Transman Transition Procedure: How to start transition from female to male|FTM?


How to start your transition journey from Female to Male transition?

These are few steps you follow when you want to opt for sex affirmation or gender affirmation surgery. Please note that it is called gender affirmation or sex affirmation surgery as it is affirming your gender, not sex change or gender change as nobody change gender after surgery.It is based on my experience it is not a standard form and it may vary.

Though in general we follow these steps.

  1. Visiting a psychiatrist for GID or Gender Dysphoria letter
  2. Visiting an Endocrinologist(Endo) to start HRT (Hormones Replacement Therapy)
  3. Visiting a psychiatrist for surgery                                                                           

Visiting a psychiatrist: Every trans person has a different journey even when it comes to transition. I visited psychiatrist when was 15 in order to know what was ‘wrong’ with me or why I was feeling this way. For transition first thing any trans person need is a GID (Gender Identity Disorder) letter or Gender dysphoria letter. Even though now the term Gender Identity Disorder is not used as Dysphoria is not categorise as disorder anymore still in India this term is used very commonly.  Some trans people may feel nervous, anxious, angry or so and it is completely normal to feel these emotions before or while visiting the psychiatrist for GID or Gender dysphoria letter. Many trans people feel anxious about saying something wrong and jeopardise their letter. Lack of money or lack of support from family or friends is also a reason why most trans people want to get the letter in one session. I am not aware about the standard procedure how a psychiatrist should analysis or in how many sessions they are allowed to give the letter. From my experience, I have seen there are many types of psychiatrists some give the letter without any psychological analysis and in one session, some do it for money they will ask you what kind of letter you want, you pay them and get the letter without any actual session, some take time they ask many kinds of questions, some ask for psychological test as well, some are trans friendly, some are not and their questions or methods might leave you offended.I would suggest to be honest in your sessions with the psychiatrist, say whatever you feel, let the doctor analyse you and don’t follow any script as the psychiatrist sitting there is not a fool he can easily ruin your script. I know not getting a letter in first session can be frustrating, can make you angry, anxious, worry about money and depressed also however once you start transition the changes are irreplaceable. It’s better to take time in starting, be sure about it, don’t fear any test or anything however if you feel the psychiatrist is practising methods that are not trans friendly, making you uncomfortable or unethical please change your psychiatrist and complain against him/her/they.

Visiting an Endocrinologist(Endo): After getting a letter you would need to visit an Endocrinologist(Endo) in order to start taking hormones or start HRT (Hormones Replacement Therapy). Endo will check your GID or Gender Dysphoria letter and check weight, blood pressure and do general check-up. Then after that he suggests some test in order to check your body is okay to take hormones or not. Do not worry if tests result is not positive as Endo gives you time to make your body healthy. Then you can start HRT. Many trans people start taking hormones without any proper prescription or taking tests, which is not recommended as it might create a risk of life or other health risk. Tests can cost somewhere around 2500 to 5000 it may vary from place to place, person to person. A friend of mine got it done in just 1500 and other got it for 5000 whereas it cost me around 3000. Do not worry if you do not have that amount of money as there are many organisation that help in this. Once your tests are okay Endo suggest the dose of the T-shot or Testosterone shot. A T shot can cost around 130 – 400 rs as the injection and Testosterone may cost around 80- 150rs and nurse who is injecting it can take anything from 50-200 or so. T-shots are taken at 15 days interval and Endo will keep you in observation for 3 months. After 3 months, he will suggest you few tests to check how your body is responding to T shots and future dose. Many guys skip this test and switch to higher dose it is not recommended as it might also create a health risk.  My endo suggests we can opt for surgery if everything is good after 3 months.

Visiting a psychiatrist for surgery: For surgery, you would need letter from two psychiatrists stating that you can go for surgery. They will check your progress with the Endo and your GID or dysphoria letter. After getting those letters, you can opt for surgery.

When you enter the community, things become clearer we have specific psychiatrist for letters and a person who wants to get letter visit the psychiatrist which other trans person has referred mostly. . Again, the journey is different for different trans people like the guy who referred the psychiatrist got letter in 2-3 sessions where as I got in one session and either way it is okay. I would really suggest people in community not to speculate rumours or try to create false image which is misleading for people who are new or unaware about procedures, surgery and doctors. Again I would like to mention this article is based on my experience.



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