Transition Questions

[Kevin Peña]

Ok, I know that I want to go through with an MTF transition, but I just had a few things to ask so that I can be clear as to how to proceed in the process:

By the way, I live in and am planning on transitioning in NYC.

1. How do I begin HRT? Does it start with seeing my general doctor who will refer me to a therapist?

2. Is there a real life test to go through before HRT? I frankly don't think I'll pass for a female and that would make this very difficult.

3. I plan on gaining money for my transition while working as an EMT for the Fire Department, so could anyone tell me how they went about transitioning while at work?

4. How much money do I need in total (Electrolysis, Hormones, etc.)? I already decided that SRS is not an option. The only surgery I would consider is facial feminization surgery.

5. I do want to become a firefighter, so I need to know if HRT will cause significant strength loss. I'm a gymnast, cyclist, yogi, and runner.

6. What are some of the other effects of female hormones (Moodiness, etc)? Do they make your face slightly more feminine?

7. I already came out to my friends and sister and they were so sweet about the whole thing, so all that I have left is to tell my parents. They're Catholic and I'm afraid of what they'll feel. How can I come out to them?

I know that these are a lot of questions, so don't feel obligated to answer all of them. Thanks in advance to any responses. 

[Jamie D]

K, you ask a lot of good questions.

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[collettemichelle]

Hi There DianaP,
Welcome to the forums.I am quite new at this myself.just to let you know.I've been on hormones for 1 year and am now looking forward to completing my transition over the next 2 years.FFS and GRS.
So that being said I can't  answer all of your questions.
Opening up to your family doctor regarding your feelings will be a good step.As when I initially spoke with mine she then got me appointments arranged with both an Endocrinologist and Psychologist.The therapy is a great help as they provide empathy and are a non-biased listener.A therapist with experience working with Transgender issues is benificial.Your therapist will be able to direct your next steps re:starting hormones etc.Not really a real life test at this time though.
Some muscle loss initially but that being a goal of mine I have changed my workout schedule and diet plans.As far as strength not massive change there.Though I don't test it much now.Shopping bags etc.LOL
Money is key with a lot of areas in transition.
Co-pay on hormone therapy approx.$40 month
Electrolgy (facial) $55 hr...approx 100 hrs total needed.I've afforded 2 hrs week at most.
My present therapist in California doesn't take insurance but even when my previous one did there was a Co-Pay of $20.That will be weekly,bi-weekly or whatever you arrange obviously.
Co-Pay with endocrinologist $40.
There are clinics set up specially for helping in the endocrinology and therapy and general doctor input areas.Location specific.Others here on the forum might be able to help you there.
Clothes and makeup whilst being more a pleasure than a chore still costs substantial as you can reasonably guess.
FFS as you can read here will be anywhere from $17,500-$much much higher.
I would imagine moodiness and or emotional upset is an individual thing.That is another area both the Endocrinologist and Therapist can help.Mine took a while to balance out but I'm finally okay;most of the time.
Coming out is an area covered in many blogs and forums.
Hope some of this helps some.
The road in life isn't easy which ever one we are on.Just try to be safe on yours,please.
Hugs and Best wishes Collette Michelle

[Kevin Peña]

Thanks a lot. You don't know how relieved I am that there isn't a real-life test to get hormones, like in the UK. As a gymnast, I would not pass. I suppose I'll decide on FFS if needed, but hopefully I'll look feminine enough without it.

Good luck in your transition.

[Constance]

Welcome!

Here are answers to your questions based on my experiences.

1. I started with a therapist who diagnosed me with Gender Identity Disorder (DSM 302.85). She wrote me a letter indicating my diagnosis and including her professional opinion that I should begin HRT. I took this letter to my GP for a physical and a referral to an endocrinologist. My insurance, BlueSheild, denied the referral. So, I pay out of pocket to see my endo, even though the HRT prescriptions are covered for some reason.

2. I started HRT on 5 June 2011 and I started my RLE on 16 September 2011. Originally, I was going to wait until January 2012 to start my RLE, but I couldn't live as "David" anymore. Three months of HRT did not do that much for my appearance. But with the use of breastforms and makeup, I was able to feminize my appearance. My hair was shoulder-length back then, so that helped, too. These days, I'm rarely misgendered. So either I'm passing, or people are humoring my presentation.

3. I'm transitioning on the job. I basically met with my boss and told him the situation. Next I met with HR. I already had vacation time in September of last year scheduled. So, I left work as David, they made the announcements while I was away, and I returned to work as Constance.

