Transsexualism defined: Understanding the transitional process

3 Jan

While defining transsexualism is actually a very easy thing to do, helping someone understand the transitional process, especially someone that will never go through it, is not quite as simple. For starters transsexualism is more accurately described as GID (Gender Identity Disorder) which is determined based on two specified criteria being met. The first is that the person must have strong persistent cross-gender identification which demonstrates the desire to be or actual belief that the person is the opposite gender of that which they physically present. The second criteria is that the person must not be desiring a diagnosis of GID and/or GRS (Gender Reassignment Surgery) for any real or perceived cultural benefits, and there must be evidence that one has a strong aversion to their birth assigned sex or a sense of their inappropriateness in their gender role.

What that all means in lay terms is that a person must in general feel general revulsion with their birth sex and feel that life as such is unimaginable in that physical shell. They cannot be seeking GRS or a GID diagnosis for any other purpose such as feeling that will cure other issues they are dealing with which are unrelated. Although it may seem unbelievable, many people present for treatment under less than legitimate grounds assuming it will be a panacea.Patients that suffer from GID generally trace their knowledge of something not being “right” back to as early as around five years old. Though they may not have understood fully what they were feeling, they understood on some level that their body and brain did not match.

The transitional process itself varies not only by country, but by individuals. Transition is the period of time in which a person is actively undergoing the process of changing genders. During this time a person will live 24/7 in their chosen gender role. They will not deviate from this for work, socializing, vacation, or any such thing which may pop up. This is done so the person knows for sure exactly what they can expect life to be like in their chosen gender, and so that their psychiatrist can be sure the person is serious and evaluate how well they are mentally coping with the change.

There are certain standards set in place called the Benjamin Standards of Care (BSOC) which outline the path a person must take from the medical standpoint to successfully complete the transitional process. A person must undergo psychological evaluation of no less than ten visits, and then have an MSW or higher counselor, preferably a gender therapist, concur with the diagnosis of GID. At that time hormonal replacement therapy (HRT) may begin. Those transitioning to female will introduce a regimen of estrogen and an anti-androgen to the system while those transitioning to male will begin taking testosterone in accordance with a program designed for them by an endocrinologist. They cocktail may vary over time, but will generally remain consistent. HRT is not something to be taken lightly nor should it ever be self-prescribed, the risks are too great.

As HRT is beginning, or in some cases slightly before, MTF (Male to Female) may start electrolysis and laser hair removal. Many FTM (Female to Male) begin hitting the gym to speed the process of taking on a more male physique. Generally at a bout the one year marker of transition an MTF may elect to have a breast augmentation while an FTM may choose that time for a mastectomy. One year is generally the marker because although cosmetic, these are serious procedures and it is important the person and presiding medical team feel sure the time is appropriate and the that the process will continue to move forward. In some cases and FTM may also choose this time for a hysterectomy.

The one year anniversary is often the time for legal changes as well. New names which reflect a person gender may be legally adopted, in some cases gender designations on legal documents like drivers licences, passports, birth certificates and the like may be sought. Although the criteria for this varies greatly by locality, when possible, most people will seize the opportunity. Generally an attorney is not necessary but is always advisable to insure that the law is being followed as in some cases the decision is left to the judges discretion.

By the time two years has passed, an MTF will usually have completed the bulk of if not all hair removal deemed necessary, an FTM will have the ability to grow facial hair just as easily as an physically born male, and in some cases other cosmetic procedures may have been undertaken such as facial reconstruction surgery, hair transplants for those in need, or even somewhat more radical things like buttocks implants or other body modifications like an tracheal shave (Adam’s Apple reduction). This is also more importantly the time in which a person will receive the letter from their medical team which physically and mentally clears them to undergo GRS.

While this a a rather bare bones overview of transsexualism and the transitional process, it is certainly enough to demonstrate that people who do go through this process do not do so lightly. For each person it may vary. Some find the process quite easy while others find it extremely difficult. Between the BSOC and close monitoring of the transitional process, the rate of success (Those measured as satisfied with the change) is rated around 94% according to most studies. Being transsexual and going through transition are difficult for the person and those around them. Lending your support, understanding, and friendship during this time ill mean more to the person than you may ever know.

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