On the day after Thanksgiving 2009, Christine Daniels took her own life. She finally succumbed to the hatred and bigotry so many of us in the transgender community must face every day. The societal and family pressures can be unbearable for us, and unfortunately for Christine, this has proven to be the case.

She was the subject of my final Trans Ed 101 column, and she had been a friend and mentor to me during my own transition several years before. Without her insight and support during that critical time, I truly don't know if I ever could have completed my life affirmation. Christine was an amazing lady.

I want to dedicate my writing and other educational activities on behalf of all trans people to the memory of Christine Daniels. May her life help to light the way for others who follow so they may not have to endure the same sufferring and fate.

Christine Daniels

10 Oct. 1957 — 27 Nov. 2009

September 2007: Something New!

Hi, I'm Michelle. I'm a transgender female in transition. I'm middle-aged, but like many in this position, have known about my mismatched brain and body since I understood the difference between boys and girls. At that time I felt I was literally alone in the world. How could anything so horrible happen to someone where they had an inner voice telling them all the time that the body they were in was someone else's? I was in my twenties before I understood that there were others like me. Of course, that didn't change the fact that I felt as if I were a freak. Society certainly didn't help and I became very adept at an extremely early age at hiding everything I truly was to the outside world.

For myself, this conflict came to the surface about five years ago. I had been getting deeper and deeper into a depression, finally to the point that I attempted suicide. My spouse, who was the only person who knew the "truth" about me, told me I needed help and that being transgender was the possible cause. Even then I ignored her advice until about 18 months ago. At that time I finally started to acknowledge who I truly was and to take steps to come to terms with it.

Each step I have taken in transition has been amazing. I never would have believed how liberating it could be to do what I have done. I had firmly believed that that part of my psyche was under complete control, yet it can't be unless you acknowledge who you are and do whatever you can to bring your mind and body into harmony. That first time I went out in public as myself, was the hardest thing I had ever done. Today, it is the easiest.

However, just acknowledging your true nature will not automatically make your life perfect. It is a hard thing to accomplish, especially if you don't have people who love you close by to lend support. Your family and friends may not be there for you. Some may disappear completely when they see the real you. Being transgender is what I would consider to be one of the most difficult things for anyone to overcome. There is no cure, no simple little pill to make it all go away. What you must do is still not accepted by much of society, but each day you are able to move forward you will find yourself happier within yourself, and that is what's truly important.

I hope that sharing my journey with you will make your own easier. Every day will not be perfect, but then this is true of everyone. All we can do is come to inner peace with ourselves and hopefully the rest of the world may seem a better place as we move forward.

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October 2007: Gay vs TG: The Difference

It has been exciting to come aboard this site to discuss transgender issues and to share my experiences with readers. One of these readers sent me the following question that I would like to address in this month’s feature.

"Thank you Michelle for telling everyone this. I have seen specials on TV and things on CSI dealing with TG people. It’s hard to understand if you don't know what it’s like. I was wondering, is this like being homosexual or is it something different?"

This question is probably the most common one ever asked to TG people. It’s rather funny in that when I first came out to my father, I was leading up to the big revelation and I could tell where his thinking was leading him. I immediately said, “No, I’m not gay!” before explaining the real reason behind my call. A recent episode of Larry King Live featured several transgender people, and it appeared that even with the education they were giving the host on the spot, Larry had a rough time trying to think that these people were not simply gay or lesbian.

To put it bluntly, being transgender has nothing to do with being gay, lesbian, or anything else for that matter. One’s sexual orientation and who you prefer to spend time in bed with has nothing to do with your gender identity, your own self image of who you are. I happened to have been assigned male at birth, but always knew that my brain is wired female. It took many decades for me to get to the point of being able to reconcile that dichotomy; a process I am now undergoing, usually referred to in the TG community as “transition.”

