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 ease of this post, let’s use the term medical transitioning.
ON THIS PAGE
- To transition or not to transition
- Options for medical transitioning
- Start with a visit to your GP
- What to expect from GP appointments
- The importance of mental health support
- Encouraging transgender children
- Links to helpful resources
- About Dr Tasha Patel
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 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 came out to family and friends, while others simply chose to dress more masculine/femininely.
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.
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.
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?
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.
You may consider re-defining your jaw and making your brow line more prominent to achieve this.
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, and 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.
The effects of testosterone include increased muscle bulk, 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 such a specialist (or a 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.
Surgical transitioning options are plentiful, though procedures generally require high out-of-pocket costs.
Cosmetic facial procedures and top surgery (operating on your chest and upper torso) are among the most commonly performed.
Facial cosmetic surgery includes:
- Rhinoplasty – aka a nose job
- Mandibular angle reduction (sculpting your jaw)
- Chin and cheek augmentation
- Facelifts, eyelifts, and browlifts
Examples of top surgery are:
As the name suggests, bottom surgery focuses on surgically altering the shape and function of your genitals. Many people instantly think of genital reconfiguration surgery (GRS), which includes:
- Vaginoplasty and vulvoplasty: Converting a penis into a vagina.
- Phalloplasty: Constructing a penis using skin from other parts of the body.
- Metoidioplasty: Altering a clitoris to act more like a penis.
However, only a handful of surgeons in Australia currently offer GRS, and waitlists are relatively long. Fingers crossed, more will soon offer these procedures.
Other surgical options include:
- Tracheal shaving (making your Adam’s Apple smaller)
- Hair transplants
- Buttock augmentation/reduction
Before you decide on any surgery, discussing your options, risks, and alternatives with your GP, specialist, or surgeon is essential.
Also, talk with trusted family, friends, and others who’ve had similar procedures.
Beginning Your Transition Journey With a GP Visit
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 and is 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 include 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 history 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 questions concerning:
- What to expect
- Risks vs benefits
- 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 for a chat and check-up a few times a year.
These regular consults are an excellent opportunity to see how you’re feeling about your transition and to support your mental health.
Caring for Your Mental Health Is Essential
Being at peace with your gender identity is a highly positive and affirming part of your general health and well-being.
Towards this goal, it’s important to recognise that 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 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 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.
Dr Tasha Patel is a local GP at Doctors of South Melbourne.
Tasha is only taking new patients for gender-affirming care. If you’re a new patient and would like to book with Tasha to discuss gender affirmation, please call the clinic on 8579 6838.
Helpful Links and Resources
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 multi-faith backgrounds.
- Minus18: Online portal that aims to improve the health and well-being 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.
- 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.