TransWomen

What is MtF?

Male to Female transgender or transsexual people are those who were born biologically male and transition towards female. This is probably what most people think of when they think of a transsexual; though most MtF's do not look like a "lumberjack in a dress" and many are quite passable.

Hormones

With hormone replacement therapy (HRT) providing regular doses of estrogen the biologically male body will feminize. A letter from a therapist is needed before a doctor will prescribe a hormone regimen. Once HRT has been started, the skin becomes softer, muscles become weaker, body fat redistributes and breasts may develop, and chemical castration occurs. The effects are not immediate and the body will be "in transition" for at least two years. Side effects of taking estrogen include weight gain, reduced libido, loss of the ability to achieve an erection, decrease in penile size, and reduction of sperm count. Despite these changes, it is still possible to experience orgasm, but the is quite different than before HRT. Those taking estrogen will experience strong psychotropic effects including mood swings or moodiness, altered perceptions, and changing hunger patterns. HRT can be started at any age, the younger a person is when starting HRT the more dramatic the effects. Regardless of age, hormones should be taken at regular intervals; "on again, off again" hormone usage can be dangerous and counter productive. For more information on hormone therapy check out the FAQ on MTF Hormone Therapy from Savina. All persons on HRT should be checked by a doctor periodically to guarantee quality of health and transitioning.

Surgery

Not all MtF persons chose to undergo sex reassignment surgery (SRS). Some are comfortable with their feminized bodies and do not feel a need for further surgical alteration. SRS is a major operation, few surgeons are experienced in the technique, there is a risk of losing physical genital sensation, the resulting neo-vagina may not look like a vagina, the effects are irreversible, and the cost of the surgery is around $20 thousand (costs vary). There are currently two options for MtF SRS, penile inversion and colon transplant. While the results of colon transplant tend to be more satisfactory, it is a larger and much newer operation. Penile inversion is an older and more widely available technique. Neither of these operations can be considered "castration"; both of these procedures uses existing penile tissue to create a vagina. The best recommendation about which surgery to receive or where to have it done is to talk with satisfied customers and learn from their experience. Despite the risks and enormous expense, thousands of people each year who feel trapped in the wrong body undergo the operation.

Benjamin Standards

Anyone considering HRT or SRS should become familiar with the Benjamin Standards of Care for Gender Identity Disorders (provided here). While these standards' recommendations are controversial, they currently govern medical treatment of transsexuals.

Legal Aspects

The law has yet to fully catch up with transgenderism. Only a few states and localities extend protection from discrimination to transgender people. For more about this, and ways to help change the law, read Transgender Equality: A Handbook for Activists and Policymakers (provided here). The government holds rigidly to "male" and "female" dichotomy, and does not even provide an option for biologically intersexed people. Legally changing gender can be a treacherous process, but it is possible to do so.

Passing

The stereotypical MtF resembles a flamboyant drag queen. This is not the image to portray in order to be accepted in society as female. To be passable it is much more effective to dress in a more average manner. Overdoing or underdoing your makeup or dress could make you stand out and be clocked. Always dress appropriately for the event.