Academy 10 - Possibilities 4 - How to
Let’s get started
In the last letter we took a look at the process of transitioning, what it involves and what effects it can have, and today I want to take a step backwards and look into how someone gets started and we’ll also deal with a few other issues and questions that can arise on the topic.
To begin
Some parts of transitioning can be done at will and just require your commitment. You can change your voice and your body language and how you dress whenever you decide to and then it’s down to you to work at and practice the changes until they become natural.
Access to HRT varies depending on where you are. It usually differs by country but in places like the US it differs by state.
At the lowest end of the scale are countries where it simply isn’t available, usually because trans people aren’t recognised. The drugs themselves will be available as they have many medical uses but they won’t be prescribable to people who are planning to transition.
The most common method is to require psychotherapy and a letter from a therapist confirming your diagnosis before they will prescribe HRT.
Some locations offer an “informed consent” approach where a Doctor will explain the risks to you, you will confirm you understand them and then they will then write you a prescription.
The first step is to Google “HRT” or “hormone replacement therapy” and your location and find out what is needed where you are.
Access to surgery varies too. As we mentioned in the last letter, it can take years for your body to fully change while you’re undergoing HRT and some surgeries will need for these to have been completed before they can be done.
Surgeons may require approval from a therapist for the more invasive procedures, but if you’ve reached the stage where this is something you’re pursuing it’s almost certainly not an issue.
The other concerns with surgery are cost and availability. Some countries have health services that will provide gender reassignment surgeries as they do other kinds of medical procedures or they may be available on your medical insurance but in some places, you’ll have to pay for them directly which can be very costly and why some trans people will travel abroad to take advantage of cheaper options in other countries.
Availability is down to location but also because the best surgeons will be booked up in advance and sometimes years in advance. This is more likely for “cosmetic” type surgeries like breast or facial augmentation where trans people aren’t the only ones who will be pursuing it but the opposite can be true and sometimes, only a small number of surgeons will offer some procedures meaning an equally long wait.
Am I too old?
One benefit of the internet and the increased visibility of transgender people is that there is much more awareness of the topic and transitioning is becoming more common.
This often leads to people who come to the realisation that they are trans later in life to wonder if it’s too late for them to transition, especially as the media (as it does with any topic) will tend to focus on younger, attractive trans people.
Whether you should transition or not is a decision only the individual can make, but you shouldn’t let age be a deterrence. Before it became more acceptable, older trans people would wait until they retired and then switch to living as a woman so it wouldn’t interfere too much with their life.
We’ve mentioned a few times that if you’re a sissy, age shouldn’t stop you from pursuing it and this goes double for transitioning. Living your most authentic life to the greatest degree possible should be the goal of everyone on the planet.
There are things that can stop you from doing so to the extent that you would like (personal safety is the most common reason) but you are never too old to pursue your dreams.
The importance of support
Arguably the most important thing you can do to help with transitioning is to have a good circle of support.
As I mentioned above, some countries/states require a therapist to approve before you can begin HRT. This can have some dangers but finding the right person to speak too can be an incredible help. They are a neutral third party who will deal with and encounter you completely separately from your family and social circle.
You want to find someone who is experienced in dealing with trans issues and the usual method is to Google “trans-friendly therapists” and your location and work through what comes up, looking for reviews from other people. Alternatively, look for trans services and groups in your area and ask them for recommendations.
The downsides of choosing the wrong person should be pretty obvious but fortunately, the type of therapist who is actively hostile to even the idea of transitioning is fast disappearing.
While you’re looking for trans services and groups, remember that these can form part of your support network. As with any group of people, trans support groups can be positive or negative but there’s nothing to stop you from trying any that find to see if they work for you.
Coming out
You also have your existing social circle and family. In most cases, you will have to tell them about your decision, a process known as “coming out”.
Usually, you’ll have an idea of how people will react and if you can approach the ones who will be favourable on their own and speak to them first and then you can use their support and presence when you speak to the others.
You can also sound people out about it before you talk about yourself by talking about trans issues but be aware that people can react differently to something in the abstract compared to when it’s someone directly in front of them who they know.
Before you do it, think about who you are going to approach and what you are going to say to explain yourself (and practice saying it). You can also be ready with information or details of support groups for family/friends of trans people.
Pick a good time to tell someone and then just take your time and talk to them. Once you begin, be prepared for them to be shocked or even angry at you, keep in mind you can end the conversation and leave if you feel it’s really not going well, but even if someone is angry, it can pass when they have dealt with their surprise at the news.
Once you have done this a few times and have people in your corner, it becomes easier and easier to do. You’ll have dealt with the questions enough to not be caught by surprise and you’ll have proof that the people you know will support you through this.
The Internet
You can also find many supportive communities online. As we always say, one of the real gifts of the internet is how it lets you find others going through what you are and make connections with them, so take advantage of it here too!
Detransitioning
Just like it sounds, this is where someone decides to stop and reverse their transition. There hasn’t been much research carried out on it and it’s not particularly common, so although we need to mention it, we’re not going to dwell on it here.
Sadly, the most common reason given for detransitioning is the lack of support and inadequate mental healthcare.
DIY
As I hope is clear from the last few letters, transitioning is often a medical procedure, there’s a reason why Doctors and Therapists are frequently involved!
HRT has contraindications and can have side effects and that’s even before you get to things like dosage.
However, some trans people do go it alone and decide to transition with little or no professional assistance, a process known as a DIY transition.
As with almost any medication, the drugs that make up HRT are available online so if you live somewhere where it’s not available (it’s either actually or effectively illegal) or has a long wait period (as an example, in the UK the current wait for an initial appointment at a gender clinic is over two year) then you may decide to pursue it yourself.
All I can recommend if you decide to proceed down this path is to do a lot of research beforehand. Transitioning is a serious step in your life which will have permanent, life altering consequences so treat it with the gravity it deserves and make sure you know what you’re doing before you start.
Going stealth
This is where someone transitions but only privately. In private and among family and friends, they live as a woman but in public they present themself as male.
This was more common in the past when trans people were much less visible and nowadays in countries/states where being publicly trans is not an option.
It can also be a first step when you’re not quite ready to be completely out there. You can spend part of your life getting comfortable with being yourself without the pressure that can come from taking a big leap and changing everything all at once.
My hope
With this group of lectures, I wanted to dispel some myths and inform our students about transitioning. What it is from the position of someone who is (or is planning to) transition and what it entails.
As I mentioned in the last letter, trans people are an underserved hot-button issue at the moment and any number of bad actors and people acting in bad faith are either supplying or repeating skewed or flat-out false information.
My other hope was that those of you in the student body who have come to the realisation that you are trans while following the course would have a starting point on your journey and realise that even though it might feel overwhelming or like you have a million things to look into, at least you have a framework as to how you can approach it.
Love to you all!
x
