Healthy lives for young people
Gender

Transitioning

Transitioning refers to the process of living in your acquired gender role which matches your gender identity. Transitioning can involve many different elements and stages but ultimately, is concerned with changing your physical appearance and body to match your gender identity.

Not everyone chooses to transition and those who do, may transition to different degrees.

Similarly, some people only choose to live part-time in their preferred gender identity, whereas others want to be permanently accepted in their acquired gender identity. This often begins with a process of changing their name and the pronoun they wish to be referred to as(he/she). This may then lead on to taking hormones and having surgery to make their bodies conform to their acquired gender identity. But even when it comes to hormones and surgery, not everyone will make the same choices.

There really is no hard and fast rule. It’s a very personal choice and needs to come from you and what you want. You should never feel pressurised.

To help understand your feelings about transitioning, here is a helpful list of questions you may wish to ask yourself, from the brilliant Living My Life leaflet.

  • Do I want to live full time or part time with a different gender identity?
  • Do I enjoy dressing in a different gender identity but am happy with my body as it is?
  • Does my body match with my gender identity?
  • Do I want my body to be different to how it is now?
  • Although my external appearance might be that of a male/female, is this really how I feel?
  • If I don’t identify as male or female, what do I do?
  • How do I want to live my life?

This leaflet also contains detailed information about the different aspects of transitioning and surgical procedures you may or may not wish to go through.

For male to female trans people, non-surgical transitioning may include:

  • Voice training to soften the voice
  • Padding your body to make it more feminine
  • Hair removal
  • Dressing and styling your hair in a way that reflects your gender identity

For female to male trans people, non-surgical transitioning may include:

  • Binding to flatten your breasts
  • Packing to create the appearance of male genitals
  • Dressing and styling your hair in a way that reflects your gender identity

Gender Recognition Act 2004

The Gender Recognition Act 2004 gives certain legal rights to trans men and women. Under the Gender Recognition Act of 2004, trans men and women can:

  • apply for and obtain a Gender Recognition Certificate to acknowledge their gender identity
  • get a new birth certificate, driving licence and passport
  • marry in their new gender

To apply for a Gender Recognition Certificate, you must be over 18. The application process requires you to prove that:

  • you have or have had gender dysphoria
  • you have lived in your preferred acquired gender for the last two years
  • you intend to live permanently in your acquired gender

Find out more about the Gender Recognition Act 2004 and how to apply for a Gender Recognition Certificate.

If you choose to transition

To receive this treatment on the NHS, you will need to be referred to a gender specialist or a gender clinic by your GP.

If you are under 16, you will need to be referred to a specialist young person’s clinic such as The Tavistock and Portman. You may then be offered hormone blockers to delay the physical changes of puberty which would give you time to think carefully about living as a man or woman for the rest of your life.

In 2011, the age at which young people would be offered this treatment was lowered from 16 to 12. At the age of 16 you can begin receiving hormones that help you transition but currently the Tavistock and Portman is the only clinic that offers this. From 18, you can attend any NHS gender clinic.

Most professionals will recommend that you live as your gender identity for at least 3 months before starting hormone therapy. You will also be offered counselling. This is because the effects of these hormones cannot be reversed so it’s vital you’re sure.

Taking female hormones will:

  • Decrease the size of your genitals
  • Encourage breast growth
  • Reduce and soften hair growth
  • Redistribute body fat to give a more feminine shape

Taking male hormones will:

  • Lower the voice
  • Stimulate muscle growth and redistribute body fat to give a more masculine shape
  • Increase body and facial hair
  • Stop periods

The international Standards of Care for the treatment of transsexuals require that you live in your acquired gender for at least a year before you have surgery. Here in the UK that requirement is extended to 24 months.

Surgical options

Having gender realignment surgery is a personal choice that not everyone makes. For those who do, they may only choose to have some surgery. For example, some trans women may have facial feminising surgery and breast implants but will opt not to have lower body surgery.

