Male+to+Female+Trans+Experience+in+the+Northeast+United+States

=Introduction = A person born male but identifies as a woman and wants to transition to living as a woman may identify as a trans woman, or male to female (MTF). Trans women who choose to transition must go through a variety of steps in their transition. Some trans women choose to fully transition surgically, while others are comfortable living outside of the gender binary and choose not to identify within the binary of male or female. While deciding what type of transition a person would like to pursue (if any) many considerations are made including finding trans affirming health providers, mental health providers, as well as establishing a network for daily support at transition takes place. Transition occurs at many levels including personal relationships and the work environment. Another part of transition is cost and may contribute to a transition taking longer than needed and/or prescribed due to out of pocket costs. =Transition = Transition may mean different things to different people and at different times in one’s life. Transition usually begins with some awareness of trans identity and then progresses to include counseling or therapy to work out logistics of beginning the steps to the presentation with which they identify. Therapy with a mental health professional that specializes in gender identity may be helpful, but any mental health professional should be able help a person who is thinking of transitioning. In the trans community, the [|World Professional Association for Transgender Health](WPATH) compiles a guide for individuals who identify as trans to use with the journey of transition. The goal of the Standards of Care (SOC) is to provide clinical guidance to assist transsexual, transgender, and gender nonconforming people in becoming who they want to be as a gendered self (WPATH, 2014). It includes health standards, mental health standards and recommendations for surgical/medical transition, including resources for trans identified individuals. Transition for someone who identifies as MTF may start dressing in feminine clothing and wearing makeup. They may or may not come out to people close to them as trans during this period. Planning the transition may take time and should be thought out in detail (tsroadmap.com, 2012). The Northeast area has become a mecca for trans people because of the fact that there are two major cities with many trans-affirming resources, like the [|Mazzoni Center] in Philadelphia, PA and the [|Callen Lorde Community Health Center] in New York City. Finding resources for trans health in more rural areas is an issue but utilization of the Internet has helped many. =Hormone Replacement Therapy =

For individuals who identify as MTF who want to pursue a hormonal transition, seeking out a health professional that is trans affirming is important. While any medical professional can prescribe hormones, working with a professional that is knowledgeable about the issues that may arise during transition is helpful. For those individals who identify as MTF, having a psychological assessment to assess for readiness is recommended (WPATH, 2014). The WPATH recommends that the individual have the capacity for an informed decision and be able to consent for hormone treatment. They must also be of age of majority, or have the proper consent. They also recommend that any other medical or mental health issues are addressed and under consistent care. For MTF trans individuals, hormone replacement therapy will cause breast growth, decreased erectile function, decreased testicle size and an increase in percentage of body fat, specifically in the hip area. On average, WPATH (2014) reports that most changes begin within the first six to twelve months after beginning hormones and reach a level of maintenance after a few years, with individual differences possible.

There are risks associated with taking hormones including gallstones, liver problems, weight gain, cardiovascular disease, hypertension, type 2 Diabetes and an increased risk in breast cancer. Hormone levels should be constantly monitored by a medical professional to determine efficacy levels, which will change as hormone use is continued as well as the meeting of the developmental goals, which are set by the individual. The hormones include estrogen, androgren reducing medications and progestins. Not every person’s regiment will include the same levels and kinds of hormone therapy (WPATH, 2014). toc =Surgery = For individuals who want to pursue surgical interventions, there are many different surgeries for a MTF trans person to consider. They include breast augmentation, laser hair removal, facial feminization, voice training, thyroid cartilage reduction, buttock enhancement and vaginoplasty (The Philadelphia Center for Transgender Surgery, n.d.). For most of the surgeries, the criteria according to the SOC are the same: documented gender dysphoria, capacity to give informed decision and consent, age of majority (when needed), other medical and mental health conditions under treatment (if applicable), adequate referrals (one for breast surgery, two for genital). For genital surgery, the trans person must be taking hormone replacement therapy for twelve months and for vaginoplasty, the person must have met all those requirements and lived full time as their desired gender for at least twelve months (WPATH, 2014). =Societal Implications =

For individuals who identify as MTF trans people, there are messages from society about gender identity and male privilege that may be detrimental to their ability to function in society. Transmisogyny can be described as the negative attitudes, expressed through cultural hate, individual and state violence and discrimination toward trans women and trans people on the feminine end of the gender spectrum. The experience of transmisogyny may exist due to the cultural experience of the gender binary and because MTF trans people may not conform to either male or female, they face discrimination. MTF trans people face transmisogyny because they have “chosen” to give up their masculinity and male privilege and then are not seen as “real” women according to the feminist movement are excluded from safe women and LGBQ spaces (Kacere, 2014).

= = =References =

Kacere, L. (2014). //Transmisogyny: What is it?// Retrieved from http://everydayfeminism.com/2014/01/transmisogyny/

The Philadelphia Center for Transgender Surgery. (n.d.). //Male to female confirmation//. Retrieved from http://www.thetransgendercenter.com/index.php/maletofemale1.html.

Tsroadmap.com. (2012). //Male to female transition: Primary considerations//. Retrieved from http://www.tsroadmap.com/start/male-to-female.html.

WPATH. (2014). //Standards of Care, 7th Version//. Retrieved from http://www.wpath.org/site_page.cfm?pk_association_webpage_menu=1351&pk_association_webpage=3926