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Transgender Index

What's Transgender Mean Exactly?
Busting Definitions: The New Freedom
Physical Transitioning: The Standards of Care and Real Life Testing
Sexual Reassignment Surgery (SRS)
Shared Words
Q&A with Shain:
     Hormonal Treatments and Surgical Genital Construction

     Question From a Teen Confused By Labels
"Ode to Michael" by Michelle, from Transgender Talk

What's Transgender Mean Exactly?
Traditionally transgender refers to a person who feels that they were born the wrong anatomical sex; a woman born in a man’s body, or a man born in a woman’s body. 

Some transgender people adjust their gender expression to match their gender identity through changing their name, the way they dress, speak, cut their hair, move, and use (or don’t use) make-up. Others undergo a physical transition with hormonal treatments and/or sexual reassignment surgery (SRS).
Busting Definitions: The New Freedom
Transgender people used to feel that they had to make a strict transition from one side of the gender binary to the other in order to be complete. Now trans people feel freer to make partial physical changes according to their needs, or to consider themselves the gender they truly are even without transitioning physically.
trans guy with blonde mohawk
Sexual Partnering Before Transitioning (from LGBTQGQI)
Being in a body that is anatomically out of whack with your feelings, needs and self-concept is confusing and painful.  It’s important to recognize and accept your feelings, whatever they are, and communicate them honestly when sharing your body with a sexual partner. If having female breasts feel wrong you may not want your partner touching or sucking on them. Tell them and patiently explain why. If having a penis feels wrong and you don’t want your penis engaged in penetration, tell your partner, and explain why. Likewise if you don’t want anybody or anything inside your vagina, tell them – and that’s that. Never be guilted, manipulated or coerced into having “normal” sex; that’s bullshit. The only thing that defines "normal" sex is what makes you feel happy, comfortable, and satisfied. Define and respect your sexuality.

The Standards of Care were developed as a protocol to follow during sex change transitioning by the World Professional Association for Transgender Health (formerly the Harry Benjamin International Gender Dysphoria Association). The doctors who oversee the transitioning process and the surgeons who perform sexual reassignment surgery follow these standards.

Real Life Testing (RLT):
Part of transitioning under the Standards of Care is living for at least a year as the gender you identify with. This is called Real Life Testing, and it generally involves the following:

A year or more of hormone treatments (a lifelong process) that will facilitate changing the sex characteristics of your body. 

A year or more of psychotherapy and testing to ascertain that you are a viable candidate for the transition process. Its purpose is to confirm that you are really transgender, and ready to make a permanent physical change. Prior to surgery, you will also have to obtain two supporting letters from psychological providers. 

Training sessions to help you deal with the adjustments inherent in sex reassignment. 

Changing your name to align with your new gender role. 

Changing your identity documents to reflect your new gender. 

Wearing clothing, hair style, and accoutrements that express an aesthetic definition of your new gender identity. 

Modulating your voice, movements and gestures to reflect your new gender role. 

Having electrolysis to remove body hair if desired.

Referring to yourself by your new gender pronoun: he instead of she, or she instead of he. 

Binding, enhancing, packing, or tucking to outwardly reflect gender identity, such as stuffing a bra or a jock strap.  


Feeling Second-Guessed During Real Life Testing Is Exasperating
It can be exasperating to have to go through a period of psychotherapy just to convince another person that you really are who you really are! It helps to understand that the doctors involved in your transition feel a weighty responsibility for their role in creating a permanent, very major physical change in you that will have profound repercussions on the rest of your life. The truth is sometimes people who seek SRS later change their minds; others are confused about their motivation and are actually not really transgender. Okay, this is not you, but your transition team is trying to make sure that you truly are transgender and that the SRS procedure is right for you. Vent your (understandable) impatience by talking to friends, writing in a journal, and finding other constructive ways to let your frustration out.

Sexual Reassignment Surgery (SRS)

RS is a permanent surgical alteration of the genitals, entailing remodeling male genitals into female genitals (MTF), or female genitals into male genitals (FTM). Secondary surgery may include breast removal, breast augmentation, an operation to reduce the size of the Adam’s apple, plastic surgery to modify sex trait characteristics, and body hair removal.

