The 3 Magic Steps

There are three general steps to transitioning: thearapy, hormone treatment, and surgery. I will outline the steps and how to go about them. I haven't gone through them yet, but I have a job and am saving every dollar for it.

1. Therapy:
   - You may be thinking to yourself "I don't need therapy, I already know everything I need to." WRONG! You can learn a lot through therapy, if you have a good therapist.
   - Now is the time to make sure this is what you really want. Some of the changes from Testosterone are permanent, so be 100% sure this is what you want before you move on to step 2.
   - This part won't be fun: calling to set up your appointment. You have to be brave and make the call. When they ask what you need to be seen for, you must tell them "Gender Dysphoria" or "Gender Issues."
   - Depending on the person, this step could take months or longer. It's life changing and shouldn't be taken lightly.
   - You may lose family. You may lose some gay friends if you are active in the gay community. You could lose your job. You could get harassed at school. The list never ends, but if you want to transition, just do it. Be strong.
   - You will face challenges. Be brave and face them head-on!
   - I will be posting more about therapy and therapists soon.


2. Testosterone Hormone Therapy:
   - I have posted a bit about testosterone on this blog. Please make sure to look at those posts.
   - Get the letter of recommendation for hormone therapy from your therapist. That letter will halp you get your prescription for testosterone.
   - Testosterone is a steroid; it's not to be played around with.
   - T is a safe drug when it is used under supervision and is controlled. So use the correct dosage and see your doctor as regularly as you are told to.
   - The changes take years, taking more will not make changes happen faster. You could end up really ill or dead.


3. Surgery:
   - Quite a few surgeons require you to have had hormone therapy before they will operate on you, but just as many don't require it.
   - If you were planning chest surgery first, you don't need to be on testosterone (in most cases) before surgery.
   - You need to have a letter from your therapist recommending you for surgery before a surgeon will operate on you.
   - You can read about the types of surgeries in my "Types Of Surgeries" post.


If I missed anything, send me an email. TheAidenApocalypse@gmail.com

Risks Of Taking Testosterone

Testosterone can be an FTM's best friend, but there are risks and some possible side effects that you need to be aware of. Knowing these risks can help you make an educated decision on whether you want to take it or not.

1. Testosterone can increase the risk of heart disease, diabetes, and stroke.
2. It can increase hemoglobin and red blood cells.
3. Testosterone can cause or worsen headaches and migraines.
4. It might increase the risk of some types of cancer (however, it has not been proven).
5. T can negatively affect mental health.
6. There can be social consequences due to transphobic people.

Due to all of these health risks, it is very important to get regular check ups with your doctor. Your doctor can help make sure none of these issues get too unbearable.

Also, another risk of taking testosterone could be death. Make sure you use the proper dosage as it is prescribed to you. DO NOT order testosterone from the internet or anything. You don't know for sure what is being sent to you. Only use T if you have a perscription.

Using T is your decision. Many transmen choose to use it, but many also choose not to. Personally, I plan on using it because I really hate my voice.

If you start taking it and decide you don't like the way it makes you feel, stop taking it. Most of the changes are reversable. See my "Changes From Testosterone" post to see which things will go back to how they were before.

As always, feel free to shoot me an email if you have any questions. :D

Surgeons

I will be listing some of the top surgeons for FTM surgeries. I'll say what they will perform (top, bottm, etc.) and contact info. I might add some pictures too. I'll tell what I have heard about each surgeon (if I have heard anything). I hope this list will help you.

Dr. Beverly A. Fischer, M.D.
Advanced Center for Plastic Surgery
12205-12207 Tullamore Rd.
Timonium, MD 21093
0r
2 Colgate Dr.
Suite 101
Forest Hills, MD 21050
Ftm top surgery
I have seen a lot of her work in photo galleries. It seems to vary greatly. I have seen amazing/perfect surgeries, but I have also seen surgeries that I thought looked very poorly done. The best and worst surgery photos I have seen have come from her.
http://www.beverlyfischer.com/



Dr. Yvon Menard, M.D.
Dr. Pierre Brassard, M.D.,
1003 East Boulevard St. Joseph, Montreal,
Quebec, Canada H2J 1L2
Phalloplasty, Metoidioplasty, Clitoral Freeing Procedures, Mastectomy
http://www.grsmontreal.com/anglais.html





