The Decision to Undergo SRS

 

Many people simply assume that the loss of the external male genitalia will result in a complete loss of sexuality. This very naive myth unnecessarily frightens many preop women, and it also furthers prejudice against postop TS women, who are often thought of by the general public as having "desexed themselves".

 

Certainly a typical male would suffer a catastrophic impact on body image and libido from the loss of his external genitalia. Furthermore, intensely TS women are not "regular guys". They do not suffer a negative impact on body image as a result of SRS, but instead find a greatly enhanced body image. The experiences of countless Hijra girls in India demonstrates that even primitive forms of SRS do not desex transsexual girls and in fact helps many of them. SRS has the opposite effect on intensely TS women as would the emasculation of a typical male. SRS usually releases and enhances the libidos of TS women, enabling them to frequently and fully "turn-on" and enjoy their physical sexuality and lovemaking, including achievement of orgasm during intercourse with a partner.

 

The myths and misunderstandings about the effects of SRS cause many preop TS women to remain in a state of indecision about having surgery. Although feeling an intense need to undergo SRS to achieve physical conformity with their gender identity, some preops may also feel extreme anxiety about whether or not they will still experience sexual arousal and orgasm after SRS.

 

This anxiety is enhanced by stories heard from many TS transition failures, including the cases of intense cross-dressers, drag queens and crossdressers who mistakenly underwent SRS for various sexual reasons and then found that their male libidos were greatly reduced and their male orgasmic capability eliminated. There have been so many misguided cases that the urban myths about SRS have escalated over the years, and there is now a lot of confusion about what to expect after SRS.

 

Post-op Female

 

On the other hand, many other transsexual girls learn to visualize from their preop sexual experiences that they'll probably still "turn-on" sexually and be orgasmic as women after SRS: Many preop women hide their genitals by inserting the testicles up into the abdomen, and then tightly tucking the male organ back through the crotch (with tight underwear or taping). In this configuration, the penis cannot usually get enough blood supply for full external penile erection. Even though the external part of the penis cannot erect when tucked tightly, the girl nevetheless experiences the familiar female "glow" and warmth throughout her interior genital region when she is aroused, for example, by a man's warm attentions. In addition, the corpora cavernosa shafts inside her body can become erect once the girl is sexually aroused, and that arousal feels really wonderful - even though the external part of the penis is flaccid. Sexual stimulation by rubbing and caressing the genital area and the breasts can then lead to orgasm for a girl who is sufficiently aroused.

 

From experiences like this, preop women can visualize that after undergoing SRS the remaining internal stumps of her corpora will still engorge and become erect, and that she can experience similar feelings of sexual arousal when she is postop. In addition, the postop woman can now also experience wonderful sensations from caressing her clitoris, which, in contrast to the previously hidden penis, can now be openly played with without her experiencing angst about her body-image.

There are many dimensions to postop women's sexuality, and the actual postop effects of SRS on arousal and orgasm vary greatly from case to case. Those who are male-gendered, and who have male sexual urges focused in the external genitalia, are likely to experience great loss over time. Those who are "in between somewhere" will likely experience a mixture of losses and gains. Those who are female gendered and who have strong female sexual urges are likely to benefit greatly, as a whole new life of sensuality, sexuality and lovemaking opens up to them. All of this is of course contingent upon the person having a normal-level of libido, having no "hang-ups" about being sensual and sexual, and also upon a successful surgical result.

Thus the decision for SRS must be taken with great internal soul searching and introspection, and with complete honesty with oneself about one's own gender identity, body image and likely psychic reactions to the body changes of SRS. This is especially true if sexual arousal and orgasm are very important in one's life. However, for those for whom SRS is the right thing to do, that surgery can release them fully from the physical gender trap they had been living in, and free them to experience their full humanity in sexual and lovemaking relationships.

What It's Like to Have Sex Post-op?

 

The results of SRS are made immediately obvious to the postop woman by one important effect: She now has to "sit down to pee". Peeing isn't as easy as before, and every time you pee you are reminded that you are now a girl, reminded in the same way that all the other girls are.