The SRS Litmus Test: Sexual Functioning and Body Image
Experiencing orgasm with your newly formed genitals is the first priority and standard of successful surgery. To achieve this, the internal genital structure must be very carefully rerouted to maintain sexual functioning. For this reason it is essential to have a top-notch surgeon with a successful track record perform your SRS.

You should also be aesthetically pleased with your gorgeous new genitalia! At the same time, while your genitals may finally look and feel right, they may also take some getting used to. Give yourself time to adjust to their wonderful but quite different look and feel, inside and outside. 

Sometimes an additional surgery may be performed to adjust a functional or aesthetic result.

Female-to-male (FTM):
Primary FTM surgery involves sculpting a penis and testicles in the genital region, and a total hysterectomy with closure of the vaginal canal.  

There are two types of penile FTM surgery:  

~A clitoral release, which exposes the clitoral shaft, creating a micro phallus.  

~Phalloplasty, which constructs a larger phallus with tissue grafts and fat deposits. With this surgery the clitoral head is usually left exposed at top of the penile shaft for sexual stimulation.  

FTM SRS does not produce male ejaculation, and the testicles will not produce semen.

Breast removal and chest construction may result in loss of sensitivity, especially in the nipples. This can last from weeks to years. In some cases, loss of sensitivity may be permanent. This is a factor to consider carefully. 

 This URL has photographs of phalloplasty:  www.gendercentre.org.au/phalloplasty.htm  

Male-to-female (MTF):  
Primary MTF surgery (vaginoplasty) involves sculpting a functional a clitoris, labia and vagina. It is not currently possible to surgically create a uterus. 

Multiple surgeries are sometimes required to achieve a satisfactory vaginal canal depth. What this acceptable depth is may depend on what is subjectively satisfactory to you 

Breast augmentation techniques vary. Erotic sensitivity in the breast and nipple is often lost or diminished during augmentation surgery. For those who want to retain tactile sensitivity, limiting breast changes to those produced by hormonal therapy is probably the better choice.  

This URL has photographs of vaginoplasty: http://ai.eecs.umich.edu/people/conway/TS/SRSlink.html

Get a Top SRS Surgeon!
When getting reassignment surgery, it is extremely important to work with an experienced, reputable surgeon with a successful track record. I cannot emphasize this enough: do your research carefully and thoroughly before choosing your surgeon.

Q&A with Sex Educator Shain Stodt

Stereotypes Stink. I Didn't Go Through Surgery To Embrace Sexism!
Q. I had a hard time working with my "Real Life" team because their idea of who I should want to "become as a physical man" was sexist! I didn't want to change my movement quality or voice or even stop wearing make -up sometimes. My identity didn't fit their narrow definition of masculine, and I almost couldn't get surgery approval. I finally faked it, butching it up so I could just get the surgical change I need already. Now I'm peacefully, happily me but  I still don't fit any male stereotypes - why would I want to act like freaking John Wayne? The guy's a boring stiff. I feel sexy and male and just right as I am. So did I fail to completely transition?

A. No. No no no. It's a fact that the "Real Life" protocols can be very staid and sexist. It depends on the team you work with, and how enlightened and/or outdated their approach is. The whole idea is to realize who you are, be comfortable in your skin in every way - not become a cookie cut-out of sexist social values. I applaud you for having the strength to adhere to your own inner truth.


Taking The Plunge After Male To Female Sex Change Surgery
I had MTF* (*male to female sex-change surgery) surgery about six months ago. Since my surgery I’ve only explored vaginal penetration to keep my vaginal canal open. My healing process took a long time due to a condition I have, but I’ve healed and I’m ready to have penile-vaginal sex.
It’s amazing, I’ve wanted it all my life but now I’m hesitant. There’s no one special and I don’t just want to ram a random cock in there for the sake of saying “Ta Da! I’ve done it!” But I do want to do it – I’ve waited long enough. So how come I’m procrastinating?
As an experienced vagina owner to a newby, can you give a gal any tips on getting her, er, ‘toes ‘wet? - Belle

A. Belle, I think lowering yourself gently and carefully into all that wet is a good idea. You and your marvelous new vagina deserve the TLC.

Before penile penetration with a partner, I hope you have practiced with your finger and then gradated dildos? It’s important to get used to, and comfortable with, the feel of a pleasure object inside of you.

