How To Qualify For A Sex Change

Posted on Posted in Tips and Techniques

Dear Jean Marie,

I have always thought I was a woman trapped in a man’s body, at least since the age of four or so. After reading Transformation for three years, I know I am ready for a sex change. I want to start on hormones and then have facial surgery and then complete sex reassignment surgery. But, how do I begin? Do I ask a doctor for hormones first? Do I contact a sex change clinic and they will tell me what to do. And, is there anything I should say, or shouldn’t say? I want to make sure I don’t blow it and they let me get started and go all the way through to the operation.


Atlanta, GA


Dear Suzi:

No. You don’t start with the doctors. You go to them later. The first thing you need to do is find a local psychologist or social worker who has had training in transgender issues and is already working with transsexuals and crossdressers. There are several reasons you have to start here. For one, it is such a therapist who certifies that you are a qualified candidate for the surgery, i.e. a real woman in a man’s body. None of the doctors who prescribe hormones and who perform sex change operations will work with you without a recommendation from a therapist. That’s why therapists are often called the gatekeepers by transsexuals. For another, it is a big step and a big change. Your body will look different, the hormones will make your feelings different. It naturally has an effect an your psyche and is disorienting. To make the transition to the woman you dream of being smoothly and safely, you need a knowledgeable guide. That’s the therapist’s real job.

And make sure the therapist has experience with transgender clients. Such a therapist is likely to be more sympathetic to your story and aspirations than one with little or no experience whose expertise lies in some other area. A therapist who is not knowledgeable in transgender issues may even attempt to talk you out of your desires and try to convince you are not really a transsexual, or that there is something wrong with your needs.How do you find a qualified therapist? There are several approaches you can take: 1) Check with your local lesbian, gay, bisexual, transgender help line or community center. 2) Look in a local counterculture or alternative newspaper, as you will often find ads from psychotherapists that list their specialties. 3) Locate the nearest transgender club and the girls there for a recommendation. 4) If you have web access, search around for some of the big transgender sites. There you will find links to sites like, that can guide you to lists of qualified therapists in your area. 5) Start showing up at LGBT events in your area until you run into someone who seems like they might be a crossdresser or a transsexual, and ask them.

What should you say or not say to the therapist. If she or he has experience working with TG people, just say what you said in your letter to me. But in greater detail. Describe your feeling that you are a woman in a man’s body. Tell why. Explain what age these feelings manifested. Detail the unhappiness, discomfort or pain continuing life in a male body and being perceived as male is causing you. It is okay to say that you have drank too much or used drugs at times or engaged in risky behaviors to help block out your unhappiness – if that is true for you. Not only will the therapist understand, but it will actually strengthen your case. You can even share any other mental problems it has caused. Such a therapist will know that the treatment and cure for many of those problems is a prescription for sex change surgery.

The therapist will take it from there. In, most cases he or she will see you once ever couple of weeks for a few months, and then provide you with a recommendation for starting on hormones. Your therapist will also know the names of all the endocrinologists (hormone doctors) in your area who have transsexual patients and can put you in touch with one. The process used to be somewhat lengthier, but has been shortened as therapists have learned more about transsexuals.

Be prepared. When you start on hormones, or within a few months afterward, you will be asked to begin the “real life” test. In other words, you will have to begin living full time as a woman. Of course, if some facial surgery is necessary for you to do that comfortably, you will be given a bit more time to save for and get the surgery.

If, after living as a woman for six months to a year, you still feel that sex change surgery is still the right choice, your therapist will write a letter saying you qualify. Your therapist will also know the names of some of the leading clinics. You can also find these on-line. The clinic will schedule you for surgery, and tell you how to prepare for it and what to expect. After that – next stop, womanhood.


by Jean Marie


This article was originally published in Transformation 55