 

A lot of men have problems with getting erections simply because they have to constantly avoid having erections. In other words, they get much more practice in avoiding erections than they do in getting them! Women do not need to "censor" their arousals in that way. If they have no religious or other types of hang-ups about sex and lovemaking, they can easily practice and enjoy getting aroused as much as they like, and can develop very healthy libidos as a result. This advantage can help the postop woman get into her sexuality fairly quickly and help her learn a lot in just the first year or two postop.

 

Once she begins experiencing arousals and engaging in sexual activities, one major thing becomes immediately obvious. Orgasm feels really different as a woman. It may not be quite as easy to achieve and may take longer to achieve, but it can be a much more powerful sensation than any she ever experienced before as a boy.

 

Following SRS, the perfunctory feeling of male ejaculation during orgasm is gone forever. Instead, you can build up your sexual arousal to a much higher level without ejaculation bringing things to a halt. It may take more time to reach it, but you can now experience a more powerful orgasm - with the old male ejaculation feeling now replaced by an intense neural discharge and spasm throughout the entire genital area during orgasm. It feels kind of like you are being gently stimulated with electricity inside and throughout your entire genital region. The experience can vary a lot from orgasm to orgasm in the way in which the "neural halo and spasmodic colors" of the orgasm develop, spread, and feel. It seems almost as if most men so easily and quickly reach ejaculation that they never manage to get "high enough" sexually to trigger this more powerful form of orgasm.

 

In addition, there are real differences in "body feelings" during lovemaking between the male and female experience (although many of these feelings will be "female" in form for preop TS women too). Most males are usually stimulated visually by their partner's body-appearance. Once aroused, they usually feel a growing "tightness inside" and a desire to "grab and hold and thrust and penetrate". This desire comes on suddenly, and quickly becomes quite overpowering, with most of the sexual sensations coming only from within the penis itself. However, when the release of orgasm occurs, it is usually much more perfunctory than for a woman, being accompanied by a few spurts of semen and a few grunts and that's it. The ejaculation is then followed by quite a sudden letdown and loss of any interest in sexual activity.

 

The sexual experience for the postop woman is much more "internal" within and throughout her whole body than for a male. The arousal may start in her genitals, but then can spread all through her lower body, especially inside the muscles, and her skin all over her body becomes more sensitized to caressing and touching. Instead of sexual arousal being just in the genitals as in a male, the estrogen seems to also enable a powerful "heat" to fill the woman's whole body once she is aroused - and especially once she is being penetrated. Having this heat come over her in the absence of a partner, and without any satisfaction, can make her feel like "climbing the walls" or "thrashing around in her bed".

 

Since her whole body becomes much more sensitive to touch as she get fully aroused, she is not stimulated so much by her partner's appearance as by the way he (or she) touches her and manipulates her body and the way his (or her) voice sounds. She doesn't feel the hard focused drive to quickly achieve orgasm as do males, but instead feels a desire to let go and thrash around and be "handled" and gradually heighten her erotic feelings. It isn't what she is seeing that counts as much as what she is feeling and hearing and how her body is being manipulated by her partner, as she yields to the wonders of sexual heat and lovemaking. And usually she'll like to take some time to do this and enjoy this, instead of just "rushing for ejaculation" like most guys do.

 

Finally, she will get up on a "plateau" and realize that an orgasm is going to come. This is a truly wonderful feeling. At some point, the orgasm starts and spreads throughout her genital area, with the genital nerves becoming tremendously sensitized as it spreads. The sensation of the orgasm will vary a lot from orgasm to orgasm (more variably than in the male). Sometimes it will be weak, but sometimes it can be amazingly intense, and the feeling varies a lot in form and "color" from orgasm to orgasm.

