I have no problem knowing that I'm a guy. The issue is the risk involved. For me medically especially.
My liver's healthy, my heart's healthy, my thyroid's healthy...
But I weigh 80lbs. I worry about that. I also worry about my mental health; my family WILL be ballistic. I also have to do with with my father's approval... and he wants me to wait and "make sure" at least a year or so (which really isn't a big deal). But I also hesitate myself. Yes, I am confident in my identity, but I still wonder if altering my body is the right thing. I wonder if I'll be happy with everything but a penis. I wonder if I'll be happy being a man who's 5'3" and maybe around 90lbs if the T helps me gain some weight. I ask these questions. I know I'll be happier without breasts (I'm just a size A), but I have to start T to have top surgery approved. So I have to make the biggest decision first; am I ready to start injecting myself with hormones for the rest of my life? Can I afford it? If there's some sort of world war, will I loose access to it?
I'm paranoid. I have many mental issues going on. Anxiety, OCD, and depression are the big ones. Plus the effects of GID on top of it. I am just 18 years old, and I ask myself if I am emotionally mature enough to make this decision. Adults all over have told me that they are glad they didn't make life-changing decisions when they were 18. It doesn't matter how smart I am; my brain is not done developing yet and I'm just not sure if I can trust my own reasoning. Because of this, the process with the therapists will take longer. I am less assertive because I am compensating for the fallibility of my own mind. I am trying to be intelligent, make the right decision-- do what a good man would do and do what's best for the future... Not be selfish like a child, weak and doing something for the sake of doing it because "I want now."
I have to be smart. I can't walk back from this. There is no reverse. There is no saying "oops" in 10 years. There is no, "It turns out I just had trauma from the past, which is now resolved, and I so hate being a man," or something. Yes, right now, I can't imagine that ever happening. But it's the things we can't ever imagine happening that catch us and kill us. Steve Irwin didn't expect a sting ray to pierce him in the heart and kill him. That's why he's dead. He didn't see it coming. And there's no way I'd see regret coming from transition. That is why I must be really sure and prepared. I came out when I was 17. It's been about a year. I think by two years I might really have a clue. I've felt this way my whole life, but I haven't started living full time. I think I need to live full time for at least a few months before I start shooting hormones into my blood. Full time isn't going to happen for a long time, because of my life style, obligations, and outside goals. I have school, work, family. I can't throw all those things away to transition or I'll have nothing to come back to. I must have a strong foundation on which to transition, and I must do this smartly and correctly. That is why I am hesitating.
I have not seen a GID specialist yet. I am seeing my counselor on Thursday. It is then that I will ask for a referral. If she doesn't feel like she can make one, I'll simply call the specialist and ask to work with them (a referral is not required). That is when my real journey will start. I call this part of transition, "adaptation." I will be learning, listening, discussing, and expressing. I'll be talking to people in LGBTQQI groups (in person) to familiarize myself with my position. I will start living full time with a male name and hopefully people will catch on and use the pronouns. I already dress full time, have been for many months. I started taking on some male rituals, such as not shaving my legs and instead shaving my face. The effects are subtle, but I don't have peach fuzz, so more people call me a "sir" now. I will work with the therapist on my GID issues but also my anxiety issues. This process of "adaptation" could take many months or even a couple years. It will be after this process that things will start to move rapidly.
When I feel ready, which could be months or years from now, I will start HRT. That process will take a couple years of adjusting dosages and making sure things are working out properly. It would be wise to make sure my testosterone levels are healthy before I try to have any surgeries. Perhaps during this time of transition, I call "balancing," I may have top surgery, which for me will be a very quick, inexpensive, and simple procedure (because I am only an A cup-- I'll go for a key hole procedure). At that time, MOST of my issues will have been resolved. But I will also want to go with the next part of transition, which involves the genitals.
Having been on T for many months or a few years, my clitoris would have undergone some major changes. Depending on what medical professionals say, I will either have a medioplasty done early or later. If earlier helps the clitoris develop more, than I will seek to have the surgery sooner. In the mean time, I will be considering options for hysterectomies. By the time that thought crosses my head, I should be at least 30. I will have been living full time after HRT and top surgery for quite some time before I consider doing anything drastic to the bottom portion of my body. Not only for reasons like Thomas Beatie, but mostly because of the medical risk. I might be happier if I died at 30 instead of 20. Not to mention the fact that they wouldn't do a hysterectomy when I was 20 anyway.