Content

• To step
• Method 1 of 4: Coming out to others as transgender
• Method 2 of 4: Making the transition socially
• Method 4 of 4: Undergo surgery
• Tips
• Warnings

Becoming a man when you are a woman can be a very fulfilling experience. It is also a lengthy and sometimes complicated process. As you begin transitioning from female to male, come out as transgender to your friends and family. You will still need their support! Then you can make the transition further into the outside world, by adjusting your clothing and your grooming accordingly.If you also want to make the medical transition to transgender, find a doctor you trust and start hormone therapy. It is important to follow the doctor's advice regarding the type of medical treatment you will receive. Finally, you decide whether you want to have surgery to become a man.

To step

Method 1 of 4: Coming out to others as transgender

1. Think carefully about what exactly you want to tell others and how you want to tell it. If you haven't already, make a plan to come out as a transgender person. Start telling the people you trust. They can support you and form the network you can rely on. Choose a suitable time and place where you can have a private and undisturbed conversation.
   • For example, you could say to your sister, "There is something important that I would like to talk to you about. Can you come to me this Friday? "You can then state during the appointment what you want to say and what you feel comfortable with. "I am transgender and I feel like a man," may be the right phrase to start the conversation.
2. Talk to people who support you. You can tell the people you feel comfortable with. If you just want to tell a friend or family member about this, that's okay too. It is your information and you can determine it. If there is someone who supports you, ask them if they want to be there when you come out to other people. The person who supports you and is there can offer you a lot of support!
   • Before coming out, make sure it's safe, and don't risk your health, safety, or home. If you think there is a risk, make sure you have a safety plan. This means that you have a bag with some sleeping stuff with you and are ready to spend the night somewhere. Arrange in advance that you can stay with a friend or family member if necessary.
   • Before you start talking about it with others, make sure you feel completely good about your own identity.
3. Research being transgender so that you are well prepared for questions that others will ask you. Unfortunately, many people don't understand what it means to be transgender. They will certainly want to ask you a lot of questions. Take the time to gather a lot of information about being transgender and changing your gender. You can then share this information with the people who want to ask you questions.
   • You can search online for useful information. You can also contact an LGBT center near you and ask for resources to consult.
4. Give people time to process your communication. Hopefully they support you and love you just the way you are. But some people may take time to get used to the thought of being trans. That's fine; it probably took you a while to come to terms with it.
   • You can say something like, "Thank you for listening to me." I am aware that it is quite a lot of information to process. Would you like to meet up again in a few days, if you've had the time to let this sink in? "
5. Before coming out at work, study the legislation in the sector you come from. In the Netherlands you cannot be fired on the basis of your gender. Check whether there is special legislation that protects you as a transgender person. If you think your gender reassignment may be causing problems at work, check the laws regarding your industry, occupation, and country.
   • If you think that you are not protected enough by legislation, you could engage a lawyer who can advise you.
   • If you're still in school, it might be a good idea to talk to an adult before deciding to come out. A teacher you like, or a counselor, can help you see how open you want to be about your identity at school. Hopefully everyone will support you. If you are bullied, these people will support you immediately.
6. Look for people who can support you and help you manage your emotions. Even when things are going well, changing gender can still be a very emotional experience. In addition to relatives, friends and girlfriends, ask other people for support. It can be extra nice to talk to others who have also changed sex and who can give you advice.
   • Look for LGBT groups in your area so that you can be supported there.
   • You can also get support from national organizations such as the COC and PwC in the Netherlands.

Method 2 of 4: Making the transition socially

1. Ask people to address you with the gender you're comfortable with. One of the first steps in the transition phase is to let people know which personal pronoun you identify with. Personal pronouns are important because then people know how you want to be addressed.
   • When you get to know someone, you can say something like, "Hi! My name is Tim, and I would really appreciate it if you would address me like that. "
   • You can kindly correct people who address you with the wrong sex. You can say something like, "Can you please he, tell him when you're talking about me, or say my name?" Thank you very much. "
2. Change your name if you wish. Every transgender copes differently with the transition. Keep in mind that you are free to make your own choices. If you want to change your name, you can arrange this legally, or only verbally for your environment.
   • You can start cautiously by first only asking your friends and family if they want to address you by your new name. For example, you can say, "I know you know me as Sara, but my name is Sam from now on."
   EXPERT TIP

   Make sure that the way you groom yourself and your clothes look more masculine if you feel the need to. You can further initiate the transition from female to male by changing your appearance. You may want to consider getting a short haircut. You can also start shopping at the men's department for your clothes and shoes. For example, you could wear jeans with a jacket when you go out at night. Most importantly, you feel comfortable with it. EXPERT TIP

   Find out which procedures are covered by your insurance. It costs a lot of money to change sex medically. The costs depend on the distance from your home to the hospital where you are treated, but it can cost you thousands of euros. However, there is also good news! More and more insurance policies reimburse some or all of the costs of the gender reassignment.