 

Just like natal women, trans women often experience a strong urge to "vocalize" just before and during orgasm - moaning, squealing, screaming and making other loud noises while they come. The sound and internal body sensation of these vocalizations can greatly heighten the intensity of the orgasmic experience for many women. Postop women shouldn't be afraid to let out loud moans or screams when they come. It is perfectly natural, and can help transform ordinary orgasms into ecstatic ones. In contrast, very few men vocalize when they ejaculate, other than making a few grunts. Perhaps the difference is hormonal, with testosterone blocking these emotional vocalizations, just as it blocks emotions such as "crying" in males.

 

After climax the trans woman feels a sudden relaxing and calming effect that is somewhat similar to what it is like for boys. But unlike when she was a boy, she may often feel aroused and sexy again rather soon after having sex, often getting firm internal erections again soon after her orgasms. Even though it may be difficult for her to achieve orgasm again until some time has passed (a few hours to a day or so), she may feel a desire for sex again right away anyways. These re-arousals are a really wonderful feeling, and can enable sweet sessions of touching and snuggling with a loving partner after intercourse.

Transexual Admirers 201

Excerpted from the fabulous website: http://reneereyes.com/

The Five Most Common Types of Transsexual Admirers:

Which one are you?

Guys attracted to transgender women have been called a variety of names – some not very complimentary. The term “Transsexual Admirer” was born from the earlier days of transgender existence when girls where almost always performing in clubs as a means to support themselves. It was and is a term of respect that cast such people beyond the realm of the tranny chaser.

Although it's progressing at a geometric rate, real-time transsexual relationship exploration is still fairly new. Thus, beginningadmirers constitute the lion's share of the market. This early-stage allure is typically more sexual-based than similar female-admirers. That's because it usually takes men longer to reach a sense of balance and acceptance of their transgender desires. 

My experience is that there are five core-types of admirers pursuing their trans-orientation issues. Most individuals are a combination of one or more types. They relate to almost every category. However, you'll rarely find an early-stage admirer outside these basic parameters.

Beginning male admirers

Almost every beginning male admirer is primarily drawn to trans-females on a sexual plane. Their approach might be to first befriend such a prospective lover before attempting a roll in-the-hay. However, a varied approach isn't a root change in desire: it's just a difference in style.

Almost every male admirer is drawn to that unique blend of masculinity and femininity that makes up the presentation of transgenders. Their exact equation for how much of each component is known as their personal recipe for a trans-dream partner.

Type 1: The latent bisexual

This individual fits the old-school model for transgender attraction. In our world of increasing freedom of sexual expression - they're less common. It's just not that big of a deal anymore to privately admit gay or bisexual leanings.

These individuals exhibit strong bisexual tendencies but are uncomfortable exploring those leanings with a traditional male. They see a pre-operative trans-female as the ideal bridge. The trans-woman tends to represent an ideal middle ground - the smooth, soft femininity of a woman coupled with the intensity of a man - among other things.  

Type 2: The timid bottom

Even as a growing number of men are confident exploring bisexual or gay fantasies, there's still plenty of them that can't readily admit their need to assume the traditionally submissive role in a sexual union. Nothing tends to offer these individuals more intensity via fantasy - than the thought of a sexually submissive role with a stunningly beautiful non-operative transsexual female. The bottom line? These men are most attracted to feminine beauty and being on the bottom.

Unfortunately, this is perhaps the most challenging admirer persona when it comes to ever

discovering sustained, real-life satisfaction. Why's that? Because very few t-girls sexually identify as "tops".

Real-life associations will probably be some combination of professional escorts and trans-pornography.

Type 3: The latent crossdresser

The next group is the latent cross dresser. These men are actually t-girl's at heart, but for whatever reasons...be it their lifestyle, their physique, their access to appropriate cross-dressing tips or transformation services, or their fears...they have not - and may never cross the line of full feminization. They'll usually wear lingerie on occasion or at least get very turned on by the thought of doing so.

Additionally, men who fantasize about being submissive to a t-girl usually fall into this category. They often dream of being forced into femme - as a vehicle for letting go of their masculinity - and not being held personally accountable for that action. Their attraction to transgenders completes this vision. Thus, their intimate desires often equate to a vicarious experience of being their trans-female lover.

