Source: health24.com

  The gender reassignment process

Changing the appearance of your body to that of the opposite sex is a long process. This is because being viewed as female, or male, has a lot more to do with performance and role, than it has to do with what is between your legs.

Gender reassignment as a process, follows the same path for FTMs (female to males) as well as MTFs (male to females) at the beginning.

Beyond surgery there are formal changes that need to be made to personal documentation such as passports, identity documents and the like. When you undergo gender reassignment, your whole world has to shift at every level.

Questioning gender
This is the first step for transsexuals. You usuall feel very uncomfortable with your body and role, but unsure what this all means. There are so many ways to express gender, and surgery and hormones are not for everyone.

It is helpful to locate a therapist, Trans group or find some information in books or on the internet, in order to realise how your experience fits into the context of gender reassignment, what your options are, and how to begin the journey. It is important to find some sort of support that will give you strength and love when you are coming out to those closest to you, like your parents, friends, or other family. It is important that you have a soft place to land, as the coming out process is often the hardest step in claiming and realising your identity.

Different approaches
There are two different approaches to transsexuality. The first school of thought deals with transsexuality as a mental disorder, and labels the patient as being gender dysphoric. The medical practitioners who adhere to this thinking require that the person wishing to obtain hormonal treatment and surgery, live as the preferred gender role, for a minimum period of two years. This is known as the “real life test”, and is in accordance to the Harry Benjamin standards of care.

It is thought by these practitioners that this test will ensure the validity of the patients' claims of feeling like a transsexual. The person is labelled as having Gender Dysphoria. The treatment is said to align the body with the mind, as the mind cannot be surgically treated.

There are practitioners, usually operating in the private sphere, who perform surgeries on receipt of a therapist's letter that the person wishing to undergo treatment is of sound mind, and will live more comfortably if surgery and hormonal treatment is received.

No real life test is necessary, as it is seen to do more harm than good to the patient's identity and emotional stability. Not all FTMs will want the same treatments, and it is up to each person to decide the order and necessity of each treatment.

Female to male hormonal treatment

The female to male (FTM) person will usually seek hormonal treatment as the first step towards their new body. In order to get testosterone for the FRM, which is the masculanising hormonal therapy, it is necessary to have a prescription.

It is possible to get these hormones illegally, but it is not advised, and can cause severe damage. An endocrinologist writes the prescription, and monitors how your organs are coping with the testosterone once treatment has begun. 

Some of the changes from testosterone are permanent and irreversible, while others are maintained only through continuous use.

What happens?
Each person who takes testosterone reacts to it and experiences it differently on an emotional level. You will not know how you will react to the treatment until you start it yourself.

Physically, the changes that occur are generally the same for everyone. However, it is important to be realistic about your body, and expect the changes to be in proportion to how your body looks at the start. If you are short and skinny, chances are that you will not look like a WWF wrestler at the end of it.

The permanent changes include a deepening of your voice; increased body hair on your thighs, abdomen, back, arms and chest; facial hair; receding hairline and possible baldness; Adams apple and facial bone thickening; enlargement of clitoris; and your skin becomes coarse.

The changes that are not permanent, and which will go away if you should stop taking testosterone include decrease of fat in buttocks, breasts and thighs, and an increase in fat on abdomen; an increase in red blood cells; increase in ability to grow muscle; increase in sex drive; weight gain; and menstruation ceases.

Testosterone will not grow you a penis or make your breasts disappear. The changes that do occur are slow, and depending on your dose, will take from a few months to up to five years to complete. Testosterone is not a birth control measure, and you can fall pregnant if your female genitals come into contact with sperm.

Risks associated with testosterone use include liver damage; increased risk for breast cancer, even after top-surgery; increased risk for uterine cancer.

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