I have never felt any sexual attraction to males, and this remains true even after taking steps to be affirmed as female. With this in mind, I actually identify as lesbian, and always have. This must seem very bizarre on the face of it. I am transitioning, but at this point in transition I still have male genitalia since I have not yet had Gender Confirmation Surgery (GCS), so how could I identify as lesbian? Because it matters what’s in your head, not between your legs.

You will find the full spectrum of sexual orientations within the trans community, just as you would in any cross section of people. It can get very complicated with regard to TG however. Consider a trans female who is pre-transition. To the rest of the world they appear male, and yet may have a deep sexual attraction to males, so they may consider that what they're feeling means they are homosexual. If they are later able to come to terms with the idea that they may actually be transgender, and identifies mentally as female, then they should be considered heterosexual, especially when making the transition to be affirmed as female. This does not also mean that anyone who is gay is actually a closeted transgender. Gay men like men, not men who think they are women.

Many in society might view a trans female as a man who wishes to avoid being seen as gay by presenting as a woman. This is what happened with Larry King. There are definitely men who enjoy wearing women’s clothing as a sexual turn-on, but this is considered a fetish, and is not treatable medically. If I were in this only for the kick of sexy lingerie or frilly dresses, I would not be taking medications to physically alter my body.

The bottom line in this discussion is to realize that trans people are of just as many varieties as anyone else. Never simply lump them in as being gay. Each of us is different and unique. That is what should be celebrated.

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November 2007: Defining the TG World

A couple of interesting questions have been posed to me that I would like to talk about this month.

The first concerns a matter of definitions. Sunny in New Jersey asked: “What is the difference between being transgender and transsexual? Can a person be both?” The simple answer is, “Yes.” However, nothing about being TG or TS is really simple, so let me explain further.

Being transgender means that your body and mind are at odds with each other. It doesn’t even matter if the person accepts their situation or not, they are transgender. Sort of like having a congenital heart defect. You may deny it, but sooner or later there will be repercussions! I fought being trans for a long time, but now I am finally happy with who I am, and I’m glad to be able to share this journey with our SexEd 101 readers.

Transsexual is a trem often associated with a transgender person who has completed their transition to fully integrate their mind and body through Gender Confirmation Surgery (GCS). This means their sex organs have been physically altered to match their brain-wired gender identity. Some within the TG community might say this is not true, in that anyone who now lives full time in the gender opposite their birth is a transsexual. I can understand both viewpoints, and would not quibble with either.

The second question asked a more personal question from Jannett in Delaware: “I don't want to be out of place with this question but how did your father react?”

Telling family members about being transgender can be the most traumatic thing someone in my position can ever do. There are plenty of horror stories of families that have disowned children, or worse. A common reaction is that the parents feel they have literally lost their child forever. It’s as if they have died, or worse yet, been murdered (more on this in a later column).

In the case of my father, I initially sold him short. I told my mother about 18 months ago that I am trans, but felt my father (my parents divorced when I was 13) would possibly never be told. My wife Cherie, my therapist, and my mother all agreed I should not tell him. Going against all advise, about six months ago, I decided to tell him anyway. We don’t live close to each other, so I had to do the deed over the telephone. After beating around the bush for about half an hour, I finally broke the secret. There were a few moments of silence, then my dad's first words were "My gawd, what hell you must have lived." It was as if a wall had crumbled, and my father and I finally saw each other for the first time.

Our relationship had been formal and strained for many years, but once I came clean about being trans, we have never been closer. We are now sharing a real relationship that no longer has the artificial barriers I had erected in order to hide from everyone. My facade had finally disappeared and my father is now one of my biggest supporters. I am extremely thankful, not just to him, but to everyone in my family, and all my friends, for the support I have received. No matter what else I have to endure, I know they are behind me, and there is no better feeling.

