Zak: I don’t know if its necessarily normal (what is?) but it certainly does happen. I think one thing that happens is that people go into HRT and surgery with pretty high expectations, and feel let down, and sometimes even worse than they did before, when their expectations are not met. Not only that, but changes slow down a lot after the first year, and so some people become frustrated that they no longer feel like there is as much to look forward to in terms of their transition. A lot of people have dysphoria early on in their transition, but have hope for a “cure” in the future that they can hang on to, be it testosterone or top surgery. The dysphoria “post transition” can feel much worse just because there doesn’t seem to be an antidote.
This is one reason I think it is important for there to be resources and support for people who are post-transition, because I think another problem is that a lot of individuals in this type of situation feel really alone. Most of the people who stay active blogging and talking about things are the types who are very happy with their transitions and their bodies. For many people, though, dysphoria is a life-long issue. I don’t really know what to recommend in this situation other than therapy and trying to find ways to accept your body (if at all possible).
Adrian: Your best bet is to simply call the office of the surgeons you are interested in and ask them if they take on patients that want to have the surgery covered by insurance. Some surgeons don’t, some surgeons haven’t but are willing to work with you, and some surgeons have done it numerous times. There is no database for this kind of information, and even if there were I’d imagine that it would change significantly over time as more and more physicians are working with people and their insurances to get these kinds of medically necessary procedures covered.
Zak: We can’t really speak for the entire trans* community as to what is problematic and what isn’t. There are probably people out there who think it is problematic, and some that don’t. There are trans men who would be pretty offended to have someone refer to their sex as female, and also some trans men who don’t have vaginas, so it doesn’t seem like the best way of classifying people. You can’t control who you’re attracted to, and I’m certainly not here to police that, but perhaps there is a better way of putting it.
This depends on where you live. If you live in the United States and you’re talking about your drivers license (or birth certificate), this varies by state. Social security and passport follow federal guidelines, which does not require bottom surgery, but rather a letter from a physician.
Zak: There are a couple of methods out there, some more effective than others. We are not doctors, though, and so you should check with your doctor about your options to be sure. A non-hormonal IUD should be 99% effective at preventing pregnancy and not interfere with your hormones. Withdrawal is also an option, but it’s not as effective as a IUD, condom, or the pill. As a side note, testosterone does significantly lower your risk for pregnancy, but I don’t think it is safe enough to just rely on that.
Recently we’ve received a lot of questions about partial transition and/or transitioning without identifying as male or transgender. Neither of us are medical doctors or have personal experience with partial transition, but we know of a few people who have undergone this experience and thought we’d share what we do know about it.
1. You CAN get top surgery without having been on testosterone, even if you are not planning on ever taking T. The double incision method leaves a negligible amount of breast tissue, and so you do not have to worry about your breasts growing back due to estrogen, and the peri leaves trace amounts of tissue but it is likely not a concern with that method either. We know for a fact that Dr. Johnson (Omaha NE) and Dr. Garramone (Sunrise FL) have performed top surgery on pre-T guys, and many other top surgeons are open to it as well. If you want to check out an example of someone who got their top surgery pre-T, look at Ryan Sallans (he later started testosterone and has been on T for several years). If you want to check out an example of someone who got their top surgery without ever planing on going on T, and who is not male-identified, look at Neutrois Nonsense’s blog posts on top surgery.
2. It is possible to get top surgery or go on testosterone without identifying as male or transgender. Individuals have physically transitioned who identified as neutrois, genderqueer, bigender, and so on. Many of the individuals who identify this way and choose to physically transition are open with their doctors, therapists, and surgeons about their identities and don’t have a problem with it (although some do run into issues). For an example of someone who has gone through this process, see Jude’s video in which he discusses his decision to take testosterone and have top surgery in light of his genderqueer identity.
3. Some people choose to go on a low dose of testosterone, only take testosterone for a short period of time, or go off of testosterone despite planning on taking it for life. There are medical implications of this that you should discuss with a healthcare professional if you are planning on going this route. Yan talks about going on a low dose of testosterone and partial transition here and Chase talks about why he stopped T after a year here and why he is not going back on T here.
4. As for bottom surgery (phallo or meta) without testosterone, this is something we have never heard of anyone doing but that doesn’t mean it is impossible. For the meta, several years on T is generally recommended because of genital growth, and so it seems unlikely that it would be possible for someone to do without testosterone. The complications with getting a hysto without HRT (estrogen or testosterone, the lack of these hormones and the inability for the body to produce them on their own without ovaries or testes can raise your risk for issues like osteoporosis, talk to your doctor about your options regarding this) also could rule out pre-T/no-T bottom surgery, though again we are not positive about this.
5. Some people choose to socially transition without ever taking hormones or having surgery. Forrest talks about being FTM but not taking hormones in several of his videos (including this one), though he recently has been considering taking T.
For more information about the various transition options, partial transition, and so on, check out Meiko’s excellent video on Partial FTM Transition. These decisions can be very complicated and difficult, and as always we recommend deep reflection, patience, and consultation with medical professionals before coming to any sort of action that involves hormones or surgery.
Zak: I don’t necessarily know about public online forums, other than Laura’s Playground. There are several active livejournals to check out, such as FTM Forum and The Transgender LJ community. There are private forums (based on googlegroups) I know of for friends and family of trans* people, including TYFA. There are plenty of youtube groups and tumblrs I know of that fall under this (including TMatesFTM) as well.
We’ve gotten a lot of questions like this recently, and so we will be answering this in an in-depth post fairly soon. Be on the lookout for this probably sometime tomorrow.
Zak: We get this type of question a lot and recently wrote a pretty detailed response. We’ve also written an article on the topic . Egg retrieval and IVF are expensive and invasive, but they are a great option for people in the same situation as you and your boyfriend. There is absolutely no guarantee that your boyfriend will still be fertile after starting testosterone, BUT it isn’t a hopeless situation either. FtMs like Thomas Beatie have successfully conceived and borne children after years of being on testosterone (after going off of T for period of time). Whether or not egg freezing is right for the two of you will depend on a lot of factors, for instance when you want to have children and how willing you are to wager on his fertility after testosterone. I recommend talking to a doctor to hear more about your options and figure out what is best for you two.
Zak: I don’t think it’s hypocritical…particularly if you are primarily attracted to women-identified individuals, which does not include trans* men anyway. Many people identify as queer because it is a political label or is more inclusive, it doesn’t mean that they are pansexual or attracted to everybody. Your friends should understand if you say something like “hey, I know I identify as queer, but I’m mostly attracted to women-identified people so trans* men aren’t generally my thing.”