them unable to grow back. Because hair grows in cycles, this often requires about 6 full treatments, rekilling the hair follicles, to have permanent effect. And then on occasion, there might be a slight resurgence after half a decade or so.
The problem with laser hair removal is that it often has trouble working for people with a skin tone close to their hair tone. And worse, the laser can't "see" red hairs, light blonde hairs, or gray ones.
An individual full-beard treatment of laser costs about 100 dollars.
On the other end of the spectrum, electrolysis is a method that permanently removes hair as well. Unlike laser, it can be done on any hair color or skin tone. Electrolysis is a method by which a needle is inserted directly into the hair follicle and a current of electricity is sent through the needle, zapping the follicle and rendering it dormant. Te hair is then blocked out by the root. Sounds good, right?
The problem is that electrolysis is painfully (literally) inefficient. You see, electrolysis has to be done to EACH INDIVIDUAL HAIR for it to work. A needle is inserted into one hair, the shock is given, a pair of tweezers are used to pluck the hair out. Then the process goes to the next hair, then the next, then the next... you get the idea.
Worse yet... although electrolysis IS more potent than laser, hair follicles still grow in cycles, and therefore an area killed before will often need to be treated at least once more. As such, electrolysis is best used for "clean-up" work in combination with laser hair removal.
A generally reasonable price for electrolysis is about a dollar a minute.
If you hadn't guessed already transitioning is EXPENSIVE.
-At some point, you need to come out to loved ones and tell them about yourself. I did this right away... but others need to wait for one reason or another.
The only thing that I can say about these revelations is that they are NEVER predictable. Everyone's reaction to knowing their friend/coworker/family member is trans can be very different from each others'. In my next part, I'll discuss these revelations in great detail.
-One of the next steps is often a legal change of name. For some people with "neutral" names, this sort of thing isn't necessary. Depending on the state/city/province you live in, the gender marker on your ID can also be changed after receiving a special notation from your endo.
These changes should NOT be done until you are ready start going full-time. Because once you change your name from Stan to Alice, you can't go around legally proclaiming yourself to be Stan. Especially once your gender marker has been changed.
-So, the next step is living full-time. Basically, the point of no return. You live ONLY as female in your public and private lives, and that includes your job. This can often only be accomplished after at least a year or two (often longer) of real transitioning.
And after you start going full-time, you finally come to the step everyone knows about...
-Sexual reassignment surgery. Also known as SRS. Formerly known as a "sex change operation," though this term is NOT used in common medical parlance anymore.
In order to get SRS, you have to have completed ALL of the above steps. Every last one of them. In most cases, you must also legally divorce your spouse if you have not done so already.
In order for a doctor to even CONSIDER looking at you, you have to have lived as your target gender full-time for at least a year. And that's just to get a surgeon to even take a look at you, to get your foot in the door. Often surgeons are extremely specific about the cases they'll take and have additional requirements for you to complete before they'll agree to operate.
There's not much to mention about this part, because everyone already knows about it. Additional surgeries are often taken on by transwomen, such as breast augmentation, facial feminization surgery, and in certain cases, a very technical operation that reduces the size of the Adam's Apple. Unless there's a very apparent one, this last surgery is something I don't think should be recommended.
So... that's it. That's what goes into becoming female. Factoring in wardrobe costs, hormones, hair removal, surgery, name change documentation, psychiatric visits, and other expenses... the lifetime expense of transitioning can easily measure in the hundreds of thousands possibly even more.
I've already spent way longer than I meant to (again) on this part, so I'll save more for the next "exciting" chapter. See you then!