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December 2007: Pitfalls of Coming Out as Transgender

The coming out process for a transgender person (or gay or lesbian, for that matter) is a very difficult process that can be extremely traumatic and full of nasty pitfalls. And this is not just for the person themself, but for everyone around them, including family members and friends. Anyone that goes through this must always keep in mind that even if you have lived with this all your life, those you talk to have not had the same benefit, so we have to be mindful and respectful. But those we do talk to need to keep an open mind if the process is going to work.

Now this, unfortunately, does not always turn out to be the case. I mentioned last month about what a wonderful experience it was to finally talk with my father, and how that was a huge positive in our relationship. Wouldn't it be wonderful if everyone we told were so loving and caring, and so immediately accepting?

If you are not the person coming out, but maybe have a friend or family member that comes to you in hopes of asking your understanding for this type of situation in their own life, please take the time to listen without preconceptions. There are too many people who will reject just because that's the way they were taught. A personal case in point was a good friend of mine that I worried extensively about telling because of his conservative and fundamentalist views. He was very accepting at first, but after an extremely terrible experience with a couple I've known for over 25 years, I know to wait long enough for the reaction to settle in before counting anything in the win column.

In this case, after my initial conversation, the friend went to his church and talked with them about what they thought of someone who is trans. They told him that being transgender was actually impossible, simply because God doesn't make mistakes! Many, such as the couple that turned on me, use this religious explanation as an excuse to hide their own bigotry. However, in the case of this friend, he told his church that they were the ones who were wrong, that he knew I wouldn't lie about this, and he absolutely believed what I had told him. He could see with his own eyes the pain I had lived with all my life, what a difficult decision it had been to discuss it openly in the first place, and how obviously happy was my new life. This reaction is amazing to see, and it truly shows who your friends are.

The couple that were not so kind, based their rejection, for the large part, on their religious preferences. Hiding behind the supposed teachings of the Bible, to cover their own ignorance. They went so far as to say that the old me had been murdered by the new me, Michelle. They refused to see any of the good that they knew was in me, and completely, and very vehemently, rejected everything about me. The last thing they said to me was: "If this is who Michelle is, we have no interest in meeting her. We don't like people like her."

I would hope that anyone reading this can see immediately that these people are simply bigoted. They arbitrarily rejected an entire class of people, with no thought for the individual. We need to judge people not by who we may think or want them to be based on preconceived notions of race, gender, or any other factor, but, as Martin Luther King, Jr. once said, “by the content of their character.” Powerful words that should resonate with every thinking and feeling human being on this planet.

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January 2008: First Knowledge of Being Different

A question was recently asked about how a person might know they are different with regard to gender stereotypes, at what age this might occur, and most importantly, how do you even recognize something like this in the first place. I can only speak from my own personal experiences and from the transgender perspective, but I think there are probably many similarities for people who are outside what many would consider normal.

In general terms, a transgender person may understand that they are different much earlier than might a gay or lesbian. I know this is not always true, but it was certainly the way it was for myself and for many others I have talked with. This also goes to the heart of the matter about the idea of gender versus sexual orientation. What I mean by this is that sexual attraction does not usually present itself until at or near puberty, sometime in a person’s early- to mid-teens. It is at this time a person sometimes finds they are attracted to someone of the same sex, thus changing them from the societal norm.

For a trans person, this difference in our gender identity is usually apparent at a much younger age, simply because it is a separate issue from sexual attraction. In my own case, I knew as early as 2 to 3 years old that somehow my brain was wired female and yet I had been given a male’s physical body.

With very little world experience to draw upon, it was one of those revelations that comes to you, that you know for an absolute fact, but you may not be able to describe to anyone who has not shared the same experience. I do recall getting very frustrated because I wanted to be with and play with other girls my own age, but was always guided to be friends with boys instead. At this age you don’t understand that gender is already set in stone, completely out of your control.

I recall vividly thinking about how I “knew” gender should be the choice of the individual. I identified with other girls, so that’s the choice I would make, if someone would just ask me what I thought of the matter!