A lot of beginners fall into this category. It's very common: even a quasi-normal fantasy for straight males.

So what's your chances of finding an attractive trans-female that wants to feminize you? They're almost nil. If a gal is drawn to the lesbian scene...why would she chase a neophyte in a skirt? Female-female connections are about a lot more than clothing. If she wants a man...she usually wants no competition about who is the girl in such a union. The only exception to this rule? If you're a very feminine, young smooth-bodied guy and a gal finds your potential female-image appealing.

You can either learn how to transform yourself / pay someone to do it for you....or - you can pay an escort to humor your desires.

Type 4: The emerging trans-girl

A more extreme version of the latent cross dresser is the emerging t-girl. These men are more in tune with their feminine persona. Some, are even more feminine at heart than the trans-girls they encounter. Their biggest hesitation with progressing with a fully feminine transformation is usually a fear they could never look remotely feminine.

Fortunately, that's changing.

With easy access to transformation tips and services on the internet, this group tends to evolve and develop their alternative feminine persona much faster than ever before.

These men are not usually quite as intent about a sexual encounter with a trans-women. They'll often profess a desire to date or even wed a transgender female from the onset. There's a deep-rooted need within themselves that's not being met. They usually think a committed relationship with a trans-woman would fulfill this requirement.

FYI...it won't.

Type 5: The Eroticist

The final group among beginning male admirers is what I call the eroticist. You might even term these men as sexual fanatics. Simply stated - they love just about everything that adds zing to a sexual encounter.

Trans-females represent some pretty unique real estate. If variety is the spice of life, these gals can serve up a whole pantry of sexual flavorings.

Most of these men exhibit some bisexual tendencies but prefer female lovers. Notably, they're often very oral with women in their lovemaking. These individuals are usually not seeking any sort of long term trans-relationships. In fact, they typically get bored with one girl very quickly - as variety's a big part of their satisfaction. 

Intermediate & advanced male admirers

While almost every beginner is first drawn to transgenders on a purely sexual plane, some men develop a much deeper connection. Continued real-time experience is the most common precursor to this evolution. The man who continues to be drawn to the transgender lifestyle after having already explored his earliest trans-fantasies comes to know the person beneath all that make-up. During that process, this man discovers something special - about himself.


Within this realm of more experienced admirers, you'll usually find a couple of camps:

• Tranny Chasers
• The Serial First-Timer
• The eroticist plus
• The transgender partner

Experienced Tranny Chasers

Experienced tranny chasers have been a big part of the admirer community for a long time. These guys are all about NSA fun with transsexual women. They’re not looking for any sort of relationship of the heart. Many have been doing this for lots of years - often because they’re married.

The Serial First-Timer

Experienced transsexual admirer’s learn some transsexual women prefer a guy who has never before dated a transgender. Thus, some of them create a fictional story about this “being their first time” with every new transsexual they meet. They leverage their prior experience - telling her what they think she probably wants to hear.

The problem with this approach? If you ever meet a gal you really like she’ll eventually discover your game - and that will end the connection.

The Eroticist plus

The second type of advanced admirer is what I call the eroticist plus. These men are first attracted to the erotic nature of a trans-female but in that process find themselves with a more formidable devotion to transgender relationships.

Notably, these men are often highly independent thinkers.

Because they're more experienced in transgender relations, they'll often form a long-term and special bond with one or more trans-women. Alas, they're usually not interested in a totally devoted union since their core basis is still primarily eroticism. Circumstances can also inhibit their degree of commitment. They might be already married or face severe limitations upon their lifestyle.

I'd venture to guess these men are nature's equivalent to the growing number of more experienced part-time gals in the trans-community. As the number of these t-girls continues to grow, so does some of their sexual palettes - including a desire for masculine male lovers.

