trollcity said:
hello, just being curious. i wanted to ask how long it takes to fully transition aka post-op? and is it because it's so expensive that it seems to take forever (if in fact it does) or is there some other reason? don't feel obliged to answer if this subject is too personal/touchy/intrusive or something and apologies in advance if it is D:
It takes a long time to transition because of:
1) costs:
-facial hair removal through electrolysis can be $60-100 an hour, and you can need 50-400 hours of it, so $3000 to $40000 over several years, depending on how many hours a week you can stand. It is incredibly painful and causes redness and in some cases (like mine) extreme swelling that can take days to subside.
-alternatively or additionally, depending on your hair/skin type, you can have laser hair removal. Prices vary widely and so does the success of the removal. My clinic charges $180 per session (once every 5 weeks) for the first 8 sessions and then $90 for each session after. You might need 10 sessions or more. Often people do 6 or 7 laser sessions then change to electrolysis to get what's left.
- hormones - costs vary widely from country to country. I know they are a LOT more expensive in the US than here. I think this is only $60 every few months for me - I've heard in the US it can go a LOT higher (maybe someone can say?)
- a new wardrobe - you need shoes, clothes, makeup, accessories, work clothes, casual clothes - this is the expense you don't really plan for but it really hits you.
- pre-transition therapy sessions, psychiatrist appointments during transition (mandatory if you want surgery), endocrinologist fees to monitor your blood while you're on hormones to make sure they are at the right level and that they aren't killing you.
- surgeries - $18K for bottom surgery, or you can get an orchiectomy (not sure of that spelling) which is basically just castration, and then get bottom surgery down the line. I think orhiectomies are only a few thousand. Facial surgery can vary from a few thousand to remove the adams apple only, to 40K if you see a top doctor and do EVERYTHING. I'm not sure of the cost of breast implants (never investigated but some people never develop breasts and think it's important to have them), but it would be thousands.
- Also when you get these surgeries there are recovery periods during which you can't work. You can be off work for 8 weeks with the downstairs surgery.
I've seen people estimate their transitions at *up to* $150K (don't get depressed Lexi that's the extreme case). That's a lot of money to come up with, and not many people can do it quickly. It has to be spread out over years.
2) Mandatory waiting periods and "gatekeeper" mental health professionals.
There are international standards of care for the treatment of transsexualism that define requirements for psychiatric monitoring and waiting periods for hormone therapy and sexual reassignment surgery. I'm embarrassed to say I've kind of forgotten exactly what they are - I think it's 3 months of therapy or 3 months of living as your felt gender before a doctor is supposed to prescribe any hormones, and then 2 years of actually living as your felt gender 24/7 before a psychiatrist will provide you with a letter to recommend to a surgeon that you have the surgery. It's difficult to find a doctor or a surgeon that will work outside these guidelines or some version of them.
The gender clinic that's treating me now only makes you wait 12 months after you start living as your felt gender to be approved for surgery. You see a psych regularly during that time so you are monitored to make sure you don't fall apart and that you can make transition work as a permanent life choice. If you are struggling with employment, struggling emotionally with prejudice or lack of support etc, they will hold off on approving you for surgery until you've proven you can function in society as your felt gender. The logic is that granting a sex change to someone who is then miserable in their gender role is a recipe for suicide, because once you've had the surgery, it's impossible to restore your genitals to their original state if you change your mind because it's all too difficult.
But they are VERY hesitant to let you get onto hormones in the first place, which almost everyone wants to do BEFORE they go start living as a woman (or man) and begin the 12 month wait (as long as everything goes right) to have surgery. This clinic has you assessed by two psychiastrists over a minimum 3 months. Often people have already been seeing a psychologist for ages before they even go to the clinic, but a psychologist can't do a recommendation for hormones. If there is ANY sign that you are hesitant or have psychological issues that aren't gender-identity related which could be the cause of someone wanting to change sex, (e.g dual personalities), they will keep you in therapy until they are absolutely convinced it is the right choice for you. You could be doing therapy for months and months.
3) People need time to adjust and deal with the psychological ramifications of DOING this stuff. Not everyone immediately jumps into this mindset that they're trans and that that's OK. Many people struggle with presentation issues and feel they CAN'T present themselves as their felt gender until they've been on hormones for a few years. And then there's simple fear. Transitioning takes a lot of bravery. It can take months to get over fear at all sorts of stages - admitting it to yourself (this was my issue), coming out to family and loved ones, coming out to work, fear of public ridicule and harassment and worse, fear of being a freak, fear of losing a partner - so many issues to work through. And if you try to transition WITH a partner or with children, they can really hold you back as many people feel frightened to take a next step - like dressing as female - for fear of ramifications - what if this triggers my partner to leave? Will this confuse my kids about what boys and girls do?
Also, transition is emotionally, physically, mentally draining. Sometimes you float along for a while not making any new progress because you're just tapped out.
I could write a bunch more about point 3 but this is already toooooo long. Should give you an idea of why it takes a while though. You can't just wake up one day and say "I'm going to have a sex change!" and call up the hospital to make a surgery appointment.