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Frequently Asked Questions? FAQs

Do most transgender individuals dress as the opposite sex?

Yes...at least some of the time. Transsexuals who go on to live in the opposite gender role, eventually do so full time.

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What is your experience with college-level transgender individuals? Are most comfortable in their own skin?

Today's college age, gender dysphoric youth are much more aware of what they are dealing with. Some of them find ways to express their gender identity issues openly and seem much more healthy than their counter parts who are trying to live what they think is a "normal" life. If, however, the dysphoria is deep seated, there is only so much they can do to feel comfortable. Medical intervention is usually the only answer for them.

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Is there a diagnostic test, for example, genetic testing, that will let one know if they are gay, lesbian, transsexual or heterosexual?

No. there is no genetic test that can be administered to tell anyone what their sexuality is. That can only be done by honest self examination. Transsexualism, which has nothing to do with sexual preference, is different. We can't do a genetic test, but we can administer cross-sex hormones and see if the individual responds positively or negatively to them. That procedure is routinely done after the individual has had an extensive period of psychotherapy and is fully aware of the consequences. A negative reaction would result in extreme anxiety and discomfort. A positive reaction is one where the individual reports a calming affect. Often described as a feeling of well-being.

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How long does it take, if at all, to determine a reaction from hormones?

There is ALWAYS a reaction to taking cross sex exogenous hormones. If the individual has a history of gender dysphoria or as I would prefer to call it, Gender Expression Deprivation Anxiety, the primary reaction is a relaxing one. That is the individual experiences feelings of well-being as the anxiety is relieved. If a non gender dysphoric person is exposed to cross sex, exogenous hormones, the opposite occurs; a state of anxiety is induced that goes away once the hormones are no longer being taken. The time period for all of this to occur is very short, ranging from hours to no more than a few days.

The other, more physical changes take longer and are not easily reversible. If a genetic male takes estrogens, he will start to notice tenderness in his nipples in a matter of weeks as the first signs of breast development. The rest of the feminization will gradually happen over the rest of the period he continues to take the hormones. Depending on the person's age and level of male development at the start of the process, it usually takes six to twelve months before the changes are so advanced that friends and acquaintances would notice and may start to inquiry about your appearance. Of course, a spouse or lover would notice much sooner.

In genetic females that take androgens, the physical changes are far more profound and happen very quickly. Menses stop within the first or second scheduled periods and there will be a strong and profound increase in libido. Within the first few months beard growth, body hair and voice changes begin to be obvious to the casual observer. FTMs often speak of experiencing general body pain as male pattern muscles start to develop.

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I am a TV/CD with feelings of being TS. I recently learned that I have minor Obsessive Compulsive Disorder (OCD) tendencies. Is there a connection with being OCD and being TS? If so will medicines to help being OCD at least reduce my TS feelings?

Although in the past I have worked with one or two individuals who had clinically severe OCD along with TS feelings, the conditions are not generally associated with each other. I know that it may seem that your need to crossdress is a bit compulsive and perhaps you obsesses over wanting to be the opposite sex, but that is not really the same as obsessing over everyday factors such as germs on your hands or if you shut off the stove 20 times a day. Whatever the level of OCD, medication (usually an SSRI antidepressant) has not been shown to have any appreciable effect on reducing TS feelings.

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DISCLAIMER: 

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.