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Frequently Asked Questions? FAQs

Is Male-To-Female gender identity mostly about appearance (if the person already identifies as female)?

This is an interesting question and the ansewer is, No. The administration of cross-sex hormones has a profound effect on the indifidual's brain. As you must be aware, there is more to being female than appearance and identifying as one. There is also gender expression. Gender expression includes important areas such as how one feels inside (Is it a feminine feeling or a masculine one?). Gender expression dictates how one dresses, moves and talks. And probably most importantly, gender expression has a big influence on how we are perceived in the world and how we relate to others in turn.

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What factors do you think are responsible for more young Americans coming out as transgender? Is it due to the availability of more resources?

First of all there is more information regarding gender issues out there. The internet has made it possible for young people to not only do research on their condition, they can contact others like themselves and compare notes. Twenty years ago a young person would have found it almost impossible to get any information. It would have required a trip to a medical school library to get far less information than they can now get in their own bedroom. The internet has also made it possible to easily ask someone like me for a referral for medical care in their community. I give out at least three referrals a week to people all over the country. The names come from the Harry Benjamin International Gender Dysphoria Association's (HBIGDA) directory.

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Is there a median age when certain individuals realize they identify with the opposite or both genders?

Most people who go on to transition become aware there is a problem somewhere between the ages of 4 and 7. When they decide to ask for help with their problem is another issue entirely. In the past there has been a strong tendency for people with gender issues, especially males, to chose to hold off to the last minute to seek help. By holding off, these individuals go to great lengths to try and override their gender dysphoria by investing more and more energy and time into activities that they hope will make their need to be female 'go away.' This often includes dangerous military duty, getting married and having children and macho jobs. When none of that works, and there is no clinical evidence that it ever will, they are commonly now in their forties or early fifties. More recently, with the advent of the internet, more and more gender dysphoric individuals are aware of the fact that gender identity issues are not socially based and nothing they will ever do short of treatment will resolve the issue.

Gender dysphoric females are much more direct on how they face their issues. They often voluntarily start living their lives in the male gender role in childhood. The advent of the internet has also affected their age of presentation. They are coming in younger and younger now. The current median age of my FTM clients is about 35.

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Which are the best resources for transgender individuals?

For now the Internet will work. However, readers need to be careful that they select qualified sites to read. I suggest that they start by going to the WPATH (http://www.wpath.org) site to use their directory service to find a gender specialist near you. Another great source for parents who are concerned about a child that they believe is gender variant is "The Transgender Child" by Stephanie Brill and Rachel Pepper. It is available at The Transgender Child website.

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Do most transgender individuals have reassignment sex surgery?

I can't answer this question directly. Keep in mind that the term transgender is an umbrella term that covers a large range of gender issues including transsexualism. Only transsexuals ever go on to have surgery. My guess is that most transgendered individuals never seek professional help so that would automatically preclude them having surgery.

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Nothing on this site should be viewed as providing therapeutic advice. No formation of a client/therapist
relationship with Dr. Vitale is intended or to be implied or inferred. The information provided in this site is for educational
purposes only. I attempt to keep the information current but make no representation or warranties in that regard. You should
not rely upon this information as a substitute for consul with a qualified mental health professional.