What do I need to know about transitioning?

What does it mean to transition?

Transitioning is about making changes so that you can live in your gender identity. These changes can include changing your name or getting gender-affirming medical care. People often transition to reduce gender dysphoria and/or increase gender euphoria. 

How long does transitioning take?

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

The transition process is about becoming more fully yourself — in body, mind, and relationships. So, people sometimes call transitioning “congruence.”

How do I start  transitioning?

You can start by learning about the different areas of transition, or ways to affirm your gender: 

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

Internal transition changes 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 changes information about your gender in official records and government documents.

While the laws vary in different states, you might legally change your name and/or gender marker on 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.

Learn how to change your name and/or gender marker on legal documents at the  National Center for Transgender Equality.

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. They're often low-cost or free. They include:

• chest binding, using clothing like binders or sports bras to flatten your chest; 
• stuffing, using materials like a padded bra, padded underwear, or tissue paper to make your chest, hips, or butt look fuller;
• tucking, hiding 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.

Medical physical transition — longer lasting ways to transition — include working with a nurse or doctor.

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, and not getting a period;
• 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, and less body hair;
• 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 people transition in different ways, orders, and paces?

Yes. 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 feel ready to or not want to transition in other ways.

Do all trans and nonbinary people transition?

No. Transitioning is not a requirement for being trans, nonbinary, or any gender identity. Not all trans people want the available medical procedures or other ways of transitioning.

Access to resources and support also shapes whether you transition. Medical procedures can be expensive, and not everyone has the money or health insurance coverage to afford them.

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