The Transgender Partner

The world's pretty much in agreement that for every action in our universe, there's an equal and opposite reaction. In my opinion, the transgender partner represents the masculine equivalent to the male-to-female transsexual. They usually began their attraction based upon sexual leanings. However, almost immediately these men move beyond that realm. Like their transgender brethren, they first resisted their urges, then mustered the courage to fully explore their desires, then subsequently languished over them, studied them and thoroughly contemplated them.

In the end? They come to realize: they're stuck with this wiring.

As with their transsexual equivalents, there's wide variety in terms of how far they'll actually go towards making these preferences mesh into their everyday life. Lots of factors influence these decisions and how quickly they occur, including:

Notably, it appears the number of transgender partners is growing in almost direct proportion to the number of full-time transsexual women. It'll take time for the process of effectively connecting with ideal partners to improve. However, the natural evolution by both components as a result of heightened connectivity and awareness from the internet is worth noting.

Which Transsexual Admirer are You?

Why is it so important to determine where you are? Each group tends to have different desires in a t-relationship than the other - both personally and sexually. These unique desires equate to different types of t-girls that are most compatible with your wishes.

Only you know what you really feel. Thus, lying about those desires to yourself will cost you dearly in the pleasure department.

Part of the challenge in finding a quality transsexual is that you've got tough competition, namely - genetic females and other trans-girls. Alas, most trans-girls are first attracted to women, then other transsexuals. Many are not interested in a sexual relationship of any sort with a masculine man.

Artist - Jamie Vesta

(In the artist’s own words)

My art is about gender role reversal, including the reversal of power. Like everyone, I noticed from an early age that society expects different behaviours from people based upon their sex, and I became fascinated by a scenario in which women, not men, are the dominant sex. Not the S&M world of whips, dungeons and dominas, but a simple swap of everyday gender roles. It is extremely (and surprisingly) difficult to find this depicted, so I decided to try and create this world in art. 

I used to use the moniker ‘Eve’s Rib’, but found that some people called me ‘Eve’, and assumed that I identified as female. So now I am Jamie Vesta and yes, I’m male and content to be. I’m critical of masculinity, but that’s a different thing.

I work within a few different scenarios. My usual is a situation where women, as a result of the so-called ‘genderquake’, have become the breadwinners and seized economic and political power from men. In this near-future world, it is women who wear the trousers and go to work, while the men have to stay at home, wear dresses and do the housework. This scenario offers a rationale for the pictures. It takes certain trends in the real world – girls doing better in education, women moving into the workforce, etc – and extrapolates them into a female-run future. However, if you prefer to take the pictures as illustrations of a world that’s always been female-dominated, or as stand-alone satire, that’s fine too. I also paint scenarios set in an alternative past in which it’s the men and boys who wear the petticoats and bonnets, and I occasionally base pictures in the real world. 

The pictures will serve the fantasy of a particular community, but I hope they will also provoke the viewer to question gender norms. Gender is a social construct. It is a product of history, not of genes or divine will, and can therefore be changed or ignored. Gender conventions should not prevent people from expressing themselves as they please. 

The forward strides taken by women over the last hundred years might convince some people that women are really becoming dominant. But though it’s fun to pretend, we must know the difference between fantasy and reality. According to the top indicators of power, women are still behind men: just look at the proportion of women to men in our parliaments and boardrooms, and they are sometimes paid a third less than men for doing the same job. This is why feminism – which argues that women and men are born equal, and should be treated equally by society – is still very important.

I hope you enjoy the pictures, and if you don’t, well no one’s keeping you here!

Jamie Vesta

Heterosexual Transwomen and Sexual Orientation

From: The excellent website - http://www.annierichards.com/

Fascinating information about the sexual orientation of Transwomen

From consolidated sources it would seem that about half of the transwomen who were heterosexual man (i.e. were exclusively sexually attracted to women) before their SRS, become heterosexual women afterwards (i.e. exclusively attracted to men).   This is a possible corollary from the dominance of a heterosexual orientation in natal women - even if a woman is known to be a transsexual, a heterosexual inclination (i.e. a sexual preference for men) is still subconsciously expected by society and even the woman herself, and any other orientation presents problems.