Relaxing your genitals with an orgasm will probably help this process. To that aim, I strongly recommend you try masturbating as you use a penetration toy. This way you can also begin learning how your new genitals function sexually.

Find a great, water-based vaginal lube you love and use lots of it, okay? Your hormonal treatments will not provide you with the vaginal lubrication you need for safe and pleasurable vaginal sex.

There’s nothing wrong with taking your time learning how to pleasure your new body while looking for someone special to share with. And the more familiar you are with your body, the more comfortable you will feel taking the plunge when you find them.

* Shain’s note.

img142 ~Shain 

Can I Get An Adequate Penis With Female To Male Surgery?

. I am considering FTM surgery and have heard mixed reviews about the viability of the FTM surgical penis. Several friends have told me that they were not satisfied with the result of their surgery, that their dick wasn’t big enough and couldn’t stay erect, and that you usually have to use a dildo. I don’t want to use a dildo – I want to use my own penis. Can you tell me if the surgery works or not?

A. The surgical techniques currently available are not yet ideal. There are two main types:

1. A clitoral release, which exposes the clitoral shaft, creating a micro-phallus.

Implemented with hormonal treatments, the clitoris may grow somewhat larger, but it will not reach the size of an average penis.

2. Phalloplasty, which constructs a larger phallus with tissue grafts and fat deposits.

This penile construction does not have the erectile tissue of a penis. A penile pump may be added to help simulate erection. With this surgery the clitoral head is usually left exposed at top of the penile shaft for sexual stimulation.

It’s up to you to choose whether you want a larger penis without very much nerve sensation in it but with the size and effect of an average penis, or a smaller, micro-penis made from your own hypersensitive clitoral tissue. I know that what you probably really want is a combination of both, but so far surgeons haven’t figured out how to construct this. 

FTM surgery will bring you closer to the body you need to have, but it's not perfect, and you should be fully aware of its potential shortcomings in order to weigh the pros and cons of your options. You can get some good information on our LGBTQQI  page about FTM transitioning.

img142 ~Shain

My Partner Is Changing In Unexpected Ways During Hormonal Treatments

A. My partner is undergoing hormonal treatments for FTM transitioning. Am I imagining that it is affecting his personality? There seems to be more friction between us, and he seems more impatient about communication. He also seems to want more sex - like all the time. Is this healthy and normal, or is something wrong with the treatment (or him)? I'm starting to wonder if I'm with the same person I fell in love with.

Q. I often think that when people transition their partners need as much counseling and information as they do - if not more.

Yes, varying degrees of personality change are pretty common during FTM (Female to Male) hormonal transitioning because increased doses of the "masculinizing" hormone testosterone can impact the personality as well as the body significantly.

Testosterone encourages the development of male physical characteristics: body hair, deep voice, genital masculinization, muscle mass, etc. It can also increase sexual drive and aggressive tendencies. It's important that you and your partner be aware of this and communicate openly about any changes that his hormonal therapy causes in your relationship.

Sometimes these changes lessen with time as the body integrates the transitional hormonal changes, like a pendulum swinging back to a more centered, familiar place. And sometimes the changes are permanent. There is no question that this can be a difficult period of adjustment for you if you don't feel a positive response to this aspect of your partner’s changes. I strongly recommend that you and your partner see an LGBTQQI - affirmative counselor who is familiar with transitioning issues to help you through work things through. Check into sites like www.gayfriendlytherapists.com, and also call local LGBT centers for references. (See LGBTQQI on our site). And See if our Communication section has anything to offer you.

As far as your question "is this healthy", hormonal transitioning puts great demands on the systems of the body. It's a kind of second puberty occurring in an older, less resilient body. Medical monitoring is important, not only now but for the rest of your partner’s life. This is partially to ensure the success of the treatment, and partially because there are health-risks associated with hormonal therapy. For example, dosing the body with testosterone increases the risk of cancer, high blood pressure, high cholesterol, and heart disease. Your partner’s doctor must be proactive in monitoring for any early symptoms of these.

The other side of all this, of course, is the tremendous relief and joy of becoming whole that is finally available to your partner! It's important to focus on sharing the beautiful and fulfilling nature of your partners transitioning with them, to balance the rough spots with the wondrous ones. Hopefully with love and work, you will come through this closer and more aware of each others value as a friend and partner than ever.

