This article is a general guide for people who are born female but feel male. You don't have to make the whole physical transition: it's okay to stop at any phase as long as you're comfortable. You can always make the transition further the next time you decide to do so. However, you will most likely not be able to return to the way it was.
Step
Step 1. Accept yourself
The first big part of the transition process is accepting who you are. You may have known this identity for a long time or you just realized it. Spend a lot of time thinking things over, doing research, crying, whatever has to be done. Know that you're not alone-many people are also transgender (also known as people with gender dysphoria).
- Try finding a safe support group in your area so you can meet other people who are like you, listen to their stories, get more information, and finally accept yourself.
- Find out what you need to calm down. Some transgender people feel comfortable wearing clothes in the style of the gender they identify with, and some ask to be addressed as “he/him”, while others prefer more neutral pronouns such as “them/their” in language-speaking countries. English. Some feel they have to do more with their bodies to be understood properly and accept themselves in the mirror, so they take hormone therapy (testosterone is injected in the form of a gel or cream). Some transgender people have dysphoria that is so severe that they need to make significant transitions, including the above and surgery (upper and/or lower). Keep in mind that you don't have to make a choice right away, in fact this transition process will take a long time. Many people are frustrated by the lengthy transition times, surgeries like these are not covered by insurance and can be very expensive in some countries.
Step 2. Be honest
There's no “right” time to come clean with other people as transgender and it doesn't have to be second top in your transition process. However, this is a very important thing to do. The transition process is a long one for you and your path will not be easy – you will need a support system and people to stand by you. Especially family. Be careful not to rush your family and friends to see you as a man-they have known you for a long time as a woman and this will be hard on them.
- It may be a good idea to tell a close friend or your parents in advance (especially your parents if you still live together). Letters can be used if you can't express what's in your heart or don't know what to say. Be gentle and don't rush. Let them think this through and try not to feel offended if they have to leave, cry, or do something unexpected. Even if they leave you, remember that you have been through this and thought about it for a long time, but for them, this may be the first time.
- You can test your family's attitude toward transgender subjects by talking about FTM (female to male) on the news. Look for interesting stories like “man who got pregnant” and discuss them with your family. Find out how they react to the pregnant man before you come out about who you are, especially if you're a minor. In some families there is even a risk of physical violence. Don't be honest unless you feel you are physically safe and already have a “worst-case scenario” option if the situation turns violent.
- Most people will have a lot of questions (especially family). Broaden your horizons. Know what you have to do afterwards and know the options that will come up and you are considering. Be patient with their questions and don't tease them because they say things that need no further explanation. Don't be wishy-washy, or appear to have no definite plans. They will see your attitude as a sign that you haven't really thought about this and they can persuade you not to make the transition. You should have considered that examples of being transgender (such as feeling uncomfortable around women's groups, wanting to be bulky, or dreaming of becoming a soccer player as a child) would fit into their reasoning that this is normal. for most girls, as a way of trying to show you're wrong. It's very difficult for them to understand because they are cisgender, and don't know the myriad reasons you have and are impossible to explain to be able to make them fully understand, just as a man can't explain his feelings to a woman. So take it easy and don't get angry or frustrated because of them. If they are talking to you and not yelling, they are trying to support you. They love you and that's the kind of thing you need.
- There are many support groups for families and couples of transgender people if that interests them. PFLAG (an acronym for Parents, Families and Friends of Lesbians and Gays, America's largest organization for LGBT families, friends, and relatives) can be seen on the internet and the organization has branches throughout America. You can also take them to a meeting if you go to a meeting that allows them (ask first as these meetings are usually confidential).
- The terms transgender and gay are often confused or intertwined and can lead to confusion when you're honest. Remember that transgender refers to a person's GENDER identity-a transgender person can have any sexual orientation that a cisgender person has: gay, heterosexual, bisexual, asexual, etc. This confusion can arise when giving a "label" to transgender people during the transition process. So, as an FTM, you are a man, and that means you have to make it clear to other people that if you like men, you are (arguably) gay, if you like girls, you are heterosexual, and if you like gay men and heterosexual women, You are bisexual. However, regardless of who you want to date, you will always be a man. Other reasons that people confuse the terms transgender and gay can come from people who like to cross-dress (who are shown in the media as gay but aren't actually gay), butch lesbians who are clearly not men but dress like men, and drag queen (transgender) and drag king (someone who exaggerates the style of dress a gender identity) is gay.
