What are the first steps?

[gerry]

For those of you have started or are close to starting transition, what are the steps you have taken to that end. Simply put, do I need to see a GP 1st to send me to a Endro, or do I need to see a sex therapist to refer me to an Endro or can I simply seek out an Endro to do blood work and start HRT?

[Donna Joanne]

Gerry,
You need to see a therapist who is familiar with transgender patients. Then they will determine when you need to see a endocrinologist. You can't start out running no matter how bad you want it.

[Angela Campbell]

I began with joining a support group. In that group I was able to socialize as a woman and get experience presenting in public. I spent a year losing weight and getting my appearance in order and then went to a therapist. After a period of time he referred me to a doctor for hormone therapy. The therapist I chose specializes in transitions and has helped me in many ways to do the practical, medical, and legal steps.

[Dianne S]

I have only just begun what looks to be a fairly long (2-3 year) journey. I began by going to a CD/TG support group. Next I saw a gender therapist. After that, I started on getting rid of my beard with laser. Luckily, I'm a good candidate for laser so I'm hoping I'll only need a relatively small amount of electrolysis after laser has cleared up most of the hair.

My next step will be to start the process going for getting on a testosterone blocker. After that, I may decide to go to full hormone replacement therapy. HRT is really the point of no return... after that, I realize it will be very difficult to present as male.

SRS is way too far in the future and scary for me to think about at the moment. I think I will be satisfied with being able to present as female 24/7... only then will I be able to make a rational decision about SRS.

[arbon]

Hair removal..................

[LeaP]

Any number of paths are possible, but the most common in the US is to follow the WPATH Standards of Care approach, as it's the most referenced protocol outside of the few remaining gender clinics (which typically have their own variations).

The short version is therapy, a therapist-generated HRT recommendation letter based on a DSM 5 Gender Dysphoria diagnosis, and then off to the physician for physical evaluation of suitability and prescribing.

See: http://www.wpath.org/site_page.cfm?pk_association_webpage_menu=1351&pk_association_webpage=3926

The therapy and diagnosis is psychological. Sex therapists are in an ENTIRELY different field.

(And +1 on hair removal.)

[Megan Thomas]

Hair removal..................

Definitely. Start hair removal as soon as you can. Facial hair removal will be especially difficult after you transition because of the need to have some growth showing for it to be removed. Do you really want to be travelling to your chosen hair removal practitioner in femme mode with a face of stubble? Start it yesterday...

[PretzelGirl]

Ummm... hair removal two years ago. :D Seriously. Then therapy. And let the therapy take its course. Try not to let it be rushed if you can help it at all. There is more to it than getting a letter. Then once you get the letter, you can go to an endocrinologist. But take care of yourself first so you are ready for the letter.

In our area, we have a sexologist and his wife that works with many of our community. They are fantastic and I would have gone to them for therapy, but they don't take my insurance and electrolysis was pounding the pocketbook enough.

[Lisa O]

Hair removal. It is just a very big deal, both outwardly but also for yourself as it is a very big male marker (along with voice and male pattern baldness). I am over the 2 year mark with electrolysis, have just started voice therapy but my hair is long gone! In the meantime, therapists (psychologist and psychiatrist - both gender specialists), GPs with trans experience and since October, HRT. I still feel I am just starting out at times!