    

Jennifer Hiloudaki with male friend Transwoman Jacqui and husband Stephen Kathi Stringer and friend Emma Packer (formally Martin) with wife Linda (right) Six foot tall Kelly is easily identifiable as a transsexual woman - but  also very attractive to heterosexual men.

A large study by Dr. Lawrence found that just 9% of the 232 male-to-female participants were attracted to men before their SRS, this rose to a substantial 34% after SRS, but percentages are still very low compared with other (smaller) studies.  However there may be some problems with this study which may make it difficult to generalise from - for example the age or self selecting nature of the participants.

For a homosexual man, successfully appearing to be a woman gives access to an almost unlimited number of male sexual partners - some willing to pay for sex.

Post-SRS heterosexual transwomen appear to fall in to two main categories - those that were homosexual (or bisexual) men before SRS and have simply continued to select males as their sexual partners, and those that changed their sexual preference from women to men after their SRS. 

It's been controversially suggested that some transsexual post-SRS heterosexual women are  homosexual men driven to have a sex change by their sexual preferences.  The theory is that as men, these individuals desire and want to love other men - especially 'straight' heterosexual men - but they can only attract and enter in to relationships with the later by becoming women.  Given legal developments over the last ten years, after surgery they have to be considered as being heterosexual women, not homosexual men.

Athena, an Iranian male to female transsexual

Whilst many in the medical profession seems reluctant to accept this theory, Professor J. Michael Bailey has been a strong advocate.  

It certainly seems to be indirectly supported by the fact that a majority of shemale prostitutes revert to living as a man with a homosexual orientation when their looks fade - it is only a small step from that to assume that a few homosexuals instead decide to have SRS, perhaps after entering a serious relation with a heterosexual man.  The  theory is also perhaps supported by evidence from Iran where homosexuality is strictly banned on religious grounds, but sex change surgery is allowed and is subsidised by the state.  After surgery, the transwoman can have her birth certificate and all other official documents re-issued as 'female', and legally marry a man.  The high prevalence of transsexuality and SRS procedures in Iran - one surgeon suggested eights times greater than western countries - leads to the suspicion that many homosexuals (and lesbians) are claiming to be transsexual.

Regardless of how correct the "some [MTF] transsexuals are homosexuals" theory is, it certainly doesn't account for all the heterosexual transwomen, and other factors must be considered.  One such factor may be hormones.  The radical hormonal changes in the body of a transwoman, to approximately female norms after orchiectomy or SRS, may well give her a push towards a heterosexual orientation.  This can happens sometimes to their own surprise - them blaming (perhaps correctly in part) the hormones they are taking.  For example a 27-year old MTF transsexual in love with her already post-SRS transwoman partner, admitted that "I'd now categorise myself as bisexual because since taking hormones I find men attractive too." 

Non-transsexual observers seem to find that post-transition transsexual women are often more "female than [genetic] females" in their life style and social beliefs, and a few (usually those that transition in middle age) do indeed seem to be almost a living stereotype of the feminine ideal.  Some transwomen undoubtedly strongly feel that as a woman they should only want to have sexual relations with a man, and in this instance any residual sexual attraction to women rather than men becomes both unimportant and something to be suppressed.  Going further, for a few transsexual women (like for some genetic women), marriage and even motherhood via the adoption of children becomes their overriding goal, and perhaps an ultimate symbol and proof of their womanhood.  Indeed, the Stepford Wives may be still be alive and well - albeit transwomen!

While most heterosexual transwomen are heterosexual for reasons of choice and preference, it seems likely that in some instances the adoption of a heterosexual orientation is closely related to the transsexual woman's success in passing and assimilating herself as a woman.  Social conformance - even in the twenty-first century - encourages the successfully passing transwoman to enter in to "normal" sexual relationships with men as far as she is physically capable, while intimate relationships with other women risks "rocking the boat" and unwanted curiosity and gossip.  