Step 3. Come out as a man
If you haven't already done this, you may start to dress like a man to show your inner identity. There are sites on the internet that can offer advice on "acting out" like a man, but you may find that counterproductive because you want to stop pretending and start being yourself. Some of the advice given by well-meaning transgender people is being rude, spitting, using vulgar language and swearing, taking up a lot of space by spreading your legs even when on the bus, and being arrogant. Most of the cisgender guys around you probably won't, so it's a good idea to observe what habits you were taught that were feminine and still do, such as covering your mouth when you laugh, and then break the habit. You don't have to act like a woman all the time, so the habits you adopted to fit in with your surroundings can now be abandoned. (Feeling better, right?)
- Be careful and do it stealthily. Sudden changes at home before coming out may surprise your parents and could trigger tension or other uncomfortable conversations. Doing this at school, especially in elementary or middle school, or at work, can cause a lot of trouble with the people around you. Instead, try to "migrate" at home first, or in a public place that is rarely visited by people you know. However, when you're ready to try dressing like this at school or work, try to do it in several phases, such as cutting your hair and buying boyish clothes, then changing to a shirt and jeans or shoes from the men's section of the mall, and cut your hair even shorter if you like it. Slow transitions will make it easier for you later on. The length of the transition time is completely up to you. You are now in control of your destiny.
- You can educate classmates or coworkers about being transgender to make yourself comfortable at school or work with your new look. Again, be aware that not everyone accepts you the way they should, and they can say hurtful and untrue things, like saying you're a butch lesbian. Take it one day at a time and talk to a support group as needed, even on the internet.
Step 4. Find a therapist
This step is very important for two reasons. One, living a life that makes you feel “stuck in the wrong body” can have a detrimental effect on your mental health. Transgender people are associated with depression and suicidal thoughts (about 50%). Find someone to talk to to help deal with the problem and listen to your feelings. Second, before you make the transition any further, you need a psychologist to confirm that you are transgender. From there, they can provide referrals to endocrinologists who can administer hormones and surgery for certain types of surgery. However, in some places, this could not be realized because changes in DSM 5 (Diagnostic and Statistical Manual of Mental Disorders 5th edition) removed transsexualism from the list of mental illnesses (it should be noted that homosexuality was eliminated decades ago). Surgeons in America (at least the official ones) will not perform buttocks surgery without the approval of a doctor or psychologist. Never try to buy testosterone on the internet and do it yourself! The reason why your doctor or psychologist sends you to an endocrinologist is to get a blood sample so that your current hormone levels can be checked. They shouldn't give you too much testosterone because it can be converted into estrogen by the body, and that's the opposite of your plan, right? So if your state requires you to see a psychologist, meet him and be patient. If you're lucky to live in an area that no longer requires you to see a psychologist (such as Washington DC), the process will be quicker but just as safe.
- It's a good idea to find a good surgeon or a psychologist who specializes in or sees transgender people frequently. If you're having trouble finding a reliable surgeon or psychologist, try going to a support group or looking online to find out who they recommend (and don't).
- The transition process is a very serious step in your life, so you shouldn't rush it. If you see a psychologist, it will take several sessions to provide a definite diagnosis and they can continue to help you through the transition process.
Step 5. Make a plan
There are many steps to consider, between hormones, surgery, being honest with everyone you work/live/interact with, so having a basic guide can be very helpful. This guide can help you see things from perspective, keep you on track, take note of sources, make a good list of doctors, plan when to change your name in legal documents (driving licenses, passports, birth certificates, etc.)), and motivates you to budget your money (which will be a large sum since most insurances don't pay for everything you would need to save tens of millions of rupiah).
