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Transitioning- Female to Male

Being Transgender is not a choice... transitioning is... but what does that look like? Well, it is different for every transgender person. Remember our post about SELF-IDENTIFYING? No matter how you choose to transition, YOU ARE TRANS ENOUGH!


There are so many resources out there regarding transitioning that it can be daunting trying to navigate all of the content available. That's where this post comes in! We have collected many resources (most with input from other transgender people) and put them all here for easy navigation! This post is for educational purposes for individuals 18 years or older ONLY. It is in NO WAY medical advice. Consult with a doctor before seeking any kind of medical transition.


Transitioning and Things to Know

  • If you have not talked to a mental health professional about being transgender and visit a Doctor first, they will direct you to meet with a mental health professional prior to prescribing gender affirming care

    • There may be a minimum length time requirement for meeting with the mental health professional and includes a letter of support

  • If you have already been meeting with a mental health professional, then you'll need to get a letter of support from them to bring to your doctor's appointment

  • You must be on Testosterone for a minimum of 6-12 months before you can seek gender affirming surgery. You will also need a letter of support from your therapist and doctor to have gender affirming surgeries. This is in addition to the letter you received to begin your gender affirming care journey. You can petition for this to happen sooner in cases of extreme body dysmorphia

  • Medicaid no longer covers Gender Affirming Care in Iowa. According to the State, you can still get mental health care for Body Dysmorphia, but many Iowans are reporting having difficulties even getting this covered


Resources for Care


Types of Hormone Replacement Therapy

  • Testosterone Cypionate or Testosterone Enanthate

    • Once a week injection

    • For the first year you will be required to have quarterly blood tests to ensure you are at a safe testosterone level

  • Testosterone Gel

    • Daily application

  • Microdosing vs. Full Dosage

    • Many factors contribute to the dosage that will be prescribed to you. A doctor will generally start you on a lower dosage and increase it over time if needed. Those with pre-existing or serious health conditions may only be prescribed a smaller dose (known as microdosing). This means the timeline for changes will be extended beyond the time frame listed below


Changes to Expect

  • 1-3 Months

    • Increased amount of skin oil & acne

    • Menstruation can begin to slow in frequency and/or lighten

  • 3-6 Months

    • Voice begins to drop

      • Your voice dropping in tone is the result of it moving from your upper register in your head to your lower register in your chest

      • You may experience what is commonly known as T-throat. This is from your vocal chords thickening and your voice changing. It feels similar to when you have a sore throat from a cold. This will not normally be constant. It will come and go and is usually worse around 24-48 hours after you give yourself your shot

    • Body & facial hair begins developing

      • Hair growth varies wildly person to person. Some experience the full scope of hair growth that an AMAB person going through puberty experiences. Others can experience patchy growth or growth in only certain areas like the legs, back, and butt

    • Menstruation (can) completely halts

      • If your menstruation does not completely halt, a doctor may prescribe you meds to halt this process

    • Clitoris grows and enlarges (bottom growth)

      • Vaginal lining can thin and become drier

    • Body fat redistribution begins

      • Decrease in cheek area and around hips, under arms, and glutes

      • Increases around belly

  • 6-12 Months

    • Muscle mass begins to increase

      • This is the perfect time to begin weight lifting if you'd like to maximize your muscle growth

    • Voice continues to develop and deepen

    • Body & facial hair continues to develop

      • If male pattern baldness runs in your family, being on testosterone can activate these genes and you can experience hair loss

  • Full Changes Timeline

    • Voice- 1-2 years

    • Body & facial hair- 3-5 years

      • Including scalp hair loss

    • Body fat redistribution- 2-5 years

    • Clitoral growth- 1-2 years

    • Muscle mass- 2-5 years

  • Reversible vs. Permanent Changes

    • Reversible- Skin oiliness, body fat redistribution, increased muscle mass, and vaginal dryness

    • Permanent- Body & facial hair growth, hair loss, deepened voice, and clitoral growth


Shopping


Gender Affirming Surgeries (most common)

  • Top Surgery

    • Liposuction incision- almost always used in addition to another surgery type

    • Keyhole incision- ideal for small chested individuals. Small incision on the button of the areola to remove tissue. Can only be used to remove tissue, cannot remove excess skin

    • Circumareolar/periareolar incision- ideal for moderate chest size and good skin elasticity. Incision is made around the edge of the areola to remove the nipple. A slightly larger incision ring is then cut to remove tissue and excess skin. The remaining skin is then pulled tight to reattach the areola and nipple. Occasionally a vertical incision is also needed to remove excess skin

    • Double incision- ideal for large breasted individuals or those with poor skin elasticity. Incisions are made above and below pec muscles to remove tissue and excess skin. The chest skin is then stretched to be sewn back together. Nipples can be removed, resized, and reattached during this surgery

    • Inverted T (anchor) & buttonhole- ideal for varying chest sizes. A vertical incision is made from the bottom of the areola to where the horizontal incision line is. This keeps the nipple/areola attached to nerves and other tissues

      • Disadvantage- because of keeping the nipple and tissues intact, the chest will not be as flat as with other surgery types

    • NOTE- For surgeries that involve removing and reattaching the nipple... many transgender people report having complications with nipple incisions healing. It is becoming more common for those having these type of surgeries to forgo having nipples

  • Bottom Surgery

    • Hysterectomy, oophorectomy and vaginectomy- Patients can have their vaginal canal, uterus, and/or one or both of their ovaries removed

    • Metoidioplasty- A metoidioplasty involves releasing erectile tissue (clitoris), from restraining structures, allowing it to move into a more forward and elevated position. Patients can opt for a urethral lengthening procedure if they would like to be able to urinate while standing up

    • Phalloplasty- This surgery involves the creation of a penis using a tissue flap from the patient’s groin, outer thigh, or forearm

    • NOTE- Many of these procedures, particularly phalloplasty, require multiple stages of surgery for patients to achieve their final results


Vocal Lessons


Legal Resources


Sources

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