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Frequently Asked Questions? FAQs

How long do most individuals stay on hormones?

All their lives. MTFs start by taking large doses of estrogens to counter act the continued attempt by the testicles to produce androgens. Once SRS or an orchiectomy is performed the dosage can be reduced drastically. Essentially post-op genetic males have the equivalent endocrinological system of a post-menopause genetic female. Staying on a low dose of estrogens has the same benefits for post-op MTFs as it does for post-menopausal genetic women.

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Is it true that those that take hormone therapy also find that their hands and feet shrink in size and if so by how much?

Hormones have no appreciable effect on the size of feet or hands. Both the hands and feet may eventually look a bit more feminine but the size will not change.

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From a 50 year old married man who asked if going on Estrogen for 30 days would help.

We know that to be true because estrogen (which is something of an antidepressant itself), even in moderate doses, routinely resolves both the dysphoria and the depression while SSRIs alone do not. I know this answer leads to further concerns but that is an issue that needs to be addressed in person between you and a therapist.

Given your life long gender dysphoria, there is good reason to believe that estrogen would probably relieve your depression and anxiety by relieving your gender dysphoria. That brings us to the "further concerns" I mentioned. As you know, estrogen is a feminizing agent. Once people with issues such as yours start to take estrogen, typically they find that it is very hard to stop taking it. Not only does it give them a feeling of well being, they soon learn that if they stop taking it, even for a few days, the depression and anxiety return. A 30 day trial, even on a low dose, would probably yield the same result. Permanent relief will only come with the constant intake of estrogen. That, of course, would lead to more and more feminization of your mind and body. You and your family would have to learn to live with that.

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What surgery is performed?

Depending on the appearance and health of the patient, surgery for male-to-female transsexuals may include: Facial feminization Surgery, removal of the penis (penectomy); construction of a vagina (vaginoplasty); removal of the testicles (orchiectomy); construction of a clitoris (clitoroplasty); and possible breast augmentation; nose reshaping (rhinoplasty); cosmetic surgery such as hair transplants or facial remodeling; shaving of the Adam's apple (thyroid chrondroplasty) and raising the pitch of the voice (crico-thyroid. For female-to-male (FTM) transsexuals, surgery may include removal of the womb and ovaries (hysterectomy and oophorectomy); removal of the breasts and male chest contouring (bilateral mastectomy); matoidioplasty( freeing of the hormonally enlarged clitoris) and possibly construction of a penis (phaloplasty). Only a small number of FTM transsexuals undergo phaloplasty because of the expense and what most of them consider less than adequate surgical results.

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I'm one of those males that would like to live as a woman, but I'm not sure about Sex Reassignment Surgery. I don't even like going to the dentist. Is this normal?

Sex Reassignment Surgery is very common choice amongst the people I see day to day, but it isn't necessary. Many people choose to live as non-ops. One reason they choose to do so is because they are afraid of undergoing surgery. That is why I start speaking about surgery relatively early in my work with people who have made it clear that they are going to transition. I try to make it sound as ordinary and safe as it really has become. I also encourage them to discuss their fears with several different surgeons. They should also talk with friends who are now post-op and see what that experience was like for them.

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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.