Entering into a committed relationship with a man undoubtedly tends to pull a transwoman away from any open acknowledgement of her transsexuality and male past, and encourages an apparently heterosexual orientation in public - what ever her secret inclinations might still be.  Many heterosexual transsexual women hide their male past from partners and even their husband, feeling (unfortunately often correctly) that the relationship may not survive this becoming known to him.  Even if the partner knows about and accepts the woman's transsexuality, their friends and his family might not be so open minded, and external pressures and prejudice could eventually destroy the relationship.  When the marriage of an apparently successful transwoman with a man come under stress - as every marriage inevitably does at some point - a background awareness of the wife's former life as man often seems to be a decisive factor in the divorce. 

A very sensual and sexy transwoman, but the reality for many transsexuals over 40 is depressing - intimate relations with "normal" heterosexual men are rare.

The other side of the coin is that post-SRS heterosexual transwomen who are unable to pass well are often faced with great difficulty in attracting and having a relationship with men.  One night stands with 'normal' men often end in tears.  Brief relationships with tranny chasers may occur, but these are usually seeking pre-SRS girls and thus often disappointed.  Eventual sexual abstinence is common among those in their 30's and 40's; whilst those over age 50 may struggle to get any sexual interest from men at all.  One post-SRS transwoman in her 40's - who desperately wants a relationship with a 'straight' man but finds herself to be out'ed within minutes - despairingly says "no man wants to have sex with a transsexual when they can have a real woman".   [MTF women thinking about transition and surgery should bear this in mind] 

Finally, it should should be mentioned that some transwomen consider themselves to be heterosexual, but in practice have little interest in the actual sex.  For example, Samantha Kane (who had SRS at age 37) concluded after five boyfriends that sex as a woman was rather boring - indeed far less interesting than the preliminaries to a big night out such as a shopping trip.  There's no doubt that quite a few genetic women would agree with her!

Raised as a Girl

From: Experience Project

I was raised in the 70's when many boys had long hair. I was about 5 when my mother dressed me in my 4 yr old sister's clothes. I was very small and my sister was a little bigger than me. My father left my mother when I was 3, so she dressed me as a girl all the time. My sister and I looked like twin girls. We had long blonde hair and, besides being smaller than my younger sister, I looked her age too. 

Around that time, we moved to another city and moved into my mother's sister's house. She had a daughter who was my age and my mother was a nurse. My aunt home schooled us. I was raised as a girl and played with my cousin and my sister. There were only girl's toys to play with and we had so much fun. I remember when I was 8, my hair had grown so long that it was down my back just like my sister's. She now was much bigger than me and looked older too. Even though I was a year older, I looked much younger and had to wear her hand-me-downs from when she was 6. Besides being so tiny and young looking, I looked like her cute little sister. Both her and my cousin were now bigger and stronger than me. They were bossy and teased me and called me a baby. When I turned 9, I looked like 7 and my mother dressed me in my cousin's communion dress and shoes that she wore when she was 7. I got my ears pierced and wore my cousin's matching necklace. My mother brought me to a potrait studio for my communion pictures. I looked just like a pretty 7 yr old girl in the photos. I was so happy that I looked so pretty. By now I forgot what is was like to be a boy and I loved being a girl.

Hormone replacement therapy (male-to-female)

Hormone replacement therapy (HRT) for transgender and transsexual people changes the balance of sex hormones in their bodies. Some intersex people also receive HRT, either starting in childhood to confirm the sex to which they were assigned, or later, if this assignment has proven to be incorrect.

Its purpose is to cause the development of the secondary sex characteristics of the desired sex. It cannot undo many of the changes produced by the first natural occurring puberty, which may necessitate surgery and/or epilation (see below).

The ICD-10 criteria for Transsexualism include the individual having a transsexual identity of over 2 years, a strong and persistent desire to live as a member of the opposite sex, usually accompanied by the desire to make their body as congruent as possible with the preferred sex through surgery and hormone treatments. These individuals cannot be diagnosed with Transsexualism if it is believed to be a result of another mental disorder, or a genetic, intersex or chromosomal abnormality.

