The Process And Reality of Transition

Susan (F224)

Gendys Conference, 2004


Firstly I would like to apologise to our FtM friends. There is some material herein that is common to us all but, for obvious reasons, I don't feel qualified to speak for FtM!

Decision And Planning

  • Walk, don't run, it is better to arrive safely than not at all.
  • Do your homework thoroughly - use the Internet and Support Groups
  • Work, family, friends - prepare thoroughly for transition at work. Be prepared to lose family and friends. Remember, if you lose a friend because of transition, they never were a true friend. The ones you keep are worth more than gold
  • Finances - be realistic about how much everything will cost - hormones, laser/electrolysis, surgery, housing, living costs, travelling, new wardrobe, entertainment, networking.
  • Timetable " be realistic about this. You cannot go to post-op from a standing start in 3 months!
  • One home or two? Now or later? New town? This will depend upon many different factors. Sometimes you decide, sometimes the decision is made for you.
  • Aftercare - who will look after you immediately post-op? Ideally you want a month of TLC before returning home.
  • New life - New history? Don't make it up as you go along.

Change of Name

  • Choosing a name - suit your age and personality - ask a good friend. Also, do you change your last name or not? Keeping your last name might make it easier should you eventually obtain a replacement birth certificate.
  • Statutory declaration or Deed Poll? Stat Dec can be cheaper and usually just as effective.
  • Phone first to establish exact requirements - it can speed up the process, especially with the Passport Office who have been found to be surprisingly quick.
  • Don't miss anyone out - you don't need incorrectly addressed post to your new household/town/friends
  • Always try to quote account or reference numbers.
  • Rome wasn't built in a day - 6 months or more to get confirmation from all contacts of a change of name is not impossible.
  • Be prepared to chase for an acknowledgment.

Real Life Experience

  • Don't cheat - it's for your own good. It isn't unknown for people to take short-cuts and then regret everything.
  • Stress - be prepared for it - particularly if you are working and have family problems.
  • You are an amateur - take every opportunity to learn your new role. Take advice and do practice.
  • Work - be firm but not confrontational. Do your job as well as you can and give no cause for complaint or regret. Many employers will accommodate the change.
  • Family and children - Spouses often need to work through a period of grief, which could manifest itself as depression or anger. Be patient. Younger children might cope better than older ones with transition. Adult children may also grieve the loss of a parent even though they may ultimately accept you.
  • You need friends - someone to cry with, shout at, seek advice from. Making good friends is an investment both for you and them. Be a good friend.
  • Be firm but polite - 'Need to Know'. You don't have to carry a placard which reads 'UNCLEAN'. You have a birth defect and you are dealing with it. Only if necessary, use words.

New Home, New Life

  • Consider your needs, now and in the future. You might be living alone for the rest of your life. If this doesn't suit you, consider a lodger. But do seek out and make friends.
  • Live within your means. There are demands upon your finances, short medium and long term. Don't be extravagant. Do, however, plan to have fun.
  • Choose your new location with care, you may get only one financial 'shot' at it.
  • Stealth or not? Is it sustainable? Maybe not if you stay in the same job or area.
  • Rehearse your story and stick to it - YOU MUST BELIEVE IT. If you do move to a new area, tell as little as you must in order to be credible.

Stealth or Not

  • Acceptance - Be realistic. Be aware of your height, weight and appearance.
  • Do you pass? Are you acceptable? These are not the same thing. Passing is much harder work than being acceptable.
  • Age and voice. Again, be realistic. Voice training is available, often at your local hospital speech therapy department. Transition is usually easier for younger people; transitioning when older, though perhaps more challenging, is not impossible. If appearance is a problem consider facial surgery (if funds permit)
  • Build, attitude, style. Observe other women or men your age and consider using them as role models.
  • Relationships - sexual and non-sexual. Living stealth in a relationship before surgery sounds impossible. Use common sense.
  • Sustainable relationships? Not necessarily sexual. Make good sustainable friendships
  • What if you are challenged? Children can be perceptive, tactless, rude, bullying, intimidating and frightening. Best ignored if you can. Adults - tell them if you must, as little as necessary.
  • CONFIDENCE. This is crucial. Walking along with your head down and hiding your face will draw attention to you.


  • SRS, FFS, Other? What, and to what extent, will depend upon your personal drivers, available funds and perhaps your medical history.
  • Orchidectomy? This can be an option for those unable to have SRS for medical reasons. SRS, if undertaken at all, should ideally be within 2 years of orchidectomy.
  • Do your homework - Ask around, check your finances, talk to surgeons if possible, get recommendations and, if possible, view results.
  • Choose a surgeon - cheaper abroad? May work out cost effective but bear in mind hidden costs such as the cost of a possible return visit, the cost of taking a companion with you.
  • Waiting time - may be longer on NHS? Depends on your PCT policy. Shop around.
  • Realistic expectations. Don't expect miracles. Things do sometimes need 'tidying up' even though the surgeon has done his or her best.
  • Aftercare - don't skimp.


  • Do as you are told. If your surgeon advises light duties for a year, do it. If you are told to dilate for 2 hours a day, do it.
  • Look after yourself - don't overdo it - you've just had major surgery, be careful!
  • Everyone is different - don't listen to anyone who says that 'you should be able to do so and so after 5 weeks', they are not you. And the older you are the slower (generally) will be your recovery.
  • Be prepared to revisit the surgeon. He or she will do their best but sometimes things need 'tidying up'.
  • You still need all the friends you can get - people to laugh with you, not at you. A friend is a complex combination of qualities but basically is 'there for you when you need them'.
  • Reasons to be careful - cleanliness - ABSOLUTELY VITAL. Follow aftercare instructions very carefully.
  • Reasons to be cheerful - too numerous to mention!


  • Aftercare never stops - you never stop looking after your new 'bits'. Frequency reduces but never ends.
  • Post-op depression - be prepared for it, it shouldn't last long. If it strikes, make yourself go out and visit a friend.
  • Return to work - when you are told you can. But don't overdo it. If you have a sedentary occupation, take a 'doughnut' cushion for the first few weeks.
  • Sex and sexuality Orientation may change after SRS. Be prepared to be surprised by your own body. Take it easy.
  • Women - still often seen as 2nd class citizens. Use your new-found personality to get your way; don't be aggressive - just firm.
  • Don't keep playing the record - unless you want to be a professional transsexual!
  • You are cured - Life goes on. You had a birth defect, it's been fixed. End of story.
  • You are now a man or woman, albeit with a transsexual history, so behave like one.

Useful Links

Press for Change
Gender Trust
Transsexual Road Map
Gender Identity Research and Education Society
Ftm Network
Mermaids (For Young tg/ts and Families)
Gendys Network
Tg Publications

Citation: Susan (F224), (2004), The Process And Reality of Transition, GENDYS 2004, The Eighth International Gender Dysphoria Conference, Manchester England.
Web page copyright GENDYS Network. Text copyright of the author. 09.07.06 Last amended 06.02.07, 24.09.07, 31.04.14