Chaz Bono's documentary, Becoming Chaz, gives a good picture of one couples separate reactions to hormonal therapy on their relationship. It's worth viewing with your partner.

img142 ~Shain

My Vaginal Canal Isn't Deep Enough Since M to F Surgery, Dammit!

. My husband and I have been consistently frustrated since SRS with the depth of my vagina. He really can't get in far enough to satisfy either of us. Is this a problem for other trans women, or am I just particularly fucked? ~ Julia

Q. Julia, breath in and let the tension go: it is very common to have one or more follow-through surgery's to adjust the depth of your new vaginal canal to your liking. Let your SRS doctor know about this issue, okay?

img142 ~Shain

Question From A Teen Confused By Labels

Q. My best friend is trans. Or is gay. Or was. Or is intersex. Or was. It keeps changing. I’m lost.

We used to be together as a couple. Then he said he "couldn’t have sex with a vagina anymore", because he’s gay. Now he wants to have an operation to have a vagina.

I was in love with him before. I want to support his gender identity. I just don’t really understand the changes he is going through. What is the difference between gay, trans, intersex?

A. First of all, before we get into classifications, I don’t care what his gender identity is: you don’t “have sex with a vagina.” You have sex with another human being; a whole person, not a body part. Someone whose heart you honor and respect. Whatever genitals he is or isn’t sporting, it is selfish, self-centered and grossly insensitive for your ‘friend’ to have defined you and your sexual relationship in this way. He needs to wake up, get over his preoccupation with his identity, and become a better person.

In turn, you can support his identity and accept him as he is.  That is how we truly love our friends; affirm them for just who they are. You know?

As to the semantic differences between gay, trans, and intersex, check out the LGBTQGQI page.

Definitions being spoken to, don’t get too hung up worrying about how to label people. Some people have a definite sexual preference and identity; many do not. For the majority, sexuality is a fluent continuum with many possible expressions. Go with the flow.

My one remaining concern is that you seem to have romantic feelings for your friend. It hurts, but you need to let go of these. It's important that you believe your friends sexual preference is real and has ABSOLUTELY NOTHING to do with rejecting you as a woman or a human being. Really.


Ode to “Michael” from Transgender Talk
Originally posted on
by michellelianna

ode to michael

It takes a real piece of work to actually go and write an ode to themselves. I mean really, who has that kind of self-absorbed chutzpah anyway? Well, as it turns out, apparently I do. That sounded suspiciously like an opinion, even though we all know you are reading a blog entry titled “An Ode to Michael”. Has Michelle finally lost it? Is it OK to call her a douche-bag, or is that just for guys? OK, perhaps I better explain.

Not long ago I was speaking with someone who recommended that I consider holding some sort of funeral for “Michael”, you know, since I wasn’t going by that identity anymore and because some of those closest to me might have some feelings about it. While not totally opposed to the idea, I considered my audience for such a thing and decided against it. My spouse, someone highly suspicious of the medical care industry and hospitals in particular, already has enough worry over my upcoming operation. I think introducing the concept of a generally death related ceremony at such a time would only fan the flames of anxiety and miss the point entirely. As far as my immediate family goes, I believe such a thing would be characterized as a ridiculously fluffy exercise necessitating either a Crayola decorated shoe box or functional  toilet. Yeah, it’s not going to happen.

I’ve talked before about still casting Michael’s shadow and what that means. At that time though I mainly talked about how other people felt about my change. As this is a very self-indulgent exercise, I think it’s time to concentrate on how I feel about it. There are two stories that usually get told about transition. One is about the complete euphoria that comes from expanded self awareness and the courage to do something about it. The other is about the heartache and difficulty associated with rejections, losses, and the vast number of hoops one has to jump through just to be reclassed as second banana citizens. This is different. I want to talk about the feelings associated with the loss of an identity I put so many years into.

Old, pre-transition pictures of me are still hanging about the house, and my mom naturally has dozens everywhere you look. I sometimes look at them and ask the boy or man in the picture why I couldn’t just remain that way. I had a really good run as Michael and was the for the most part very happy and living an idyllic life. I had the respect of others, a decent reputation, a strong marriage, a wonderful child, family I’m close to, a good job with a track for upward mobility, and a heady sense of self determination. As Michael I could have kept all of that going and added even more into the mix. I could have also completely avoided causing a great deal of heartache, sorrow, and loss in those closest to me. The greater sense of inviolable self determination has left and at many turns I feel but one step away from living out that Bob Dylan song about a Rolling Stone (I really love that song). Why could I not have just kept Michael going and made everyone, including myself, happy?

