Medical Transitioning: Where to Start

by | Jul 10, 2021 | LGBTQI+ | 24 comments

Dr Tasha Patel is a GP at Doctors of South Melbourne. She previously practised at The Centre Clinic and has a particular interest in LGBTQI+ health, including hormone replacement therapy for gender affirmation.

If you feel you were assigned the wrong gender at birth, you might consider asserting your true identity with medical assistance, known as medical transitioning.

Doctors such as myself prefer the term gender affirmation therapy as your gender identity is more about affirming who you are rather than changing yourself via a transition. However, for the ease of this post, let’s use the term medical transitioning.

Not everyone who’s transgender decides to transition medically. You might choose to socially transition first, a mix of the two, or something in between. Only YOU can decide what best makes you feel comfortable in your own skin.

Discussing your unique circumstances with a GP who specialises in gender diversity can assist guide your choices. The medical options available to you range from speech pathology through to hormone therapy and surgery.

Not All Transgender People Transition

Identifying as gender diverse or non-binary doesn’t mean you must transition.

Some trans people are happy just knowing who they truly are. I’ve consulted with patients who’ve simply come out to family and friends, while others chose to dress more masculine/feminine. By the same token, many have undergone surgery.

People should respect your gender identity regardless of how much or how little you transition. There’s no transgender sliding scale by which others dare judge you.

Let’s take a closer look at:

non binary gender symbols

Medical Transitioning Options to Consider

If you’re considering heading along the medical path, I suggest taking it slow – you can always do more later. Certain procedures aren’t reversible if you change your mind.

Here’s an overview of the options available to you.

Speech Pathology

Though there’s no such thing as a gendered voice, you may want to alter your voice to a pitch with which you’re more at ease.

Specific to your needs, speech pathologists can help change your vocal tones, inflections, and word styling through voice training and exercises.

A great starting point is to consider the voices of people to which you’d like yours to be similar, both trans and cis. Georgie Stone? Billie Eilish? Morgan Freeman? Your next door neighbour?

Latrobe University offers a trans and gender diverse voice clinic for anyone over the age of 16 years.

Non-Invasive Cosmetic Procedures

Whether you’re affirming your gender from male-female (MTF), male-non binary (MTN), female-male (FTM) or female-non binary (FTN), there are heaps of non-invasive procedures available to help adjust your aesthetics, including:

  • Dermal fillers
  • Muscle-relaxing injections, such as Botox
  • Laser skin resurfacing
  • Laser hair removal

Popular procedures to help with MTF and MTN affirmation aim to soften your jawline, make your face appear more heart-shaped and full, and remove facial hair.

With FTM and FTN affirmation, the focus is often more so on making your face appear squarer and more defined. To achieve this, you may consider re-defining your jaw and making your brow line more prominent.

Hormone Replacement Therapy

Hormone therapy aims to help trans people increase or decrease gender-specific characteristics.

For MTF affirmation, oestrogen replacement therapy contributes to feminising effects such as breast growth, a curvier body and softer skin.

I regularly prescribe oestrogen in tablet form, patches and gels. Testosterone blockers, or anti-androgens, are another complementary option. They work by reducing your body’s testosterone production and minimising its masculinising effects.

Masculinising hormone therapy typically involves 3-monthly testosterone injections. I also prescribe gels and creams. Testosterone therapy’s effects include bulking up your muscles, more facial hair, a deeper voice, and body fat distribution changes.

To achieve partial effects, MTN and FTN people may prefer lower hormonal replacement doses. This is something we can chat about together.

I offer advice and prescribe most hormone therapies at the clinic, though testosterone requires a specialist endocrinologist’s review before starting. A referral to a specialist or gender service is also a good idea for people with more complex needs.

It’s important to note that I only initiate hormone therapy for gender affirmation in people over 18 years old.

cosmetic face surgery drawing

Surgery

Surgical transitioning options are plentiful. Cosmetic facial procedures and top surgery (operating on your chest and upper torso) are among the most commonly performed.

As the name suggests, bottom surgery focuses on surgically altering your genitals. Many people instantly think of gender confirmation surgery (a.k.a.  gender reassignment surgery) which encompasses:

Though gender confirmation therapy isn’t currently available in Australia, other bottom surgical options are accessible to trans people.

Generally requiring high out-of-pocket costs, surgeons across Melbourne perform procedures such as:

Facial cosmetic surgery:

Top surgery:

Bottom surgery:

Other surgical options include:

Before you decide on any surgery, it’s essential to discuss your options, risks, and alternatives with your GP, specialist, or surgeon. Also talk with trusted family, friends, and others who’ve had similar procedures.

Beginning Your Transition Journey With a GP

Transitioning can be an exciting, confusing, and anxious time. With many options to consider and questions to ask, visiting a GP experienced in gender therapy is golden.