Daniel A. Medalie, MD
Assistant Professor of Plastic Surgery
Metrohealth Medical Center
Case Western Reserve University
http://www.clevelandplasticsurgery.com/transgender-surgery



 
Dr. Raphael
1600 Coit St 105
Plano, Tx 75075
Ftm top surgery




John G. Gregory, MD, FACS
Deaconess Institute of Sexual Medicine
6125 Clayton Ave., #141
St. Louis, MO 63139



Eugene A. Schrang, M.D., S.C., Theda Clark Regional Medical Center
125 E. Forest Avenue
Neenah, WI 54956
Ftm top surgery
I was considering going there because it's pretty close to home and he seems pretty skilled.




Dr. Kenneth L. Stein
414 N. Orleans, Suite 209
Chicago, IL 60610


Dr. Alan N. Wilson
Detroit Medical Center,
573 Fisher Theater Building,
Detroit, MI 48202





Dr. Marci Bowers
406 First National Bank Building
Trinidad, CO 81082.
Ftm bottom and Mtf surgeries
http://www.marcibowers.com/grs/gender.html


Dr. Gary Alter
435 N. Bedford Dr. Suite 300
Beverly Hills, CA, 90210
http://www.altermd.com/

           


Dr. RE Moulton-Barrett, MD
2070 Clinton Av, Alameda, CA 94611
http://moulton-barrett.com/



These are obviously not all of the surgeons available. I just wanted to give you some to start looking at and comparing.

Changes From Testosterone

I want to give you a brief overview of the changes that may/will result from the use of testosterone and the changes that will stay if you choose to stop using it.


Changes that occur while you're on Testosterone:

• Facial hair growth
• Voice deepening
• More body hair growth
• Enlargement of the clitoris
• More muscle mass
• No more periods
• Possible hair loss and male pattern baldness
• Body fat moves from hips to abdomen
• Skin may become more oily
• Increase in red blood cells
• Cholesterol changes
• Scent of body odor and urine may change (that's kind of a weird one)
• Skin may become rougher
• Increase in your sex drive

You could have any combination of the above results. You may not notice them right away, but you should see at least a few changes.
Some things only occur for some transmen, but don't happen super often. These include:

• More angular face
• More energy
• Larger feet/hands
• Become hungrier
• Slight decrease in density of breast tissue
• Emotional changes

If you choose to stop taking T, some of the changes are permanent and some are not.


Voice: should stay at the deepness it has reached due to T use
Facial/body hair: The hair that is already there will continue, but new areas of hair will not grow.
Clitoris growth: should stay at the same length and thickness
Muscle/fat changes: will revert back to more feminine states
Hair loss: If you have lost hair while on T, it will most likely not grow back upon quitting.
Menstrual cycle: If the ovaries are still in working condition, periods will return
Skin oils/acne: may decrease
Body scent: may change
Sex drive: may decrease

FAQ

People ask a lot of questions about transgenderism and it's hard to know what to say to answer them. Transgenderism is hard for friends and family to understand, but it is also hard for the trans person as well. I will try to help answer trans people's questions and help them know how to answer their loved ones' questions.

1. What causes transgenderism?
         - Nothing has been proven to cause it. People speculate that it is genetic, just like homosexuality.
        - I had a discussion with my amazing Psychology teacher and he gave me his ideas. It has been proven that homosexuality happens in the womb. You get two washes of testosterone if you are a male. One changes your body and the other changes your brain. He thinks that this is what happens to transgender people. One part changes, and the other doesn't.

2. After surgery, will everyone consider me a male/female?
    - No. No matter what you do, some people just won't accept you. Some people just suck.

3. What did I do wrong as a parent?
    - Nothing. Some kids are trans; it just happens. Once you accept that, you can move on from there. They are still your kid and are still amazing. Love them for who they are.

4. Why can't I be normal?
   - I have asked myself this question many times. But do you know what I have realized? No one is really "normal." Everyone has quirks and habbits and things that make everyone different. You are never alone; there are many other trans people that go through the same things you do. And being "normal" is overrated anyway!


These are all the questions I have right now. If I have missed any of your questions, shoot me an email. I hope these have helped you.
TheAidenApocalypse@gmail.com

Surgery Types

I will be discussing a few different types of surgery and will probably add more information later.

