Some of this is mtf specific but some of it is general.
Anyway should you exhibit gender dysphoria and wish to transition a timeline might look something like this:
- Accepting being trans. Usually described as trans “pre-everything.” I’m not sure if this is much of a stage but it involves coming to terms with the possibility or reality of being trans. Determine whether this is gender dysphoria that I am experiencing. Dysphoria is defined differently from professional to professional. It ranges in variety from a consistent feeling of not liking your gender to feelings that you’re certain that you should have been the opposite gender. The latter definition does not account for non-binary genders however from my understanding some professionals still go by that. Self-doubt is common during this stage (and any stage). The struggle to conform to society’s ideas of what you should look like or be as your desired gender can come from anywhere whether it is internal or from people around you or complete strangers. In most situations there’s an example of a cis-gender of your desired gender that experiences the same struggles. Obviously this doesn’t include the struggles specific to transgender.
- Try to establish what you want out of transition. What are your goals with transitioning–what do you hope to achieve.
- Set reasonable expectations with each stage of transition and its outcomes.
- Be aware that some developmental/hormonal effects are permanent
- reproductive health
- skeletal development is different (hips, skull)
- voice deepening (testosterone)
- breast development (estrogen)
- membrane responsibility for lubrication develops slightly different among males and females. (for mtf this means penile inversion may not provide proper lubrication, some have seen improvement in this area after short term progesterone typically prescribed short term to encourage breast development)
- Assess health risks with a professional (this is done for both hormone replacement therapy and for surgery consultation–especially Cleveland).
- Start hormone replacement therapy. I’ll list only mtf stuff here.
1-3 months most doctors will block testosterone production. Side effects include a drop in energy level while adjusting to the changes. Others will include a small dose of estradiol (produces estrogen in the body). When there is concern of liver or other side effects doctors may do a patch delivery instead of pills or shots. The shots can be preferred when there is a risk for blood clots. Changes are usually negligible in this phase.
- Decreased libido
- Decreased spontaneous erections
- slowing of scalp hair loss
3-6 months
- Softer, less oily skin
- Testicular atrophy
- Breast development
- Redistribution of body fat
- decreased muscle mass
6-12 months
- decreased facial and body hair growth
- Breast development continues for the next 2-3 years, stopping after about 5 years.
Surgery and prep
- As soon as you know you want surgery: electrolysis most surgeons want this to be 70% or more complete.
- 1 year full time presenting female
- 2 letters following WPATH standard
- Surgeon consultation
- Surgeon’s recommendations (Probable BMI <= 30)
- Discuss types of surgery with the surgeon