We implicitly understand that gender affirmation encompasses social, emotional, and physical aspects that are different for everyone. Whether you’re unsure about your gender identity, looking for help with medical transitioning, or unsure where to start, we’ll help you navigate through the complex structure of the medical system.

What’s more, we can be the primary source of your general care by advising on all the non-transitioning aspects of your health. These are things like general check-ups, preventive health, and sexual health advice.

What You Can Expect From GP Appointments

During your initial appointments, together we’ll delve into your life and gender journey so far. In the process of doing so, I’ll gain a complete picture of your general health: involving medical conditions, family health history, medications, allergies, smoking, drug & alcohol use, and more.

I’ll listen to your ideas and plans for gender affirmation and answer question concerning:

  • What to expect
  • Risks vs benefits
  • Costs
  • Common side effects
  • Fertility preservation options

You’ll need to carefully consider the above and ask a million more questions before we discuss formally consenting to treatment.

Once any treatments have started, I’d initially like to see you every 1-2 months to monitor your progress, then every 3-6 months as things begin to settle. These appointments may involve ordering blood tests, and physical, mental, and social health checks.

Over the longer term, I’d like to see you a few times a year for a chat and check-up. These regular consults are also an excellent opportunity to see how you’re feeling about your transition and to support your mental health.

he pronoun card pocket

Caring for Your Mental Health Is Vital

Being at peace with your gender identity is a highly positive and affirming part of your general health and wellbeing.

Towards this goal, it’s important to recognise that your gender diversity doesn’t cause mental health issues. Yet unfortunately, the lives of gender diverse people are often met with family and relationship difficulties, as well as discrimination in the workplace and community.

I’ve cared for many patients by talking over their mental health needs and providing access to practical solutions. I regularly refer people to specialised LGBTQI+ psychologists to discuss the emotional effects of transitioning, usually with success.

Depending on a range of factors, you also may be eligible for a Mental Health Care Plan.

Maintaining a network of friends, support groups, and family is a crucial piece of the well-being puzzle. You may be surprised by the number of people who actually want the best for you.

Do You Have a Transgender Child?

Gender dysphoria can be particularly upsetting and confusing for children, especially with a good dose of puberty thrown in. Kids typically find social inclusion, self-acceptance, and family relationships harder to navigate than for adults with more life experience.

I ask parents of trans kids to have the patience of a saint and be prepared to escape their comfort zones. I recommend they learn as much as possible about gender identity and the options for social and medical transitioning.

Supportive behaviours such as addressing and introducing their children using their preferred names and pronouns, for example, are a great start.

From a clinical point of view, juvenile medical transitioning is a highly specialised area of paediatrics that we can explore together. I can help guide your child’s treatment, including by providing referrals to specialists and the incredible people at the Royal Children’s Hospital (RCH) Gender Service.

happy trans girl

Here are some excellent resources to which I direct trans people and their families.

  • AGMC: National body for LGBTQI+ people and community groups of multicultural and multifaith backgrounds.
  • Minus18: Online portal that aims to improve the health and wellbeing of, and provide a safe environment for, young LGBTQI+ Australians.
  • Queerspace: LGBTQI+ health and wellbeing support service
  • Rainbow Door: Specialist helpline providing information, support, and referral service to all LGBTQIA+ Victorians, their friends and family.
  • Rainbow Network: Directory connecting you with LGBTQI+ groups and services across Victoria.
  • The Shed: Melbourne based support group for trans masculine people and their allies.
  • Switchboard: Peer-driven support services for LGBTQI+ people, their families, allies and communities.
  • Trans 101: Gender diversity crash course helping people better understand what it means to be trans.
  • Transcend: Parent-led peer support network for the families of transgender children.
  • Transgender Victoria: Victoria’s leading body for trans and gender diverse advocacy.
  • TransHub: Broad information and resources for all trans and gender diverse people.
  • Ygender: Peer-led social support and advocacy group for trans/gender diverse young people.
You can book an appointment with Tasha online or by calling us on (03) 8579 6838.

24 Comments

  1. Christine

    Is Dr. Tasha providing HRT to the client?

    Reply
    • Doctors of South Melbourne

      Hi Christine,

      Yes, Dr Tasha can prescribe Hormone Replacement Therapy (HRT) for people over 18 years old. However, this can only happen following a thorough assessment and discussion.

      King regards,
      Doctors of South Melbourne

      Reply
  2. Tim

    I think the practice needs another option in the new patient form under ‘Title’. At present it contains no titles for people who do not identify with binary terms.

    Reply
    • Doctors of South Melbourne

      Hi Tim,

      Thanks so much for your feedback. We’ve previously requested this change from the software provider and are pushing them to expand the ‘Title’ field options to reflect all people in the community.

      We’ll pass your comment on to the provider to bolster our request.