- Try to be realistic. No matter how much you desire to complete this transition process within a year, the reality is that it will take you several years to complete. If your plan is to make a full transition, the realistic goal might be around five years. That way, you have time to adjust each step of the way, and also give your family, friends, and coworkers time to adapt. The therapist can also help support you in this process by determining when you are ready to move on to the next step. Some states in America also require you to live as a man for one year before receiving hormones or having surgery (though that's now changing).
- Your therapist will be the best person to turn to for help as you plan for your future. They know the estimated waiting time between transition steps and they may have a good idea of a realistic plan based on the past experiences of other patients. If you don't see a therapist, check with members of a transgender support group because they can tell you when to take these steps.
Step 6. Begin hormone therapy (optional)
Not all transgender men choose to start Hormone Replacement Therapy (HRT) for a variety of reasons, including price and the fact that their bodies cannot accept the "T" (androgen sensitivity), which would not make them any less male or female. transgender. FTM is very lucky when it comes to testosterone, which is also known as the “T”, because testosterone is very powerful for transforming a person's body, unlike the gentler estrogen used by MTF (male to female). Testosterone makes your body look and feel more masculine by:
- regulates the distribution of fat so that the fat that has accumulated in the hips, buttocks, thighs, and (a little) the chest moves to the abdomen (you won't lose fat, but the fat is just redistributed so you still have to exercise to lose weight).
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build muscle (if you exercise, this hormone won't make you muscle if you're lazy), widen the shoulders, and possibly thicken the skin on the hands and feet (it could also expand the hands and feet due to cartilage growth, but not sure).
- Increased muscle tone and fat transfer usually make your face more square or defined (if you're under 21, you may also be able to grow an Adam's apple).
- Men can also lose fat faster because they can gain muscle mass more easily (which usually burns a lot of fat), so you should be able to reduce belly fat sometime in the future (but you will also gain weight first because You'll feel hungrier and you won't be able to lose weight by just relying on a T and slacking off. You have to get your metabolism going regardless of your gender).
- Most FTM feel stronger and more peaceful after getting the testosterone hormone.
- increases the growth of facial hair and the loss of fine hair on the temples due to the common male problem of baldness and this problem is irreversible even if you stop using the T hormone.
- deepen your voice (your voice may sound unstable and you may lose your vocal range while singing).
- thickens the skin and makes you more tolerant of cold.
- change your body odor and increase sweat volume when hot.
- Testosterone can increase your height slightly if your puberty is not over and you are still growing.
- Testosterone will also stop your menstrual cycle, generally around 3 months (depending on the dose).
- Your sex drive will also increase, so will your appetite.
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Your clitoris will also start to grow. The clitoris and penis develop from the same cells in the fetal phase, and the T hormone triggers an increase in size. Usually, the clitoris will grow about 2-5 cm.
This is especially important for metoidioplasty (one of the two options for genital surgery), which is used to enlarge the clitoris and shape the penis
- Starting hormone therapy feels like going through a second puberty. It should be noted that if you notice a pimple appearing for the first time, you will once again experience a breakout phase or your skin will become more oily (prepare a face wash).
- There is no definite time for these physical changes to occur, but your menstrual cycle will stop within 6 months. Your voice will also turn heavy in about 6 months to a year. Likewise with the growth of the clitoris.
- Most people start taking the T hormone through injections. But this method can be turned into pills, plasters, creams, or gels. Prices for testosterone therapy will vary depending on dose, method of administration, and insurance (if you don't have insurance, you'll have to spend your own money; if you have insurance, some policies will cover the cost of hormone therapy as you transition, and some policies also exist. It should be noted that some universities have insurance for their students that can cover some or all of the cost of hormone therapy, and some will cover the costs of surgery).