The ICD-10 criteria for Gender identity disorder of childhood in males include the individual being pre-pubescent and having intense and persistent distress about being a boy. The distress must be present for at least six months. The child must either:

1. Have a preoccupation with stereotypic female activities, as shown by crossdressing, simulating female attire, or an intense desire to join in the games and pastimes of girls, rejecting male games and pastimes.
2. Have persistent denial relating to their male anatomy. This can be shown through believing they will grow up to be a woman, that their penis or testes is disgusting or will disappear, or that it would be better not to have a penis.

The DSM-IV-R criteria for Gender Identity Disorder includes four main criteria. The DSM-IV-R also requests that the individual's sexuality is noted.

Strong and persistent cross-gender identity.

In children this may be demonstrated by them meeting four or more of the following criteria:

1. An insistence that one is or desires to be the other sex.
2. Boys must display a preference crossdressing or simulating female attire, and girls must persistently wear only stereotypical male clothing.
3. Persistent fantasies of being the other sex, or strong and persistent preference for cross-sex roles in make-believe play.
4. Intense desire to participate in stereotypical games of the other sex.
5. Strong preference for playmates of the other sex.

Persistent discomfort with their sex or a sense of inappropriateness in the gender role of that sex.

In boys this may manifest as an assertion that their penis or testes are disgusting or will disappear, or asserting that it is better not to have a penis.

In adults and adolescents this manifests as a preoccupation with removing primary or secondary sex characteristics, such as a demand for surgery or hormone replacement therapy.

The disturbance must not be concurrent with a physical intersex condition.

The disturbance causes clinically significant distress or impairment in social, occupations or important areas of functioning.

The DSM-V moves from Gender Identity Disorder to Gender Dysphoria to avoid the implication that gender nonconformity is in itself a mental disorder, but a similar entry remains in the DSM-V so that individuals may still seek treatment. The DSM-V, unlike the DSM-IV and ICD-10, separates Gender Dysphoria from sexual paraphilias, and diagnoses on the basis of a strong desire that one has feelings and convictions typical of the other sex, or that one strongly desires to be treated as the other sex or be rid of one's sex characteristics.

The readability of patients to transition is also relevant to undertake hormone replacement therapy, which includes the patient's likelihood to take hormones in a responsible manner, have made progress in mastering other identified problems that leads to improving or continuing stable mental health, and have had further consolidation of gender identity during psychotherapy or Real Life Experience of their desired gender role.^[3]

Some organizations still require a period of time living as the desired gender role, based on standards such as the Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People (WPATH). This period is sometimes called the Real Life Experience (RLE). Endocrine Society in 2009 specified that individuals should either have a documented 3 months Real Life Experience or a period of psychotherapy of length specified by the mental health provider, usually a minimum of 3 months.

Some people, especially individuals from the transgender community, say that RLE is psychologically harmful and is a form of "gatekeeping" — effectively barring people from transitioning for as long as possible, if not permanently.

Some individuals choose to self-administer their medication ("do-it-yourself"), often because available doctors have too little experience in this matter, or no doctor is available in the first place. Sometimes, trans persons choose to self-administer because their doctor will not prescribe hormones without a letter from the patient's therapist stating that the patient meets the diagnostic criteria for GID and is making an informed decision to transition. Many therapists require at least three months of continuous psychotherapy and/or a real life test in order to write such a letter as is suggested in the HBIGDA Standards of Care. In these circumstances, the individual may self-administer until they can get these authorizations, feeling that they shouldn't have to wait for a medical professional to be convinced of their situation. In addition, as many individuals must pay for evaluation and care out-of-pocket, expense can also be prohibitive to pursuing such therapy.

However, self-administration of certain hormones (namely ethinyl estradiol) and anti-androgens (namely cyproterone acetate, flutamide, and nilutamide) is potentially dangerous and can cause an elevation in liver enzymes.