The Excitement of Medical Transition

Many people, I’ve found, think that the medical interventions are the hard part of being transgender.


In fact they are often the most exciting part.


The hardest things to deal with, usually, are hiding your identity before deciding to transition, or dealing with discriminatory behaviors from those around you. And these pains are invisible. If you can’t see something, it’s hard to understand how difficult it is. The pre-transition times are usually the most damaging times for a transgender person.


The results of surgery can be liberating and thrilling. I liken it to having a large growth on your face. Many people would tell you it doesn’t matter what other people think. Even if people don’t stare at it, you will be very self conscious and would rather it wasn’t there. Now if a surgeon comes along and says they can remove it for you, you’re going to be very excited by that prospect. Yes, it will leave a visible scar, but that is far preferable than living with the growth. And I think this is pretty close to how a transgender person feels about surgery, and hormone treatment too. Things will never be 100% perfect, but will be greatly improved for sure. Most people who need surgery or need to take medication, do so to stop something bad from happening, in the hope of continuing life at the same level as before. This is why most medical interventions carry a negative feeling. But for a transgender person, everything that happens with treatment brings positive changes and is raising their life to a higher level.


One of the most risky periods for a transgender person is often between asking for help and then receiving medical intervention. They’ve reached a point where they are ready to make huge changes, but now they are faced with a long period of time before those changes start to happen. There are guidelines [W-Path Guidelines] that physicians the world over follow before initiating treatment, and as a result of these guidelines the assessments can be a lengthy process. The wait to even begin the process can be lengthy, thanks to long waiting lists or the need to raise funds before seeking treatment.


A great comparison is a child waiting for Christmas. If it’s a long way off, it’s easy to wait. But as the time approaches, the waiting can become almost painful. When you’re ready to make huge, fundamental changes to your life, and to remove such heartache from it, time seems to pass slower. It also becomes psychologically harder to cope with the bad things. Stresses already there can be heightened; any risk of self-harm or suicide may be increased during this period. This is one reason GP’s can prescribe bridging prescriptions for hormones during this vulnerable time, to reduce the risk of harm to their patient.


Not everyone wants to follow the same path, some people may choose hormones and all the surgeries that are available, while others may choose just some of these. Some people decide not to have any medical intervention at all, choosing just to transition socially. Each of these choices are as valid as the others.


For those who take hormones, this can be a very exciting part of transition. Hormones are a very effective way of changing and maintaining secondary sexual characteristics. They change the shape of the face, muscle mass, fat distribution, texture of skin and hair, and much more.


Hormones can have drastic effects on the appearance. But there are still a lot of people who have no idea quite how effective hormone therapy is, even including many within the medical profession. I once heard of a trans man (that is, he had transitioned from female to male) whose status as ‘transgender’ had been revealed to a work colleague; the colleague, convinced he was born physically male and was wanting to transition to female, told him he’d never be a real woman because he looked too much like a man! Just goes to show!