- Some FTMs prefer to have upper breast surgery before starting on the T hormone. There are many reasons for this: some people choose breast surgery as a first step because continuing to have breasts after you start looking like a man can be awkward or embarrassing; for others, breast surgery is very important for psychological health and physical appearance – the general public holds the belief that breasts represent a person's feminine nature, and for most FTMs, breasts make them uncomfortable and an unwanted part of their body. In some instances, breast surgery may be more successful before the use of T hormone, and in other cases, breast surgery is better performed after the use of T hormone, so make sure you consult with your doctor and surgeon for advice on what is the best thing to do at this time. Some FTMs also choose to wear clothes to reduce the shape of their breasts while they save up for surgery; they also usually start a weight loss program in an effort to reduce bust size so that they have more options for breast surgery (there are three types of surgery based on bust size; keep in mind that weight loss will not reduce the size of breast tissue in everyone).
Step 7. Change your name
Most transgender people will start asking their friends and family to call them by the name of the man they chose in the early stages of the transition process. Usually, when you start using the T hormone is a good time to change your name because you will start to look like a man. You should check the laws in your country. There is usually a name change fee (in America, it costs around $200 or the equivalent of around Rp. 2,500,000, in Indonesia a court fee of around Rp. 200,000 or more may be required) for processing fees.
Make sure you update your official ID (SIM, KTP, NPWP, etc.) with a new name and photo, if possible. You should also notify your school or office, especially if you have to use ID to enter school or work. accommodation for transgender students by placing them in different rooms during the transition period, and some other schools will place them in the same dormitory or pair them with a roommate of the same gender as they choose. However, most schools will not do this this before the person is designated-by the state, county, or province-as their chosen gender. Check your school's policies beforehand so you won't be surprised by something)
Step 8. Perform the operation
Like HRT, not all transgender men choose to have surgery. If you feel comfortable with how your body looks without surgery, that's okay, as well as when you feel uncomfortable with your physical state. Transgender men's bodies come in many shapes and sizes, just like cisgender men. There are three kinds of surgery that can be chosen to have a man's physique.
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Breast surgery: remove breast tissue and make your chest look more masculine. There are several different procedures for this surgery, depending on your chest size, skin elasticity, and what you prefer (for example, wound, healing time, and risks/benefits). These three operations are:
- Bilateral Mastectomy or Bilateral Slicing (if you have a C, D, or larger cup size, this is the only option)
- Subcutaneous or Keyhole Mastectomy (suitable for men with thin breast tissue, such as size AA)
- Subcutaneous or Peri-Areolar Mastectomy (not as scary as “keyhole”, but if you have a breast cup size larger than B, you can't do it)
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Hysterectomy: removal of the uterus. This surgery is combined with bilateral salpingo-oophorectomy ie removal of the ovaries and Fallopian tubes.
- Because testosterone stops the menstrual cycle, some doctors have speculated that this surgery may increase the risk of reproductive cancer (most research is currently underway to determine if this is true). Your doctor may recommend doing this procedure within about 5 years after starting testosterone use. However, it is important to remember that once the ovaries and uterus are removed, your body will not produce testosterone on its own and you will only rely on T therapy. If you decide to stop this hormone therapy, for whatever reason, you may need to take estrogen and progesterone pills to prevent this. bone loss.
- Most men choose to have a hysterectomy so they don't have to see a gynecologist because they find it embarrassing.
- Some countries require genital surgery before transgender people can officially change their gender.
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Sex surgery: male genital formation. There are two types of genital surgery, namely: metaoidioplasty or phalloplasty.
At the same time, the surgeon can lengthen the urethra so that the formed penis can be used for urination. The vagina may also be closed during this procedure. Patients can also choose whether they want to shape the scrotum and insert an artificial testicle
- Some health insurers consider genital surgery to be cosmetic surgery, which means the patient is financially responsible for covering the costs and the costs for genital surgery can be very expensive. In America, breast surgery can range from $ 5,500-7,000 or about 70-90 million rupiah; hysterectomy also costs the same. Genital surgery costs around $5,000-20,000 or 65-250 million rupiah depending on the procedure chosen.
Step 9. Change your gender legally
Again, each region/province/country has its own laws on what must be done for a person to be able to change his gender. Many areas require documentation from a psychologist or doctor who can confirm your gender. The state of New York requires an endocrinologist to confirm that the person is taking testosterone, as well as a surgeon to confirm that breast surgery and hysterectomy have been performed.
