As a trans person, you feel born into the wrong body. What further steps you take in this can vary greatly from person to person. Some have enough of a few simple adjustments to feel better in their skin such as appropriate clothing, wigs, breast prostheses or they measure themselves a new first name that better suits their true identity. Others choose to actually change gender.
Preparation
Before surgery is possible, the doctor will refer you to a psychologist or someone who specializes in gender issues. That person will judge if you are actually a trans person and explain the impact of a sex operation.
If those conversations have been successful, you can start hormone therapy, possibly supplemented with surgeries. But hormone therapy is always the first step. If you are given hormones, you can already get a taste of what your life would look like after sex surgery. And this therapy is still reversible.
Forms of hormone therapy
Trans men – people with a (predominantly) male gender identity but female birth sex – are given testosterone. As a result, they develop masculine characteristics such as a lower voice and hair growth. For trans women, the reverse is true: testosterone levels are slowed down and they also have to take estrogens. As a result, hair growth stops (for the most part), the body takes on rounder shapes and the voice becomes higher.
After the trial period (usually of a year) you have the chance to complete your transformation by going under the knife. There are many surgical procedures for this: voice surgery, facial surgery, breast augmentation or removal, and sex surgery.
Surgery feminization
Trans women can have a voice operation performed during their transition that causes the voice to sound more feminine (phonosurgery). Furthermore, one can opt for a breast augmentation, facial surgery to feminize the face and sexual surgery. In addition, the penis is almost completely removed and used to construct a vagina: from the anterior part of the glans one makes the clitoris; parts of the scrotum serve for the reconstruction of the labia majora.
Surgery masculinization
Various operations are also possible for trans men. The breasts are operationally removed and possibly one can give the face a more masculine shape via facial surgery. The entire uterus will also be removed, as the ovaries continue to produce estrogen. For the sex operation, the clitoris - which was developed by hormone use - is used to make a micropenis. The surgeon can make a larger penis additionally with skin of the forearm. The scrotum is formed from the labia and can be filled with prostheses from silicone gel. In some cases, one can also eventually place a prosthesis to make the penis stiffen.
