Gender Transition Jitters

A core reason I started this blog was to share my personal journey through the long, fretful, process that is Gender Transition (yes, it's important enough to be capitalized)!  When I first started seriously thinking about transitioning - I turned, as so many of us do, to the internet.  Like pretty much any subject, the internet is full of personal and professional sites discussing Gender Ttransition.  Many of the websites act as chronicles of one's journey (much, I suppose, like this one will).  This was all good stuff - but not terribly helpful from my specific point of view.  Everyone's journey was so different, so central to themselves, and not really specifically helpful for someone wanting to start the process themselves.  I discovered, however, that reading enough of these accounts really did help me codify what I ultimately wanted for myself; things to shoot for, and things to avoid.  Thus, I add my voice to the growing pool.  Read, share, and enjoy!

This will get very personal - so if reading things about sexuality and such disturbs you, then you've been warned.  But don't worry too much - there will be no talk of genitals (although there might be some talk of boobs).

It all started with sex (as so many things do).

OK, first a little background.  I'm 36 and I used to identify as male, but I now identify as transgender female.  I started hormone replacement therapy (HRT) about ten months ago (as of this writing).  While I consider starting hormones my 'formal' gender transition start, my 'informal' start was years before.

I wish I had some cute stories about playing dress-up in my mother's skirt and blouse when I was very young - stories which might have given me (and others) clues about my eventually identity.  I don't (or if I do I don't remember).  In fact, I've had others question my self identity specifically because I didn't have memories like that.  I had a pretty normal childhood and teenage years, doing things typical for my male-identified gender.  I was even pretty active in Boy Scouts (Yep, I'm an Eagle Scout - shhhh - don't tell the BSA I'm trans)!

Growing older was pretty uneventful (gender-wise).  When I went to college, I was a typical heterosexual guy with girlfriends (generally one at a time).  I did, however, start to have some bisexual feelings and encounters during my later years at college.  My bi side grew as I finished college and went on to graduate school, where I experimented more with guys, and decided I was probably bisexual rather then (as many guys seem to claim) 'straight but curious'.  

I do wish more men would be comfortable admitting their bisexual side to themselves.  Meh.

While in graduate school, I fell in love and married a wonderful woman, Elena.  We were monogamous while we were dating - and for a couple of years after our marriage.  Then we started exploring what it would mean to have an 'open relationship'.  Elena was understanding about my bi side, and that opened opportunities for experimentation with other like-minded couples and singles.  We evolved to have a healthy sex life - with each other and occasionally (but rarely) with others.

I had been doing some light, and very rare, cross-dressing during my college years and later - as something of a sexual fetish.  This occasional interest should probably have been a clue to my eventual identify.  I didn't start to question my reasons behind this interest until much later - years after being married.  Elena was supportive of me exploring my gender-bending interests - though, at the time, neither of us realized the full importance of it.

Eventually my cross-dressing evolved to the point of dressing up almost every night (wig, makeup, painted nails, etc.) and seeking validation by taking cute photos of myself, or chatting with guys online.  I would clean off my nails and makeup every morning before work (why is eyeliner so difficult to remove?).  With support from Elena, I started shaving my legs and letting my hair grow out.  I still hadn't admitted to myself that I might be something other than male - I still thought it was simply an evolving fetish.

It was around this time I had a couple of solo encounters with guys - while I was dressed up.  Being dressed up with a guy and being treated as entirely female was an eye-opening experience.  I also had some experiences with a couple of other cross-dressers - which I did not enjoy nearly as much as I thought I would.  I know now (hindsight is 20/20 right?) that my interest in cross-dressing was changing from a sexual one, to an exploration of who I really was.

Elena got a new job, I left my old one, and we moved a few states away.  I thought this would be a perfect time (without a full-time job) to explore more of my cross-dressing interests.  I started dressing up at home during the day while Elena was at work.  I quickly discovered that my sexual interest in cross-dressing was fading fast, but I was still very interested in exploring my female side.  I started calling myself 'gender-fluid' and I eventually started to consider whether I might actually be transgender.  After discussing it with Elena over the course of a year or so, I started to research what would actually be involved in gender transition.  

Quite a lot, as it turns out.

As I said earlier, the internet is a huge repository of information - and it can be tough to find a succinct answer to anything.  It didn't help that the state we had moved to was North Carolina (home of the dreaded HB2 law).  I looked into to self-medicating hormone treatments - but I was dissuaded by the potential for massive health problems.  I decided to pursue things along proper channels, and with that decision, I wrote one of the most important emails of my life.

