Gender affirmation resources2024-01-31T20:51:47-05:00

Gender affirmation resources

Transition options available to you today

Gender exists on a spectrum, and many people may find that their chosen place on this spectrum does not match the sex they were assigned at birth. This feeling of incongruity, or gender dysphoria, is a feeling many people experience, and can become evident at almost any stage of life.

The overwhelming scientific consensus, which we support in this guide, is that the best treatment for gender dysphoria is to engage in a gender transition, adjusting one’s external presentation to match their internal sense of self. This guide is intended to provide an absolute beginner with the information needed to make an informed decision about whether undertaking transition may be right for you, as well as a detailed overview of social, hormonal, and surgical transition.

At present, the information provided is focused on resources for individuals planning on medical transition. Future versions of this guide will include high-level tools to aid in better understanding your gender identity, basic and thorough overviews of sex and gender, the social/non-medical aspects of transitioning, and how to discuss transitioning with healthcare providers, just to name a few.

If you are just starting out, or are just looking for more information on the basic terminology used for sex and gender, we have compiled a glossary of common labels and terms, which includes links to further reading:

Gender and sex basics: Common labels and terms

So you’ve realized you might be transgender. What now?

Authors: Moonbeam and Lilith. Reviewed by Elapids and Roo.

Where should I start?

Even if it isn’t required for treatment in your region, we strongly recommend consulting with a therapist before beginning a medical transition. A qualified, open-minded therapist will be able to provide information beyond the scope of this guide, and help you make an informed decision about whether a transition is right for you. 

Some aspects of a transition, such as voice training, require no special approval anywhere and can be freely practiced in your own time with a large number of resources available online. Others, such as hormone replacement therapy (HRT), may require interacting with a physician, who will be able to help with medical details that are important for your safety. Additionally, some procedures require navigating bureaucratic or financial hurdles.

Several of these procedures may be covered by your health insurance, or alternatives that may operate in your region such as Folx (https://www.folxhealth.com/) and Plume (https://getplume.co/).

There are important medical reasons to consult with clinicians before HRT, especially due to low but real risks such as blood clots or cancer in some populations, as well as other side-effects. Lab tests and dialog with physicians before and during HRT can help manage risks and side-effects, and also help optimize your dosage for the best results.

Whenever you have access to properly trained clinicians, we do not recommend attempting to obtain hormones without a clinician’s approval (“DIY HRT”). In addition to management of the aforementioned medical risks and optimization of results, medications should come from manufacturers that the Food and Drug Administration (FDA) can inspect, to ensure drugs are produced without contamination. Still, we understand that this is sometimes impossible in several jurisdictions in the current climate. Some patients choose to pursue DIY HRT despite the risks.

Who should I talk to about this?

Unfortunately, gender nonconformity is not a topic everyone understands, or cares to understand. While some areas are generally more tolerant than others, hateful individuals can be found anywhere. As such, it may be wise to carefully consider whether disclosure is right for you in a given situation. When looking for a therapist, online resources like Psychology Today’s therapist finder and the Open Path Collective for those who are uninsured or underinsured have resources to filter therapists by specialty so you can find therapists who specialize in gender non-conformity and other similarly aligned issues.

For friends and family, it can be difficult to get an accurate picture of how they may respond. Every individual is different, but it may help to consider how the people you know have responded to transgender topics in the past, such as on the news. If your friend or family member seemed open to the concept, it may be a positive sign. If you think this person might respond negatively, or aren’t sure how they would respond, it might be best to avoid coming out to them at first. If you are financially dependent on someone, especially a parent, consider waiting to come out to them until you are financially independent if possible. For more details on coming out, consult Planned Parenthood’s guide.

What is Informed Consent?

In much of the United States, gender dysphoric adults have the ability to make an informed decision about their medical treatment, especially with regards to hormone replacement therapy. Rather than placing the decision of what care is best into the hands of the medical practitioner, informed consent intends to empower you as the patient with the ability to make an educated decision on the best treatment for them. In practice, this means barriers to gender affirming care such as referrals from therapists or waiting periods are reduced or absent relative to other areas such as the United Kingdom. Transgender youth and individuals in much of the rest of the world are generally not covered under informed consent at this time. Further details on international transgender healthcare will be provided in a future version of this guide.

Transition timeline

Diagrammed by: Elapids. Reviewed by Lilith, Moonbeam, and Nix.

This flowchart serves as a visual depiction of the steps an individual must take for transition as outlined by the World Professional Association for Transgender Health (WPATH) Standards of Care 7. As of September 6, 2022, WPATH released its Standards of Care 8 to the public. The diagram will be revised in accordance with the WPATH Standards of Care 8 in a future release of this page.

If you have arrived at the conclusion that you are transgender or non-binary, it is possible you may not be aware of all of your options for medically transitioning. There are many choices when it comes to hormone and surgical treatments, and it is highly likely there is something available to suit your needs. These resources break down many of the options–including their expected outcomes, risks, benefits, pros, and cons–to help you make an informed decision about what will make you the most comfortable in your own skin.

After learning about the general effects of HRT, you can read about many of the specific medications actually in use in our Common Meds in HRT page.

And finally, for bonus points – if you’re interested in how HRT actually works, check out Biological Concepts in HRT. Optional reading!

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