Being raised in a religious household, I was taught that whatever you truly believed, god would supposedly provide. And since I knew wholeheartedly that I was destined to be a girl, then there was nothing to worry about. Going through the changes of puberty finally made me understand that I had been betrayed and lied to in church and at home. It was a horrible revelation, and was the first in a long line of steps away from religion in my life. Knowing I would have to live this way, and be what society said I should be, rather than as the person I knew I was, probably for the rest of my life, was the most terrible thing I could imagine.

The teen years are those most filled with crisis for everyone, but for gay, lesbian, bisexual, and transgender youth, this time of crisis can go so far beyond what others have to endure. Suicide is unfortunately not a rarity. If even once someone had asked me my true feelings about my gender, it would have made all the difference in the world. To avoid this, you must have loving and caring parents, who will encourage you to talk about your feelings. This time of discovery can be amazing, but if you don’t have a family that supports who you are, you must seek others, such as a health care professional or a local LGBT facility. Living with this by yourself is not living at all.

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February 2008: Fitting In

This subject could be for just about anyone. Who hasn’t had some difficulties fitting in to some situation at one time or another throughout life? Many of our readers may be teenagers, and I can bet that you think about fitting in just about all the time. There are cliques, and teams, and so many other ways to delineate your standing in school or society. Often conforming to what your parents want is completely contradictory to what you need to do to survive in school or on a job. Getting older does not always make this any easier.

Now take the plight of someone who is already different from the norm, just by their very nature. In my case, it is because I am transgender, but it could be because of being gay or lesbian, or being too smart or not being good at sports, or any number of things. There are so many pitfalls it’s amazing any of us make it through our teenage years into adulthood. But believe me, it doesn’t stop there. This is something we all must live with our entire lives.

Being different from societal gender norms can make the idea of fitting in harder than some can even imagine. My younger years were pure hell. The time around puberty was indescribable. Now, here I am, middle-aged, and finally making the transition I should have had the courage to do decades ago. Amazingly, in my case, the transition has been rather easy in that all but a very small group of people I know have welcomed me without judgment. I never thought this would be so, and that I stood the chance of losing everything I had spent a lifetime building.

Unfortunately, some trans people do just that, lose it all. The family and friends they have do not allow them to simply fit in. They are rejected, possibly persecuted, and sometimes even attacked and killed. This is the reality we must face every day once we decide we can no longer live as the gender assigned to us at birth. Trans females often have it the roughest, but trans males can also suffer. An example is the comment made to me by the couple who outright rejected me. They asked what it was I hoped to accomplish with all this I was going through. I told them, “I just want to fit in.” They replied, “How could you ever fit in since you’re only a man in a dress!”

Contrary to their opinion, even though I know I may not be as beautiful and elegant as I would hope to be as a female, I do find that I have been able to fit in. The support of my wife Cherie, my family, and my friends, has certainly helped boost my confidence. However, when I’m out on my own and surrounded by strangers I never really know how any given person might react, so I have to remain wary and on guard. One area I have found more than any other where a trans person may be treated badly is with younger males. I don’t know why this is. Maybe just showing off their machismo in hopes of impressing those around them with their prowess. It is these types of confrontations that have often led to violence and harm to the trans-person. Just recently I found myself in a huge group of kids just released from their day at high school. If anything was about to test my ability to fit in, this would be it. To my utter amazement, I did not get one look or comment from anyone. Maybe I fit in better than I think I do. It’s great to believe that, but it doesn’t mean I can relax.

My request to our readers is that if you every find yourself in a situation when someone is trying to fit in, no matter being transgender or any other obstacle that might make this difficult, and you see someone else making it hard for them to do so, take the initiative and diffuse the situation. Show kindness and understanding. Don’t let hatred and ignorance win the day. It is up to each of you personally to make that happen.