There are three general types of surgeries:
1. Chest reconstruction surgery (sometimes called top surgery or male chest contouring)
2. Hysterectomy and oophorectomy (removing the uterus and ovaries)
3. Genital reconstruction surgery (sometimes called bottom surgery)

Within the Chest reconstruction surgery group, there are two subgroups:
1. Double incision/Bilateral mastectomy
2. Keyhole/Peri-areolar incision

Double incision/Bilateral mastectomy:

• usually used for guys with larger chests (usually B or higher)
• two incisions are made across the breasts, right below the nipples
• the skin is peeled back and the fatty tissue is removed, using a scalpel
• the skin is then trimmed and put back over the chest

Pros:

- best method for guys with large chests
- muscle growth and hair growth can help hide scars
- resizing and placement of the nipples make the chest more masculine looking

Cons:

- huge scars
- little or no nipple sensation
- may require revision
- areas of numbness
- appearance of puckering along the scars

Keyhole/Peri-areolar:

• effective for individuals with small chests (cup A or smaller is preferred, but a lot of surgeons will do size B)
• incisions are made around the areola
• fatty tissue is "scooped" out
• areola might be sized down
• skin is pulled taut toward the incision
• the incision is closed

Pros:

- minimal scarring
- sensation in the nipples

Cons:

- nipple placement might not be ideal
- possibility of sagging skin
- chest may not appear completely flat
- may need revision
- risk of nipple loss

Genital reconstruction surgery:
1. Metoidioplasty
2. Centurion
3. Phalloplasty

Metoidioplasty:

• clitoris grows because of testosterone
• the ligament holding the clitoris is cut, bringing the clitoris forward
• it will look like a small penis
• scrotal implants may be available

Pros:

- unassisted erection when aroused
- natural looking
- no visible scars

Cons:

- too small for penetration
- sometimes the clitoris doesn't get big enough by using testosterone


Centurion:

• round ligaments are freed from the labia majora and brought together along the shaft of the clitoris
• it provides girth
• the extraction of the round ligaments leaves a pocket
• silicone scrotal implants are placed into the pocket
• a urethral extension is made by using a catheter, which will be removed when it is healed

Pros:

- natural looking
- erotically sensate penis
- unassisted erection
- no visible scars

Cons:

- too small for penetration
- sometimes clitoris doesn't get big enough by using testosterone

Phalloplasty:

• many different types
• Gillies: flap of abdominal skin is rolled into a tube to create a penis
• Suitcase handle: improvement on the Gillies, flap is attached to the abdomin for a few weeks for proper blood supply and then released to hang down
• Free tissue flap transfer: more recent and improved; a flap of skin is removed, nerves and blood vessels in tact, and transferred to the groin area
• MLD flap: skin is taken from the torso, under the arm; considered to produce the most realistic looking penis; more erotically sensate
• scrotoplasty: paired with the phalloplasty; labia majora hollowed out and silicone implants are inserted to create a scrotum

Pros:

- average-sized penis
- realistic looking
- can urinate through
- can engage in penetrative sex

Cons:

- multiple surgical visits
- may need revisions
- expensive
- scarring
- pain
- long time for recovery

Personally, I am planning to get peri-areolar chest surgery and the MLD phalloplasty. The chest surgery will leave little scarring and that's what I want (also I have a small chest). The MLD is the best bottom surgery available. The pros outweigh the cons for me.

Even though I told you what I want for myself, only you can decide what's best for you. Even if you choose not to have any surgery, you will always be a man. Think very seriously about all your options before you make the choice. Surgery is serious and can not be undone.

Reference

I just wanted to define some terms that a lot of people have problems distinguishing or understanding.

Transgender -  general term applied to a variety of individuals, behaviors, and groups involving tendencies to vary from culturally conventional gender roles

Transsexualism - an individual's identification with a gender inconsistent or not culturally associated with their biological sex

Pansexuality -  sexual attraction, sexual desire, romantic love, or emotional attraction toward persons of all gender identities and biological sexes

FTM - biologically female, mentality of a male

MTF - biologically male, mentality of a female

pre-op - before any surgery

post-op - after surgery

Bio-female - woman

Bio-male - man

transman - an FTM