For trans women, surgical options may include:

  • Breast implants
  • Removal of testicles (orchidectomy)
  • Removal of penis (penectomy)
  • Creation of a vagina (vaginoplasty)
  • Creation of a clitoris (clitoroplasty)
  • Creation of labia or ‘lips’ of the vagina (labioplasty)
  • Facial feminisation surgery
  • Trachea (or Adam’s apple) shaving
  • Removal of male brow bossing
  • Jaw reshaping

For trans men, surgical options may include:

  • Breast removal and chest recontouring (double mastectomy)
  • Removal of the womb (hysterectomy)
  • Removal of the ovaries (oophorectomy)
  • Removal of the vagina(vaginectomy)
  • Creation of a ‘micropenis’ from the clitoris (metoidioplasty)
  • Construction of a phallus (phalloplasty)
  • Creation of a scrotum with testicular implants (scrotoplasty)

For more information on transitioning and treatment, visit the gender dysphoria section of NHS Choices and read this guide to gender dysphoria services (PDF). You can also visit the various organisations that are dedicated to giving you the advice, support and information on all aspects of being trans or non-binary and transitioning.

Content reviewed by Kirstie McEwan – Lead tutor in Gender Studies, Cambridge Institute of Clinical Sexology, accredited therapist and trustee of the College of Sexual and Relationship Therapists.

Gender identity clinics in the UK

Gender identity clinics in London and the Southeast

  • West London Mental Health NHS Trust Gender Identity Clinic
    179-183 Fulham Palace Road, London, W6 8QZ
    Telephone: 020 8483 2801

    The West London clinic’s website has an overview of information useful for anyone with gender identity needs, not just those in the area.
  • The Tavistock and Portman NHS Foundation Trust Service for children and young people with gender identity issue
    The Tavistock Centre, 120 Belsize Lane, London, NW3 5BA
    Telephone: 020 8938 2030
    Email: gids@tavi-port.nhs.uk

    The Tavistock’s website includes information about the kinds of treatment the service offers people with gender identity issues.

Gender identity clinics in the North

  • Sheffield Health and Social Care NHS Foundation Trust Sexual and Relationship, Sexual Medicine and Transgender Services
    Porterbrook Clinic, Michael Carlisle Centre, Nether Edge Hospital, 75 Osborne Road, Sheffield, S11 9BF
    Telephone: 0114 271 6671

    The Sheffield Gender Identity Services website includes information about referrals, clinic opening hours, and links to eligibility criteria and the Porterbrook Clinic.
  • Leeds Gender Identity Clinic
    Management Suite, 1st floor, Newsam Centre, Seacroft Hospital, York Road, Leeds, LS14 6WB
    Telephone: 0113 855 6346

    The Leeds clinic’s website covers referrals and commonly used medications.
  • Northumberland Gender Dysphoria Service
    Benfield House, Walkergate Park, Benfield Road, Newcastle, NE6 4QD
    Telephone: 0191 287 6130

    The Northumberland Gender Dysphoria Service website has a leaflet outlining eligibility and how to access service.

Gender identity clinics in the Midlands

  • Northampton Gender Clinic
    Danetre Hospital, London Rd, Daventry, Northamptonshire NN11 4DY
    Telephone: 01327 707200
    Email: genderclinic@nhft.nhs.uk

    Visit the Northampton Gender Clinic’s website for more information.
  • Nottingham Gender Clinic
    Mandala Centre, Gregory Boulevard, Nottingham, NG7 6LB
    Telephone: 0115 960 2820

    The Nottingham Gender Clinic’s website has information about staff at the clinic and the legal standing of gender dysphoria services.

Gender identity clinics in the South West

  • The Laurels Gender Identity and Sexual Medicine service (Devon Partnership NHS Trust)
    The Laurels, 11-15 Dix’s Field, Exeter, EX1 1QA
    Telephone: 01392 677077

    The Laurels’ website has information about the types of services on offer and the help available during transition.
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