Tips
- Be yourself. Do whatever makes you comfortable, but always be mindful of your safety.
- Try to understand your friends and family who may take some time to get used to this change. You may have always known and felt that you were a man, but they just learned this information. While you never meant to be flashy or disrespectful, you also need to be patient. Even though they are perfectly comfortable with your new self from the moment you tell them, it may take a while to remember and get used to calling you by your masculine name.
- Don't be in a hurry, especially if you are young. You may feel like it just happened and you can no longer be trapped in a woman's body. Be strong, be patient, and make sure you make the right choices. Talk to people you know and trust, visit support groups (in person and online), and talk to other transgender people. This decision can change your life, many doctors will even tell you to see a psychologist and live as a man for a while before agreeing to hormone therapy or surgery. Several “earlier generations” are already prepared and waiting for acceptance from society. Some have paid for it heavily (such as addiction, isolation, suicide, and even murder) but many have lived happy lives, whether they have made the physical transition or not. Consider your options and don't isolate yourself. Make the transition in a way that suits you.
- Be prepared to talk about this, because your friends and family will have lots of questions. Be prepared to share why you feel this way, especially if you plan to talk to a doctor about hormone therapy and surgery. Use examples from throughout your life, which can help show that this is how you've been feeling for years and it's not a feeling or decision that just pops up and is made without a second thought. Look for books on transgender issues so you can discuss next steps and plans. Be aware of the money you have to collect. Your insurance may not pay for hormone therapy or genital surgery, and your family and friends may not be willing or able to pay for or lend money for these procedures. Study financial plans, or visit a professional financial planner so you can determine the best option for raising treatment funds.
- Be honest about what you want. Tell people you trust when you feel comfortable telling them. Gently remind everyone that this is private and personal to you, you're telling them this because you trust them, and you don't want them to share this information with anyone else-if you want someone to know, you'll tell them when the time is right. it's right.
- Choose a good setting to come clean with “important people” (such as parents). Choose a place that is neutral and comfortable for you, and the other people involved can leave if they wish. You don't want them to feel cornered if their emotions don't take them and they need to be alone for a while, and you also have to choose a place where you can let go quickly if the situation gets worse or dangerous.
- You can of course defend yourself, if needed. While you shouldn't be mean to anyone, if someone makes fun of you because you're transgender, don't just sit back and let the ridicule seep into your mind. Defend yourself! You will feel much better if you do.
Warning
- If you choose a transition by operation, the result will be permanent. While breast implants and vaginal reconstruction can be done, no reconstructive surgery can realistically return your body to its original state. Even many of the side effects of testosterone therapy (growth of fine facial hair, widening of the shoulders, enlargement of the clitoris, vocal changes, etc.) can be permanent and won't go away once treatment is stopped, but if you still have ovaries, fat and muscle changes will usually return to female characteristics. Sex drive, oily skin, and body odor can return to normal, but it can also be permanent. Make sure you know your options, and make sure that you really want this. This is an option that a psychologist can help you achieve, but it all depends on your decision. Do what you think is right.
- Being honest with other people can be dangerous, especially to your family, even if you're of age and don't live with them. Make sure they are calm and not overly stressed or angry when you tell them. If you know they have negative judgments about transgender people and you anticipate that they will react violently to your news, practice caution. If you anticipate a violent reaction, seek advice from people you trust first, and assess whether you should share this information with them. Your safety is paramount.
- Don't let someone force you to take hormones or have surgery if you don't want to because they say you're not a “real transgender” or “real man” if you don't. Many transgender men live happily without changing their physique. Every transgender man has his own reasons for choosing to undergo hormone replacement therapy and surgery or not. What's more, surgery is an expensive procedure and a personal choice. Some transgender men cannot afford the procedure, some have a bad reaction to anesthesia, and some are afraid to have surgery because they are worried about pain, complications, or anesthesia. The people who really need to know your naked body are you, your doctor, and your intimate partner.
- Be wary of bigotry and people who don't accept transgender people. Some of them will be rude, but others can threaten you physically and this is very dangerous.