Well, we all actually know why. Under auspices that it would have been easier and better to do nothing at all, that option was never really on the table. After all, I did choose that from the moment I became self-aware at 4 (or earlier) up until early 2011 when I faced the reality that the identity of Michael was just not mine to keep. The best threats and bribes I and those around me could muster were nowhere close to the asking price to retain it. A happy caterpillar still reaches a day when it’s time to start spinning, even if continuing to defoliate my tomato plant seems like the best of all possible worlds. No power known can halt or slow the ticking of the clock that brings with it the beginning and end of all things.

So to Michael, I acknowledge that you had a really good run. You did your job, had a quiet charm, carried my load, and did little harm (OK, I didn’t mean for that to rhyme, just so you know). I know people are going to miss you, and honestly, so will I. I liked myself as you, and that feeling is just a little harder to achieve at present, but I’m learning and at least now it’s real. Had I been able to afford you, I would have been happy to keep you on, but that account is empty and now closed. If you don’t mind, I’d like to leave with you my fears, my failings, my limitations, and my secret self-loathing; buried so deep none of us knew it was even there. Though you are behind me now, you will always be remembered by me and others and I can only hope that I carry with me forevermore the best parts of you, and farther than you could have ever gone. Rest in peace, still with us and forever inside me.

Shared Words 

Sharly: Trans sex is Trans formative
FTM was a Becoming in every way. Sexually I transitioned from pale grey into volcanic colors, from luke- warm radiator heat into scalding flame. From not wanting to be touched to ravening pursuit of touch, licking and being sucked and kissed every molecule of flesh. Sensuality enfolds me like water, nowhere does it not infuse me. ..

The sex you have waited for all your life is earth shattering, it confirms your whole soul and body and mind. You do not walk away from it the same. Time and molecules are altered. Your spirit soars and your heart ascends, rises, unclenches....and finally beats serenely in your chest. You've cum home. 


Meryl: Lessons On Sexism Revealed (and It's Stinky)
"I had the MTF operation last year and it provided me with some insights into being a woman that I hadn't appreciated. Like who do men think they are assuming I can't change a tire or do math or handle power tools? Who do they think they are assuming I'm weak or less able than them to make decisive decisions?
I was not a man like that but I never understood how much women are subjected to second class status on all levels. When I apply for a job, I'll only get a fraction of what I earned as a man.
And who does anyone think they are assuming anything about me because of my gender? I became the person I am physically, that is all. I don't wear make- up or bake or want children because I am a woman.
I choose to become myself, not a stereotype. No one defines me but me.


Peter: At Last
At last sex without shuddering or hiding. At last not twisting on the sheets.
At last sex thrusting instead of receiving.
At last not confronting the hand that creeps up to fondle the alien lumps on my chest.

At last the self-hatred drained.

At last a man.


Rex Amigus: Trans Nation
I wasn't comfortable with my body until I started hormone treatments. I was a sex diva babe in a drab accountants body. Like my body was another person I lived with, not me.

My curves and hips and swag ain't drab now. I'm in living color, baby. It's perfection. Like a soufflé. Just right.
Trans nation, I'm here for you, we are the future.


Trans Lifeline: US: (877) 565-8860    Canada: (877) 330-6366

The Trevor Project
866-488-7386 You will not be charged for this call and your name will not appear on a phone bill anywhere.

Human Rights Campaign




National Transgender Advocacy Coalition





Gender Education and Advocacy








For trans youth


We Happy Trans


For Trans youth




Information and support for the transsexual community   


Human Rights Campaign


Transgender identity documents


Transgender Law Center



Photos: Background Image: Transgender Pride Flag; (via acheappinkspotlight); thatqueersouthernkid via fuckyeahisupporttransmen; Polarities, via procrasturbating;nancygirleatyourheartout via macaronithecat; "A TransGender-Symbol Plain3" by User:ParaDox – en:User:ParaDox – de:Benutzer:ParaDox - Own work. Licensed under CC BY-SA 2.5 via Wikimedia Commons

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