What to expect during transition

Transition involves a profound change in your life; this may seem daunting but we are here to help. There are a range of challenges to be addressed during your transition, so we’ve prepared a checklist to help you prepare.

This list is not exhaustive. Transition involves much, much more than the obvious medical interventions of hormone therapy and surgery. You will also need to consider its social and legal implications, from formally changing your name through to dealing with the emotional aspects of informing family and friends.

The West of England Specialist Gender Identity Clinic will support you in all aspects of your transition and will provide you with a personalised file to hold all this information.

Good practice guidelines require people to live in a gender appropriate role for at least a year before they are referred for surgery.

Checklist for transition

  • You will be provided with a great deal of new information about gender identity issues by the clinic. We recommend that you keep it in your personal file for future reference.
  • Living life in your new social role may be very different to your current life and you are likely to have many new experiences; be ready for change and for some challenging situations. Ask for help if you feel overwhelmed by everything; difficult challenges can be overcome with help.
  • Medication and hormone treatment may be offered. We strongly discourage self-medication with irregularly sourced drug treatments. Internet-sourced hormone therapies can be dangerous and are sometimes contaminated. Their use is likely to affect blood test results and, if our medical team are unaware of your self-medication, they may inadvertently offer inappropriate advice or recommend unnecessary investigation. Please, be honest with us. You will experience both physical and emotional changes. Keep notes on how you’re feeling.
  • Gender reassignment surgery (GRS) cannot be provided until you have lived in a social role appropriate to your gender identity for at least twelve months. It is often very helpful to “grow into” your new role in society; rushing in to change without adequate planning and preparation may result in your making mistakes and experiencing preventable suffering.

    We understand that many people feel that they have already been waiting too long to transition, and have hormones and surgery. Just a little more time spent in preparation now may lead to greater happiness and satisfaction for a lifetime. The clinical team are able to discuss with you in detail what is involved in gender reassignment surgery. Not everyone wants surgery, currently, less than half of trans men seek GRS.
  • At some point, you will want to tell other people about your transition. We can advise you on how to carefully and sensitively inform all those who need to know about your transition, from family members to employers. Employers have legal responsibilities to protect you and Unite have written a guide on Trans Equality at Work, click here to view the Trans Equality at Work Guide.
  • Dealing with relationships and, where relevant, maintaining access to your children can be a concern. We recommend that your discuss this with your therapist as soon as possible, particularly if your partner and family are not yet aware of your transition plans. Make notes on your planned course of action.
  • You will need a letter of gender confirmation treatment for use if challenged in using gender-segregated facilities, such as changing rooms or toilets. Ask your consultant or therapist for details.
  • You may be eligible for NHS-funded treatment to reduce your facial hair (epilation).  There is a limit to the amount of treatment funded by the NHS and there is no guarantee that this will reduce your facial hair to your complete satisfaction. If you want additional or future epilation treatment, you will have to pay for this yourself. We can advise you about this.
  • A recent research document identified that 52% of the participants had experienced problems with work due to being trans or having a trans history.  Of concern was the finding that some people had not provided references because of their gender history which may affect the jobs they could apply for, whilst others had left a job due to harassment or discrimination with no job to go to. This could have significant implications should you be reliant on work in order to pay for your accommodation and food. Nevertheless if you’re in transition whilst working for the same employer there is legislation in place to protect your rights. 
  • Your pension and any benefits arrangements might be affected if you’re a transsexual. Seek advice from your private provider and/or the Department of Works and Pensions.  
  • Appropriate use of pronouns may become an issue. Politely advise people of your preferred pronoun.
  • Your entertainment and social activities are likely to change. Here is a link to a list of online resources: Guardian life and style: transgender advice.
  • Transphobic hate incidents may happen and can take many forms including verbal and physical abuse through to threatening behaviour and online abuse.  Transphobic hate crime is a criminal offence.
  • You may require legal support to deal with some issues. It may be beneficial to find a solicitor who has experience in transgender  topics.
  • Counselling is an important part of the transition process, make time to go to these sessions and keep notes of what’s important to you in your personal file.
  • As you prepare for your new life you may require assistance with clothing, footwear, wigs, and cosmetics. You may also need guidance on how to behave and deportment, the clinic’s staff and volunteers will be able to provide advice on all these matters.
  • Voice and communication skills training is provided where required by a specialist speech and language therapist to help particularly with feminising aspects of transition.