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March 2008: Less Than Human

At the end of the Civil War the slaves were granted their emancipation, supposedly with the full rights of citizenship in the United States. In actuality, the “rights” they were initially given were not as full and complete as you would think. One example is that although the black population was given the right to vote, their votes only counted for 2/3rds as much as a white vote. And, at that time, women didn’t even get that much recognition. What this meant, in essence, is that blacks and women were literally not considered as human as white males, certainly not in the eyes of the laws of the land where we have all been “created equal.”

African-Americans, and women, all eventually did receive full citizenship rights, and to have the ability to have their vote counted as much as anyone else. Unfortunately, some citizenship rights are still excluded from a significant percentage of our population. Yes, everyone can supposedly vote, but that doesn’t mean that there are not other exclusions. I would bet that most people reading this column hardly think about this sort of thing. You take your rights for granted. You expect to be treated equally under the law. Say for example that no one can simply fire you from a job you are competent at, just because they may not happen to not like the way you dress or act. Further, you expect to not be harassed by law enforcement officials for the same sort of reasons, and that if something were to happen to you, that legal system would back you up and protect those rights.

I happen to be a full-fledged citizen of the United States. I was born here, raised here, served my country in the military, and many more things, because I believe in what my country supposedly represents. However, unlike most all of you readers, I no longer get the same rights as you because I am of a class of citizens known as transgender.

Recently, there was an attempt to create a law which would grant full rights to everyone in this country. Seems ridiculous that this should even be necessary, but it definitely is. In this case the law was titled the Employment Non-Discrimination Act (ENDA). It would have put protections in place for everyone in the Lesbian, Gay, Bisexual, and Transgender (LGBT) community. In the end, the Senate passed a revised version of ENDA, but only after all protections were dropped for transgender. Even this was basically a waste of time, since President Bush had already promised to veto any version of ENDA that crossed his desk. But the message sent by this action was clear: the T in LGBT was still a long way from being considered human enough to be granted rights and protections everyone else gets without difficulty.

In many ways, I am lucky, in that I live in California. In this state, and a few others across the country, we are already protected by laws that grant us full legal rights under any circumstances. If I was to move to some other state, I stand a good chance of losing those rights. Even here in California we still face hostility and violence. Look at the situation in February where a teenager was shot and killed in an Oxnard junior high simply because a classmate was angry at the victim’s gender expression. A young boy now faces the rest of his life in prison, while another is dead, for no other reason than that the victim was transgender.

What kind of world do we live in where this kind of hatred over someone just being themselves is tolerated in any fashion? It is all too common that we are considered less than human, someone to be shunned, despised, or even murdered. Don’t allow this kind of hatred into your own heart. Be open and understanding of anyone around you that might not fit your definition of "normal." We are all 100 percent human and deserve the respect and love that everyone else expects in their lives.

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April 2008: Making the Grade

Events of the last few months have been somewhat depressing for me, and for many others in the trans community. There have been major setbacks for not only those of us who are TG, but also for the entire community of people who live their lives a bit differently from what many would call the norm.

The Senate took up the question of equal rights for everyone, and came up wanting. First they dropped transgender from the the list of those who were to be protected from discrimination, then the legislation they finally passed for everyone else, fell flat and has disappeared. Maybe with a new administration next year, things will be different, but unfortunately my crystal ball doesn't see that far ahead.

Then, within the course of a week or so back in February, four transgendered persons were murdered simply for being who they were. In mid-March when presidential hopeful Barack Obama made a stirring speech about equality for all, he very visibly left out any mention of people from the LGBT community. As I pointed out in last month’s column, even those who believe in equality for all, often do not extend those feelings to others they don't understand, and often literally consider less than human.

There are some signs of hope, however, at least on a personal level for myself. It was less than a year ago when I first started my coming out process to the rest of the world, and yet today I stand as a person who has surmounted everything and completed my transition, not just to myself, but to the satisfaction of all legal barriers that were thrown up in my path. On March 14, I finally made the grade. I got my "F."