      Kind regards,
      Doctors of South Melbourne

      Reply
  3. Samra

    Amazing post

    Reply
  4. Ray

    Is this for Australian citizens only or any international transgender who is also interested?

    Reply
    • Doctors of South Melbourne

      Hi Ray,

      Though we can’t offer appointments to non-Australian citizens while they’re overseas, you’re most welcome to see Dr Tasha if you’re ever in Melbourne for an extended period.

      However, we must stress that the costs would be pretty high without government Medicare subsidies. This is compounded by the fact that medically transitioning often involves numerous GP appointments and potentially with psychologists and endocrinologists.

      Kind regards,
      Doctors of South Melbourne

      Reply
  5. Kiki

    Can the doctor provide a medical certificate for the change gender?

    Reply
    • Doctors of South Melbourne

      Hi Kiki,

      There are specific requirements depending on exactly the type of documentation you need. However, your GP should be able to issue most medical certificates.

      Kind regards,
      Doctors of South Melbourne

      Reply
  6. Astra

    Does Dr Tasha Patel offer hormone implants for trans women? Thanks.

    Reply
    • Doctors of South Melbourne

      Hi Astra,

      Dr Tasha doesn’t currently offer hormone implants for trans women. However, she’d be very happy to help you with any other aspects of care.

      Kind regards,
      Doctors of South Melbourne

      Reply
  7. JayElle

    Can your clinic recommend any clinics down in south east melbourne near Frankston? can people from all over Melbourne visit your clinic?

    Reply
    • Doctors of South Melbourne

      Hi JayElle,

      We’re not aware of any GP clinics in the general Frankston area that offer LGBTQI+ health services. However, allies such as Peninsula Pride and Peninsula Health may have more local knowledge.

      And yes, we warmly welcome people from all over Melbourne visiting our clinic.

      Kind regards,
      Doctors of South Melbourne

      Reply
      • Ricky

        hey there!
        does dr tasha work remotely (e.g. via telehealth)?
        there are almost no services here in rural latrobe city. 🙁

        Reply
        • Doctors of South Melbourne

          Hi Ricky,

          Yes, Dr Tasha does telehealth consults.

          You can make an appointment with her by clicking the BOOK ONLINE button at the top of this page, or by calling us on (03) 8579 6838.

          Kind regards,
          Doctors of South Melbourne

          Reply
  8. Flynn

    Hi, does dr Tasha Patel prescribe hrt to people over the age of 16? Cheers

    Reply
    • Flynn

      And can she provide a diagnosis of gender dysphoria aswell?

      Reply
      • Doctors of South Melbourne

        Hi Flynn,

        Dr Tasha only initiates hormone therapy for gender affirmation in people over 18 years old.

        Regarding a gender dysphoria diagnosis, this all depends on what the person needs the diagnosis for. Generally, if you need an ‘official diagnosis’ to access top surgery, for example, this would have to be done with a World Professional Association for Transgender Health (WPATH) psychologist or psychiatrist. Tasha can provide a referral but cannot do that assessment herself.

        Kind regards,
        Doctors of South Melbourne

        Reply
  9. Peter

    do you have a contact in the Wodonga area as it would be a 12 hour return trip to see you. Can this be done via zoom and blood test at local clinic?

    Reply
  10. Hannah

    Hi does Dr Patel offer HRT to international students in Melbourne as well? I am in the process of getting enrolled in UniMelb and will probably be getting an OHSC cover pretty soon. The university has recommended some providers but I would like to know which ones would be the best for trans health covers.

    I am also not out to my parents yet to to scepticism and plan to come out hopefully after getting on hormones though I am over 18 years of age, so it would be crucial for me to get covered by insurance.

    Thank you

    Reply
    • Doctors of South Melbourne

      Hi Hannah,

      All doctors at the clinic, including Dr Tasha, can treat international patients. However, appointments can be relatively expensive without Medicare.

      We can’t recommend health insurance for trans health cover. It’s best you do your own research while considering your specific needs for an insurance policy.

      Please note: Our fees are unlikely to be fully covered by international health cover, and we charge according to the time spent with you.

      For prescribing HRT, each patient is different. Depending on the situation, Tasha might refer you to a specialist such as an endocrinologist.

      Rest assured, we take patient:doctor confidentiality VERY seriously. It’s illegal for any health provider to disclose an adult patient’s information to their parents, spouse, or anyone else.

      Kind regards,
      Doctors of South Melbourne

      Reply
  11. Ella

    Hi, just wanted to check but does this clinic offer HRT using the informed consent model?

    Reply
    • Doctors of South Melbourne

      Hi Ella,

      Yes, Dr Tasha Patel offers patients HRT through the informed consent model.

      During your appointment, she’ll complete a detailed consent form with you while answering any questions along the way.

      Kind regards,
      Doctors of South Melbourne

      Reply

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