4. The amounts will probably vary wildly. I opted for laser instead of electro, and a 2-year treatment was around $2800. My hormones are about $30 per month, and the therapy sessions at $20 per session due to my insurance co-pay. Without the copay, I think they'd be $120. With informed consent, therapy might not be needed to start HRT. I find the therapy to be quite helpful, as I went through a divorce and other issues during my transition thus far. For my part, I won't be having FFS but am planning on SRS. I might get breast augmentation surgery, but I want to give the hormones more time to work before I make any decision about that.

5. I haven't really noticed a big decreas in strength even after a year of HRT. But, I was never all that strong to begin with.

6. I'm on a steady level of hormones rather than a cycle. I was very emotionally wobbly for the first 4 or 5 months. My ex-wife and daughter have both said my face seems rounder, but I don't notice this. I also found that I've had the munchies since August 2011. For me, HRT seems to have increased my appetite. My affectional orientation seemed to become more flexible, too.

7. My parents are also Catholic, and I was married for about 22.5 years before I came out. I just told them what was happening, as well as the new name I had selected for myself. What I did not tell them was that I was also picking out a new last name in case they decided to reject me.

[Kevin Peña]

Thanks a lot. The finances don't seem too bad, I suppose. However, what exactly do you mean by "informed consent"? Consent from a physician? I appreciate the advice to go blunt with my parents. I guess if they know I'm an atheist, this won't be too bad either. I really appreciate your input.

[Constance]

The concept of "informed consent" is probably better described by the Wiki here than by me.

https://www.susans.org/wiki/Informed_consent

[Kevin Peña]

Thank you so much! Turns out a clinic using informed consent is only 8 miles from my house. Luckily, I'm a biology major, so I actually already knew most of the medical aspects of HRT. Seriously, thanks. If this works, I can get started a few months ahead of schedule.

[Meshi]

You question is very complex, because we do not know what color hair you have and the density/how much.?  Your face also depends on how masculine it is right now, as to how radical you want to be and what it will take to get it in the female range.  One usually will take an anti-androgen like spirnolactone and estrogen for at least 8-12 months b4 actually doing any kind of physical plastic surgery.  You should follow the HHSOC guidelines.  Find a good therapist and they will normally give you a referral to a hormone dr after about 6 months of counseling, but it would be presumptuous of me to not say most get the hormones alot quicker.  The longest or "Godfather" of FFS is still in practice ( Dr. Douglas Ousterhaut) and he charges around 45K for total FFS, but you can get good work for around the high 20's to 30K.  I would not go with the cheapest on this, as revisionary surgery after could end up costing you more in the long run.  Total body hair removal is typical done first with laser, depending how many darker hairs you have, then electrolysis on the finer/light hairs.   It can cost from 12k up to 30K or more depending how long you need treatment.  All together with hormones being the least expensive and not having SRS done.  I would venture to say it will cost anywhere from 45K and up.  Are u planing on having BA (Breast Augmentation) done?  That is another cost factor that I have not added in.  With a surgeon that really know what he is doing (most do not) it will cost $6,200-$7,500.  This is using silicone implants.  I can inform much more, but this is just the general. It will not be easy bein an EMT and transitioning, and depending on your department, you could very well loose your job..I am just stating fact.  Alot of MTF ive known have lost their jobs not to mention many friends/family due to their transitioning, but if this is what you want.  It is your life..Have you been diagnosed for GID?

[Kevin Peña]

I am not getting breast augmentation, since large breasts aren't necessary, especially seeing as to how silicon can be dangerous. I haven't been diagnosed with GID nor have I started therapy. I'm still in high school and don't want to come out due to risk of an adverse reaction from my mom while I still live with her. I also decided on not going with FFS since I really don't want any type of surgery since all surgeries have risks. I appreciate your honesty, regardless of how brutal it seems. Hopefully, NY will be an open-minded place to transition. Thanks for your response.

[Meshi]

Hmmm...I am wondering where you are getting that silicone implants are dangerous, because as far as implants go they do not leak nor cause any issues in general as long as you massage them daily.  Most genetic males, even when on estrogen for more than 2 years will not develop enough breast tissue that will make them look genetic..Most do not get implants to have really large breasts but to have decent sized and more genetic appearance.  B4 transition most will go to counseling with a therapist that is knowledgeable with ->-bleeped-<-.  Almost every part of transition with MTF is dangerous., lol!  Even hormones have their risks.  If you are not having anything done but hormones and hair removal then how can you even call it "transition"?  At least physical transition..Even I went to a therapist b4 I had GRS and I am intersex.  Being TG is not just the body, but in your mindset.