I wrote to my doctor (my recently-attained PCP), and in very few sentences, I told him I was seriously interested in gender transitioning, and I wanted his advice for starting the process.  He was immediately helpful (it turns out he had some experience in his past helping others transition).  He was willing to make a referral for me to an endocrinologist - but the one he had in mind required a letter from a therapist stating I was suffering from 'Gender Identity Disorder'.  I did not have this, so he made a referral for me to a therapist.  

There are a few standards that many doctors adhere to when it comes to gender transition.  One of these standards is the 'World Professional Association for Transgender Health' (aka WPATH).  The standards of care outlined by this organization are followed by many doctors - including the doctor I was planning to see.  This standard is viewed by many in the transgender community as a 'gatekeeper' method - keeping some from being able to transition if they cannot satisfy the requirements imposed by WPATH.  There are other doctors and organizations that follow an 'informed consent' model - which basically states that if someone wants to transition, and understands all the risks involved, they should be allowed to proceed (no therapists involved).

During this time I was starting to dress more feminine, and grow my hair longer, although I was very nervous/shy about going out in public in feminine attire.  I wanted to, but I didn't feel comfortable.  I started to dress semi-feminine, which is how I presented myself at my first therapist meeting.  I was certainly nervous, but I was helped by knowing very clearly what I wanted, and by being open and honest with the therapist.  Thankfully, I had my 'letter' after only a few meetings (a formal letter that states I have 'gender identity disorder').

Finally I was able to get my appointment with the endocrinologist.  I was pretty nervous for that meeting too - but the doctor was friendly and agreeable to starting me on hormone replacement therapy.  Many endocrinologists have their own guidelines - one of which is 'Endocrine Treatment of Transsexual Persons' from the 'The Endocrine Society'.  My hormone therapy started very slowly - with anti-androgens (testosterone-suppressing) drugs, before building to doses of estradiol (estrogen).  The reason for the slow start was lots and lots of blood work - taken many times - to ensure the hormone treatment wasn't having any adverse effects (and was having the effects we wanted).  It was a little frustrating to get this far in the process (finally on HRT) and for things to move so slowly, but I started to experience physical and emotional changes from the drugs relatively quickly.

Everyone who starts hormone replacement therapy has different stories about what changes they notice first, and how powerful those changes are.  I noticed a marked increase in anxiety from the anti-androgen drugs.  Increased anxiety is not a good thing in someone who already has high anxiety from gender dysphoria!  Thankfully those feelings faded pretty quickly.  This is a good time to mention something really important - starting hormones is a risky process.  There are many health concerns associated with HRT medications (blood clots being one of the biggest), and it is really important that anyone considering this road does their research.

OK, so I warned earlier that there might be some discussion of boobs.

The first, for me, obvious physical change from HRT was boob growth.  I was thrilled, to say the least.  Another change was a lessening of body hair (thank god - because that made it much easier to shave my legs / arms / etc.).  I'm sure there have been lots of other little physical changes (body fat redistribution, muscle loss, etc) but they have been too gradual to really appreciate.  Unfortunately, HRT does not affect facial hair - so my beard shadow was (and is) a source of unhappiness.  But the boob growth (after only 7 or so months on estrogen ) is fantastic.  I'm not going to be a C cup (or B cup) anytime soon - but still, anything obvious is a plus.

So, this brings us about up to the present.  My closet is now mostly female clothing - and I always dress in feminine attire - even when going out.  I'm self-employed, so that is helpful (I'm not sure how comfortable I would be job hunting as a transgender female).  I've started laser facial hair removal (which, I should mention, is MORE PAINFUL THAN ANYTHING I HAVE EVER EXPERIENCED), and hopefully I'll be rid of this beard shadow in the next year or so.

I have to talk about Elena some more.  One of the side effects of less testosterone in my system is a lessening of interest in anything sexual.  I'll admit I used to think about sex a fair amount, but after starting HRT, my libido is in the negative range (I find this pretty ironic - seeing how I once used to cross-dress in order to get a sexual thrill).  Obviously, this loss of libido affects Elena.  We aren't intimate nearly as often as we once were.  She has been so supportive and wonderful throughout this entire complex process, I can't image surviving it without her.  When we go out and I'm nervous about how I'm dressed, she's there.  When I'm nervous about a doctor's appointment, she's there.  When I'm feeling doubt about my transgender status, she's there.  In short - she is the best thing in my life - and I hope others who transition have a special someone to help and support them (Sadly, I know some marriages don't survive when one person transitions).

I'm going to end things there for now.  My gender transition is an ongoing process, and I'll surely post more about it in the future.  

For now, I'm happy with my boobs.  :)

 -Lia

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