Transgender/Transsexual/Transitioning Transsexual


Hello Mike, My name is Rowan. I am a transgender, who has not yet started to physically transition. But I really do want to.

However before I begin, what is the process of it. I hear a lot of transgendered people state they have to even see a therapist before they receive HRT (hormone replacement therapy) Is this true in California?

What is the process for beginning anything?

Dear Rowan,

Thanks for your email.  I transitioned so long ago, that the standards have changed again.  I'm not up on them, but here is what I do know:

The current Standards of Care (Version 7) are available at WPATH's website at

If you click on the language that you want, it will take you to the page.  Do not click the "buy" button.  You can download the document directly, so you can read what the recommendations are.  Please keep in mind that "The SOC are intended to be flexible in order to meet the diverse health care needs of transsexual, transgender, and gender-nonconforming people. While flexible, they offer standards for promoting optimal health care and guiding the treatment of people experiencing gender dysphoria—broadly defined as discomfort or distress that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics) (Fisk, 1974; Knudson, De Cuypere, & Bockting, 2010b)."

Most doctors who are going to prescribe hormones are going to want you to go see a mental health professional.  Whether you need to see a therapist depends on the doctor.  Do your research and see what the MD says, but it would probably save time, aggravation, and help you navigate some of the beginning transition issues like coming out to co-workers and family, etc.

WPATH has a link on its page to help you find providers.  However, my recommendation is that you connect with other transmen and get recommendations from them. I don't know where you are in California.  LA has FTM International.  San Francisco has the Lou Sullivan Society.  If you need help, let me know a major city or general area, so I can try to run a Google search for info.

If you have health insurance (you probably do), the next step is going to be to find a provider in the network.  With Obamacare passing, I believe that there are policies now covering transition, but you'd need to read the benefits section of your particular policy.  Most health insurance carriers allow you to access those documents when you log into your account.  My doctor is covered, but testosterone is not.  The meds run about $100 per vial which lasts 10 weeks if you are using injectables.  The cream and patch cost more.  You will need to check your prescription plan.  

1.  So, whether you are ready to start or still exploring, I recommend that peer support.  Find a network of FTMs and go to meetings.  You will learn more from them than you will from a therapist or doctor.

2.  If you are ready to go, find a therapist - either by searching online or getting recommendations from other FTMs.

3.  Explore cost/insurance coverage.

If you need anything else, please don't hesitate to write.


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Mike Hernandez


I can answer questions that pertain to transition, coming out, dating, surgical options, etc., related to FTMs (female to male) and genderqueer individuals with a masculine gender expression.


I'm FTM who started transition in 1991. I have published articles and have spoken at colleges and universities on being and living as a transgendered individual. I have also presented workshops at a variety of FTM/transgendered conferences including FTM Conference of the Americas (1995-1997), Southern Comfort (late 1990s) Forward Motion (1999), Gender Odyssey (2000, 2004), and Forge (2007). I was one of several organizers of the Forward Motion conference.

Former boardmember of FTM Alliance of Los Angeles, Inc.

"Transgendered Lust " appearing in From the Inside Out: Radical Gender Transformation, FTM and Beyond by Morty Diamond (San Francisco: Manic Press, 2004) A contribution to Bears on Bears by Ron Suresha (San Francisco: Alyson Publications, 2002); "Redemption" appearing in Best Lesbian Erotica, ed. Tristan Taormino (San Francisco: Cleis Press 2001); Best of the Best Lesbian Erotica 2 , ed. Tristan Taormino (San Francisco: Cleis Press 2004); originally appearing in Academy: Tales of the Market Place by Laura Antoniou (New York: Mystic Rose Books, 2000); Appearance in Transmen & FTMS: Identities, Bodies, Genders & Sexualities by Jason Cromwell (University of Illinois Press, 1999); "I Am Neither Man Nor Woman" Trans Liberation: Beyond Pink or Blue, ed. Leslie Feinberg (Boston: Beacon Press, 1998); "Holding My Breath Under Water" Looking Queer , ed. Dawn Atkins (Boston: Hayworth Press, 1998); "Boundaries: Gender and Transgenderism," The Second Coming , eds. Pat(rick) Califia and Robin Sweeney (San Francisco: Alyson Publications, 1996); and # "Packing, Passing & Pissing," Dagger , eds. Lily Burana, Roxxie, and Linnea Due (San Francisco: Cleis Press, 1994).

Post graduate.

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