[Kevin Peña]

Silicon implants require being cut open to be implanted, thus making them risky just to acquire. Also, they can cause infection and blood vessel blockages. I know that hormones can be dangerous and potentially cause DVT and liver issues, but they are vital, unlike breast implants, for transition. After all, there are flat-chested women (look at Debra Messing). I can call it transition because I will be changing my entire identity and lifestyle as a result of that. I already see myself as female and that's all that matters to me in terms of being one. However, I need to be perceived as female by the rest of society if I ever want to LIVE as one with minimal hassle.

[Tanya]

HI Diane P.

I live in NYC also and it is very easy to find a therapist who specializes in gender related issues. 

I am not sure how realistic it is to go the firefighter route.  Not usually a very accepting bunch.

I would also caution you that prices for almost everything in NY are higher than most of what is quoted here, but you probably know that as a Nyer.

Good luck!
Tanya

[Kevin Peña]

Thanks for the tip; I'll take that into consideration. By the way, I just read some articles about real transgender firefighters. It seems as though they don't care as long as you have sound character and know how to do your job.

[Meshi]

Well..I do agree..but it also depends on how well a person wants to look, and implants ARE an elective procedure as even SRS is.  Maybe not as defining, but still none the less.  It all depends how one would perceive there own body, and that is a personal choice.  I was talking in general, that most transitioning TS want to look as genetic as possible, but everyone's ideal is different. When transitioned, yes most will live as that gender.  Someone may consider themselves "transitioned" and really not have anything done, but to have or be on hormones and dress as the opposite gender but I am talking not only about the lifestyle, but in the physical.  I know someone that has done virtually nothing other than take a very low dosage of hormone and has not really done anything else but to dress in the opposite gender.  She considers themselves transitioned.  That is their opinion and not anyone else's to judge.

[Nicolette]

You don't know how relieved I am that there isn't a real-life test to get hormones, like in the UK.

In the UK, I got hormones from my private psychiatrist on the first consultation. I presume you're referring to the prerequisites under UK's National Health Service.

[Chloe421x]

DianaP how have things gone since you posted here? I too am very new to this and would lvoe to here of your progress : ) Love the avatar picture as well, beautiful

Chloe

[Kevin Peña]

Well..I do agree..but it also depends on how well a person wants to look, and implants ARE an elective procedure as even SRS is.  Maybe not as defining, but still none the less.  It all depends how one would perceive there own body, and that is a personal choice.  I was talking in general, that most transitioning TS want to look as genetic as possible, but everyone's ideal is different. When transitioned, yes most will live as that gender.  Someone may consider themselves "transitioned" and really not have anything done, but to have or be on hormones and dress as the opposite gender but I am talking not only about the lifestyle, but in the physical.  I know someone that has done virtually nothing other than take a very low dosage of hormone and has not really done anything else but to dress in the opposite gender.  She considers themselves transitioned.  That is their opinion and not anyone else's to judge.

Well, talk about a delayed reaction. I forgot this thread existed! 
Anywho, I can understand why people would want to go with all of those surgeries, but I just don't like surgery and want to minimize the amount I get. Besides, I've been sleep-deprived since I was a baby (only got 8 hours/day as a baby, now down to 3 hours/day WITH MELATONIN SUPPLEMENTS!) so I've always been too tired to care to try hard at much. Therefore, I just want to go with the bare minimum since, to me, even being an ugly girl would be better than being a handsome guy.

DianaP how have things gone since you posted here? I too am very new to this and would love to here of your progress : ) Love the avatar picture as well, beautiful

Chloe

The most I have done is come out to everyone I know. However, I'll wait to start HRT in January since I'm still in high school and I don't want to look too girly by the end of the school year (you know how mean kids can be). Sorry for the let-down. 

In the UK, I got hormones from my private psychiatrist on the first consultation. I presume you're referring to the prerequisites under UK's National Health Service.

Yes. Private doctors have always been easier to work with. 

[Chloe421x]

No let down go at your own pace and balance that with what makes you happy

Best wishes with everything!

Chloe

[Kevin Peña]

I appreciate the sentiment.