With all the negative things happening around me, I felt I still had to move forward, and with the support of Cherie and my friends, I filed papers with the court to legally and forever change my gender marker from male to female. This can be a time consuming and expensive process. Not only do you have to file your papers and pay your court costs, but you must put a notice in a newspaper for a month that informs of the pending name and gender change. This supposedly offers a chance for anyone who might object to be able to step forward and offer evidence to prevent your change. In my case, no legal challenges arose, at least none outside my own head.

As the date approached, I grew more and more apprehensive since I "knew" the court could never allow this to happen. How many people had told me I was a man and had better face that fact? I knew different, but convincing others was not always easy, nor successful. A former friend whom I had not heard from in over a decade found out through others about my transition. The email I received was one of the most hateful things I have ever read. But through it all, there were so many who offered their support and encouragement. On that fateful day just a couple weeks ago, I sat in court with my spouse Cherie, and my good friend Ray, waiting to be called, as just one of many who sought to change their names for one reason or another. As each name was called, I would perk up for a second, then slump down when it was someone else. Finally, my name was spoken, and instead of getting up to approach the bench, I nearly fainted.

I quickly overcame my fear and went forward. Expecting to be quizzed and prodded, instead I was told that my request for name change was granted. I stammered for a second, expecting more. When I found my voice, I asked, "What about the gender change?" They replied that it was all there.

In a moment, my world changed forever. The knowledge I had shared only with myself for so many years, and with so few up until just recently, was now and forever complete, backed by legal documents I never expected to set eyes upon. Everything, up to and including my very birth certificate would now reflect the proper name and gender. The impossible had happened and I got the one grade I always wished more than anything to have. I got my "F."

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May 2008: The Transgender Virus

I want to first thank “V” from New York, who passed on congratulations and well wishes following my April article about how I received my legal identity change after going through transition. I am always gratified to receive feedback from anyone reading my articles, so please feel free to drop me a line with comments, suggestions, and questions anytime.

And with that, let me dive into this month’s entry, the idea about there being a transgender virus. I know this sounds really incredible, but you’d be amazed at how many people seem to think this way, or at least act like they do. This is akin to someone who believes they can catch AIDS just by being in the same room with someone who is HIV-positive. Unfortunately, it is true for many other diseases, as well as things like my own situation or others who may be gay or lesbian. How many times have you seen someone take a step backward when they come in contact with a person who may be LGBT, or with someone who has AIDS? It may sound silly, but it happens all too often. Believe me, I’ve seen and experienced this first hand on too many occasions to count.

Let me tell you of a recent experience of mine.

I have worked for many years in the field of education. I do a lot of volunteer work with schools specifically concerning science education and getting kids excited about the future possibilities of space exploration and settlement. In this instance, there is a local private religious school where I have done many presentations and displays over the years. In May they are having their annual star party, which will include many telescopes to view the heavens, as well as interior events with the kids and their parents. A regular treat for everyone at the end of the night has traditionally been Moon Pies! What great fun it has always been to take part in this and see the students light up with enthusiasm when they catch their first glimpse of the Moon or a planet like Saturn and its glorious rings through a telescope. It can literally change their view of their universe.

This year, the teacher I have known for a decade once again invited me and my group to participate. She has known of my transition for six months and has never expressed a problem with me. She has continued to be very active, even serving on the Board of Directors of the educational organization of which I am president. She is a wonderful person that I love to work with, and I was extremely gratified that even with her fundamentalist religious views that she has continued to embrace our friendship.

The problem arose when she decided to play it safe by discussing my situation with the school’s principal where she teaches, and where the event will take place. She wanted to make sure that no one would have any problem with someone such as myself attending and interacting with the kids. It was an innocent enough question, but has now had terrible repercussions. The principal said, “Sure. No problem at all, but let me take it up with the superintendent.” She did that and the response from the superintendent was along the lines of, “Over my dead body will a person such as this be allowed on our campus and get near our children!”

