3. LIVE AS A WOMEN BEFORE SURGERY

Throughout history, there have been many stories about individuals who were miraculously changed into the opposite gender. Funk & Wagnall's Standard Dictionary of Folklore, Mythology, and Legend tells many tales of sex changes. In one account, the Greek goddess Venus Castina was assigned the task of responding with sympathy and understanding to the yearning of female souls locked in male bodies. In keeping with this myth, we are also told of the tale when the Sythians' rear guard pillaged the temple of Venus at Ascelon. The goddess Venus was so enraged that she made women of the plunderers.

Times, thankfully, have changed. There are now many surgical options available to an individual who feels that he/she is living under the wrong sex. Understandably, such a decision should not be made on a whim; once a man loses his appendage, it's he can't get it back. Furthermore, one oft-cited study found that about half of all men who undergo surgery and change their sex are no happier after their surgery than before. Granted, the validity of this study has been questioned, but it nonetheless indicates that Sexual Reassignment Surgery (SRS) will not be the answer to all of life's problems. It's for this reason that there are systems in place to make sure that you don't jump right onto the surgery boat; rather, men who want to become women are required to first live life as a woman before the operation. That way, there's still a chance for the man to change his mind and not undertake permanent measures.

There are many options that do not require expensive surgical procedures. One popular option is that of hormones.

Hormones

Believe it or not, there are several requirements to satisfy before a pre-operative transsexual can even begin taking hormones. The Harry Benjamin International Gender Dysphoria Association's Standards of Care for Gender Identity Disorders states that before beginning a hormone regimen, the following criteria must be met:

  1. The patient must be of legal age (at least 18 years old).

  2. The patient must have demonstrable knowledge of what hormones can medically do and not do, and be aware of their social benefits and risks.

  3. Either:
    • A documented real life experience should be undertaken for at least three months prior to the administration of hormones.

      OR

    • A period of psychotherapy of a duration specified by the mental health professional after the initial evaluation (usually a minimum of three months) should be undertaken.

The Association also provides "Readiness Criteria." This means that they are not requirements per se, but are judgment calls to be made by the patient's doctor:

  1. The patient has had further consolidation of gender identity during the real-life experience or psychotherapy.

  2. The patient has made some progress in mastering other identified problems leading to improving or continuing stable mental health. This basically implies an absence of mental problems such as sociopathy, substance abuse, psychosis, or suicidal tendencies.

  3. Hormones are likely to be taken in a responsible manner.

Male to female transsexuals use the hormone estrogen to feminize their voices, faces, and body characteristics. This hormone changes their fat distribution, increases their breast size, and decreases their body hair. One thing that this hormone does not do, however, is to eliminate facial hair. Transsexuals must often go through painful and expensive treatments such as electrolysis to remove this hair. Estrogen also shrinks the penis and testicles, so the decision to go through with hormones is a fairly permanent one (though nowhere nearly as extreme as surgery).

Any medical doctor, including a psychiatrist, can prescribe hormones once they determine that their patient is suitable for them. Again, these hormones will not be administered until the requirements above have been satisfied. Once both the doctor and patient are satisfied that the patient is ready for the hormones, the therapy can begin.