   • It is best to first request a consultation with the attending doctor through your doctor, and ask for an explanation of the treatments and costs. Then you can see what is reimbursed by your insurance. If you cannot determine from your policy what exactly your insurance covers, you can call the insurance and speak to an employee.
   • There are more and more health insurance policies for transgender care.
3. Make an appointment with a doctor who has extensive experience in treating transgender people. If your doctor has no experience in treating transgender people who want to change sex, it is best to seek out a doctor who is experienced. An experienced doctor can guide you through the process and answer your questions properly. Make an appointment and talk to your doctor about the steps you want to take to go through the sex reassignment medically. Hormone therapy is probably the first step.
   • Talk to your doctor about the risks that hormone therapy can bring. After hormone therapy, your health profile will be male. This could mean that you run a greater risk of cardiovascular disease and high blood pressure, for example.
4. Choose the right dosage and method that work for you. Testosterone can be administered in 3 ways: orally (a pill), by means of a skin patch or gel, or by injection. It depends on your own wishes which is the best way for you. Talk to your doctor about all three options. Do not hesitate to ask a lot of questions. Doctors are here to help!
   • Taking testosterone orally is the least effective, and for that reason it is not done very often. If you are undergoing transdermal therapy, you use a skin patch or gel every day. If your doctor recommends that you take injections, you will usually receive a dose every week or every two weeks.
   • The dosage varies a lot. It may take time for your doctor and you to find out what works for you.
5. Keep in mind that your skin will change first. Shortly after you start taking the testosterone, your skin will look and feel different. Your pores will widen, which may also make your skin thicker and oilier. It is quite common to have one or more acne breakouts.
   • Maybe your sense of touch changes, so that things "feel" different when you touch them.
   EXPERT TIP

   Then you can start looking for changes in your weight, hair and voice. You may notice that your weight is now distributed differently across your body. For example, you may now have less weight on your hips and thighs, but more on your stomach. Overall, you will likely gain more muscle mass than before.

   • See if your voice changes after a few weeks. The testosterone makes your vocal cords thicker, which will make your voice sound a bit more typically masculine.
   • You can assume that your hair will change more and more over time, that it will become thicker and darker. Your body hair will get darker and thicker. It will also start to grow faster.
   EXPERT TIP

   Ask your doctor about changes in the sex organs. You may find that your period is getting lighter, that you menstruate less often, or that it stays away altogether. But it is also possible that your period lasts longer and that it is heavier. Every person responds differently to testosterone hormone therapy.

   • If you are concerned about something, talk to your doctor. He or she can help you figure out what is part of the process and what is not.
6. If you find yourself struggling to manage your emotions, seek therapy. Make an appointment with a therapist if you have trouble regulating your emotions. Hormone therapy is very similar to going through puberty again. That means that not only will you undergo physical changes, but you may also end up on an emotional rollercoaster. A sex change is an emotional process anyway, even without all kinds of hormones that run through your body!
   • In therapy you can learn all kinds of useful techniques with which you can learn to deal with situations and feelings.

Method 4 of 4: Undergo surgery

1. If necessary, see a therapist to get a diagnosis. Gender dysphoria is a recognized condition, where the gender of the affected person does not match the gender with which he or she was born. It is included in the DSM-IV, making it an official identity disorder. However, it does not mean that people with this disorder are labeled as mentally disturbed; the diagnosis can help obtain insurance reimbursement for treatment. Some doctors do not proceed to surgery until this diagnosis has been established. Therapy is important not only for obtaining a diagnosis, but also for learning the right ways to deal with the stress of surgery.
   • You often need a diagnosis if you want to claim under your insurance for medical procedures.
2. Find out how much your insurance reimburses. The medical procedure for sex reassignment is increasingly reimbursed. View your policy carefully and find out which procedures are reimbursed. Don't worry if you can't figure it out! You can also simply call and have an employee explain which reimbursements you can claim. Do not forget to check with your treating doctor whether he has contracts with your health insurer.
   • If your insurance does not cover everything, there are still options. Ask your doctor or the hospital if they facilitate payment arrangements for patients. You can also consider taking out a personal loan so that you can pay for the operations.
3. You can opt for surgery to remove your breasts so that you get a male breast. It is up to you whether you want to undergo surgery and, if so, which ones. Take the time to think about which interventions would make you happy. There is no right or wrong way to make the transition from female to male. Talk to your doctor and decide if you want to have surgery to make your breast masculine and remove your breasts and breast tissue.
   • You will need to rest for the first days after surgery. Follow your doctor's advice for lifting and moving. Most people can go back to work 7-9 days after surgery.
   EXPERT TIP

   You can also have a hysterectomy, which involves the removal of your female reproductive organs. You can also choose to have your female reproductive organs surgically removed, such as having your uterus removed. Talk to your doctor about this so you can find out if a full hysterectomy is right for you. It's a big decision, so it's okay to ask a lot of questions. There are various methods of this procedure, including surgery on the abdomen and vagina. Ask your treating doctor if he wants to go through all the options with you, so that you know what to expect.

   • There are many people who have experienced the hysterectomy as positive. But know that it is a very personal choice, so do what feels right for you.
4. Talk to your treating physician about the option of a phalloplasty. In this surgical technique, a human penis is constructed from skin grafting. If you have had a phalloplasty, you can pee and make love like a man. Talk to your doctor about the risks and benefits experienced with this surgery.
   • Phalloplasty carries the usual risks associated with any surgery, such as wound infections. Make sure to make post-surgery appointments with your doctor for proper follow-up care.

Tips

• Try not to feel pressure to undergo a "typical" gender reassignment. Each individual makes his or her unique journey.
• Gender reassignment sometimes takes years. And that's ok.
• Not everything is reimbursed and medical treatment including surgery can be very costly. Make a budget for it so that you can cover the costs.
• If you think you can't afford the cost of the gender reassignment, talk to someone who knows about budgeting and see if you can bear the process financially.

Warnings

• Make sure you have a doctor who is experienced and who you trust.
• Follow your doctor's advice regarding hormone therapy and recovery from any surgical procedures.