This was a very sad situation for me because I certainly do not wish to press the issue and harm my friend, the teacher who first invited me. But the bottom line in what the superintendent did was not only illegal, but was to show his extreme ignorance of the issue. This is especially upsetting in that it also shows he is so closed-minded to as not want to learn more, as was shown when he firmly denied to even talk with me in hopes of understanding the situation. In effect, he appears to believe that I have some sort of virus and I might be contagious. Can you possibly imagine all the poor children who will be turned away from their normal and natural gender identity just by my mere presence!

What I have is not catching. If it were, there would be a pandemic of gays, lesbians, and transgender folk the world over. No one would be safe! The Plague of the Dark Ages would be nothing compared to this. What utter nonsense! There would be millions in research to find a “cure.” Instead, the students at this religious school are denied knowledge of the great diversity of life.

I hope that you readers out there are a bit more intelligent than that school superintendent. I think just by being here and reading this column, and the others that appear throughout the month, that you are all inquisitive and respectful of those around you. I applaud your diversity and understanding. Don’t let ignorance of gender and sexual matters rule the day.

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June 2008: Gender Reassignment Surgery

For those who are transgender there are several ways to handle our situation. The one that most of us follow is to do absolutely nothing. We try to hide who we are, not only from others, but from ourselves. Being assigned the wrong body for our gender at birth is a frustrating, debilitating, and often, life-threatening situation. There is no right way to handle things, especially when society places as many barriers in our way as possible, to prevent us from knowing what may be available. If and when we do finally find it within ourselves to come to terms with this, we may still be afraid of what we must do in order to live.

Having surgery of any kind can be a frightening experience. The odds are always in our favor, but you still hear those stories about the one in a thousand chance that something will go wrong, that you may never wake up once the anesthesiologist puts you under. The idea is to only have surgery if you really need to do so — if there is no other option available to you. This is where many transgender people find themselves at a crossroad. We accept that we must transition, but how far do we go with the process? How much do we need to do in order to be happy and to want to live?

The overall process goes something like this:

First come the visits to a therapist to discuss the situation. Are you truly transgender or is there some other problem lurking below the surface, masquerading in this bizarre identity crisis? Once that diagnosis is complete, then it becomes a matter of trying to live with it or to transition. In my case, transition was the only answer that held the promise of survival. This is a critical juncture for many of us, one that is difficult to cross.

Second is the decision to take hormones related to the gender to which your mind is actually wired. In the case of a trans male they would go on testosterone, or as trans-boys often call it, “T.” For trans females, such as myself, you have a whole battery of different hormones and medications at your disposal. In my case, my doctor prescribed estrogen and spironolactone to start, then monthly injections of a nasty and expensive drug called lupron. These meds gave me many desired results such as giving me softer and less oily skin, inhibited body hair growth, and greatly decreased my body’s natural ability to manufacture testosterone. An additional side effect is that breasts start growing, just as in an adolescent female.

Third is the biggest and most irreversible decision: surgery or not, and if so, how much to do? Complete top and bottom surgery, or just one or the other?

For trans men this surgery can consist of chest reconstruction to eliminate the breasts and re-sculpt the chest to male proportions. A very risky, costly, and sometimes not very effective surgery can also attempt to create a penis, but many choose to stop at the chest reconstruction, along with a possible hysterectomy to remove unwanted female reproductive organs.

For trans females bottom surgery is often more successful, and the results more satisfying. This comes about because of the fact there is more raw material to work with. The operation is known as a vaginoplasty. Here the doctors perform an orchiectomy (removal of the testicles), then turn the penis inside-out to create the vagina. The now empty scrotal sac is then used to form the labia.

What this all adds up to is known as Gender Confirmation Surgery (GCS).

In my personal case, since the time I went on hormones my doctor discussed these surgical options with me. I finally found the solution that works, the compromise of drugs and GCS that will allow me to live with myself. It was scary to face surgery, but my future now holds such promise. Thank you for riding along on this journey of discovery with me.

XXXX