Understanding medical transition options


Every trans person is different and there is no ‘fixed path’. Below are some of the different ways a trans person may choose to transition.

Hormone blockers

These suppress the body’s natural sex hormones:
For trans women (people with a female gender identity who were assigned male at birth), blockers will suppress the testosterone that their body would normally produce.
For trans men (people with a male gender identity who were assigned female at birth), blockers will suppress the oestrogen that their body would normally produce.

Depending on the age a person starts receiving support with their transition, blockers can be prescribed with parental consent to delay / prevent their natural puberty. This can be extremely positive as it stops body changes that would be deeply upsetting. For example, a trans girl would not want her (male) biological hormones to cause her voice to break. Likewise, trans boys would not want their (female) biological hormones to cause their breasts to start developing and periods to start.

If blockers are started after puberty has taken place, they cannot ‘reverse’ all of the body’s changes. For example, once a voice has broken it cannot be restored.

The GP and Gender Identity Clinic will work very closely with the family to ensure it is the correct path for the child.

Blockers can be stopped at any stage and the body’s biological hormones will start to function again.

Hormones

Cross-sex hormones are prescribed to individuals where appropriate to enable their body to develop in line with their gender identity.

The GP and Gender Identity Clinic will work very closely with the individual to ensure it is the correct path. Hormone levels are also monitored regularly to ensure the treatment is effective.

It is essential that individuals taking cross-sex hormones are carefully monitored and supported by a GP.

In trans women, oestrogen may cause the following effects:

  • Fat may be distributed on the hips
  • The size of the penis and testicles may be slightly reduced
  • Some trans women find that erections and orgasm are harder to achieve
In trans men, testosterone may cause the following effects:
  • It promotes beard and body hair growth
  • Male pattern baldness may develop
  • The clitoris increases slightly in size
  • Libido may be heightened
  • Muscle bulk increases
  • The voice deepens, but not usually to the pitch of other men.
  • Periods will stop, although there may be some breakthrough bleeding requiring adjustment of dosage
  • Some individuals develop acne

Cross-sex hormones can be stopped at any time, though some changes to the body will remain. For example, trans men have successfully become pregnant by pausing their hormone treatment and allowing their (female) biological body to function. However, changes such as a deeper voice, facial and body hair will remain.

For full details on hormone therapy and the impact of blockers / hormones click here for our useful websites page which includes the NHS guide.

Surgery options

Some of the key surgery options for trans men (people with a male gender identity who were assigned female at birth):

  • Breast removal
  • Hysterectomy
  • Penis construction

Other plastic surgery options can be considered as with any individual wishing to alter their appearance, such as muscle enhancers.

Some of the key surgery options for trans women (people with a

female gender identity who were assigned male at birth):

  • Breast enhancement – though often trans women find that breasts develop naturally as a result of hormone treatment
  • Vagina construction

Other plastic surgery options can be considered as with any individual wishing to alter their appearance, such as Adam’s apple reduction and facial feminisation.

There is a common misconception that all trans people will undergo ALL relevant surgery, but this is not the case.  Each person is different and unique and many trans people are comfortable with making a social transition (name change, appearance etc). Every surgery carries potential risks and so it is a big decision to make. For example, we have worked with many trans men who have chosen to have breast removal surgery, but they choose not to proceed with a hysterectomy (as the hormone treatment prevents monthly periods) and many choose not to proceed with penis construction surgery.



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Please be assured, whatever you are feeling right now is ok and there is plenty of support available to help you through this journey. 

Please do get in touch if you’d like to speak to our qualified parent worker for information, advice and guidance: 

Nicki Ryan 07884 425408 | Nicki@free2b-alliance.org.uk 


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