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Gender transition is different for each person. There aren’t any specific steps required for someone to transition — it’s all about what feels right for you. It’s sort of like a buffet, where you can try everything, a few things, or nothing at all. Also, you may not want or have access to some kinds of transition.

What does it mean to transition?

Transitioning is about making changes so that you can live in your gender identity, like changing your name or getting gender-affirming medical care. Transition is often about reducing gender dysphoria and/or increasing gender euphoria

Transitioning isn’t necessarily a straight line or direct route. Transitioning can be a long and ongoing process, or it can be something that happens over a short period of time. You might try out different things as you learn what’s best for you. 

Because this process is about becoming more fully yourself — in body, mind, and relationships — people sometimes call it “congruence” instead of “transition.”

When you hear “transition,” you might think about medical transition first. Medical transition is important to many transgender and nonbinary people. But there are ways to transition that don’t require doctor’s visits, too. 

How do I start  transitioning?

There are a few different areas of transition, or ways to affirm your gender: 

  • internal 
  • social 
  • legal 
  • physical (medical and non-medical) 

Internal transition is about changes in the way you see yourself. You might try dressing differently when you’re by yourself, calling yourself by a different name only in your head, or practice using your voice differently. You might start to notice times that you feel gender dysphoria or gender euphoria. Other people might not know about or be able to see this kind of transition. 

Social transitioning may include things like:

  • coming out to your friends and family as transgender or nonbinary; 
  • asking people to use pronouns that feel right for you;
  • going by a different name;
  • dressing/grooming in ways that feel right for you when other people can see you; and 
  • using your voice differently when talking to other people. 

Legal transition is about changing information about your gender in official records or other government documents. While the laws vary in different states, you might change your name and/or gender marker on different formal records, like: 

  • your driver’s license, state ID, or passport; 
  • your birth certificate;
  • your social security number;
  • your immigration documents, permanent resident card, or naturalization certificate;  
  • with your school or employer; and 
  • with your doctor or health insurance.  

Some kinds of legal transition require paperwork and can be expensive. Some can be free and pretty easy. It depends on where you live and what you want to change. 

This resource from the National Center for Transgender Equality can help you learn more about how to change your name and/or gender marker on different legal documents. 

Physical transition is about changing your body, either temporarily or permanently, to line up with your gender identity.

Non-medical physical transition includes ways that you can temporarily change your body without a doctor’s help. These strategies are helpful for lots of trans and nonbinary people — especially if done safely. They’re often low-cost or free. Some include things like:

  • chest binding, using clothing like binders or sports bras to help make your chest flatter; 
  • stuffing, using clothing like a padded bra, padded underwear, or tissue paper to make your chest, hips, or butt look fuller;
  • tucking, tucking away your penis and/or scrotum to make your groin flatter; and 
  • packing, using items like a packer, cup, or balled-up socks to give your groin a bulge.

All of these strategies are temporary, so someone can do them regularly, for special occasions, just one time, or while they wait to access medical transition.

There are other less temporary or more permanent things you can do as part of your transition.

For trans men and some nonbinary people, medical transition may include any of the following:

  • gender-affirming hormone therapy: taking hormones to develop secondary sex characteristics such as a deeper voice, facial hair growth, muscle growth, redistribution of body fat away from hips and breasts, not getting a period, etc.;
  • mastectomy, also called “top surgery:” the removal of breasts and breast tissue;
  • voice training: working with a professional to learn to use your voice differently;
  • laryngoplasty: surgery that changes your vocal chords; 
  • hysterectomy: the removal of internal reproductive organs such as the ovaries and uterus;
  • phalloplasty: construction of a penis using skin from other parts of your body;
  • metoidioplasty: surgery that makes your clitoris longer and more flexible, like a penis;
  • scrotoplasty: surgery that creates a scrotum and testes;
  • vaginectomy or vulvectomy: surgery that removes your vagina and/or vulva — commonly combined with other genital surgeries; 
  • nullification: surgery that hides or removes all external genitals, like the clitoris or vulva, to create a smooth groin; and 
  • fertility preservation: saving eggs that can be used to have biological children in the future.

For trans women and some nonbinary people, medical transition may include any of the following:

  • gender-affirming hormone therapy: taking hormones to develop secondary sex characteristics such as breasts, redistribution of body fat toward hips and breasts, less body hair, etc.;
  • breast augmentation: also called “top surgery” (aka implants);
  • voice training: working with a professional to learn to use your voice differently;
  • laryngoplasty: surgery that changes your vocal cords; 
  • laser hair removal: removing hair from your face, neck, or other parts of your body;
  • tracheal shave: making your Adam’s apple smaller;
  • facial feminization surgery: surgeries that change the shape and/or size of parts of your face, like your nose, lips, cheeks, or jaw;
  • orchiectomy: removal of testes;
  • vaginoplasty: creation of a vagina, often by inverting the skin of the penis;
  • nullification: surgery that hides or removes all external genitals, creating a smooth groin; and 
  • fertility preservation: saving sperm that can be used to have biological children in the future.

Gender-affirming medical procedures vary in cost and availability. Some procedures might be covered by your insurance, and others might not be. This depends a lot on where you live and what kind of medical care you can access. 

Do all trans and nonbinary people transition?

No. People transition in different ways, orders, and paces. For example, you could transition socially without wanting any medical procedures. You could transition medically by doing one or only a few of the procedures listed above. You could change your name and gender marker on formal records. You might transition internally and not want to or feel ready to transition in other ways.

Other things can shape how you transition. Not every trans or nonbinary person has access to resources and support. Medical procedures, in particular, can be very expensive, and not everyone has the money or health insurance coverage to afford them. And finally, but most importantly — not all trans people want all of the available medical procedures.

Transgender people who don’t transition in certain ways are just as “real” as those who do. Someone’s gender identity should always be respected.

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