Building A Team to Support Your Gender Transition

Transitions are hard, but you don’t have to do it alone. Though it is largely a personal journey, it can be extremely helpful to find the right people who can help you navigate the physical, emotional and social challenges required by a transition.

One theme I keep coming back to is how much there is to learn when transitioning genders. Even after a couple of years, I was still finding out how little I knew about certain subjects, and how much I was still learning about myself. Having a group of people I can rely on as new challenges arise helps to keep me emotionally and physically healthy.

These professional roles are in no particular order, but I’ve found each to be a really important and ongoing part of my life. The upside of COVID is that it is now easier than ever to build a support network of people who may not live in the same city as you; especially if you are in a part of the US that is increasingly transphobic, you can find and work with people who are accepting of you.

A Therapist

I know of many people who have transitioned without the help of a therapist, but this is one of those supporting relationships that I can’t imagine doing without. More than anything, gender transition is about integrating a lifetime of traumas and fundamentally changing the way you look at yourself and your place in the world. Doing this alone is incredibly difficult.

A good therapist is someone who can help us reach a new perspective on our lived experience which has so often been warped by the negative influences of the people in our lives. On my own journey, the hardest part of transition has been dealing with the constant sense of shame and failure that I’d lived with for a lifetime. For example, having someone who could tell me, from the outside, “that makes sense why you would want to grow breasts” was a shockingly validating experience; I had lived for so long thinking I was crazy.

Finding a therapist is more than making an appointment; you need to build a relationship with someone you can trust and work with long-term. It took me almost three years of seeing my therapist once a week before I felt like I could talk about my gender identity.

I would recommend searching for someone who is a Licensed Marriage and Family Therapist (LMFT), even if you’re not married or in a relationship. They typically have more experience dealing with the types of family trauma common to trans people, as well as training that you will find helpful when navigating your own interpersonal relationships during transition.

A Primary Care Physician

Transitions take a toll on your body, and in some cases can lead to unexpected health consequences. Finding a good primary care physician who can help you make informed decisions about your health is a long-term win. You’ll want to find someone who has direct experience working with trans patients, and can to tailor your hormone regimen along with other lifestyle changes to help you meet your goals.

I know many trans people who have worked exclusively with an endocrinologist during their transition, but I think there is great value in finding a primary care doc with a wider range of knowledge and experience beyond the effects of estrogen and progesterone.

Transitions involve more than your hormones; for example, do you know when to start and how often you should get a mammogram? There is actually a lot of conflicting advice on this, with some doctors saying trans women don’t need mammograms as the breast tissue is different, more typically gynocomastic, than cis women. Other doctors will advise you to get a mammogram as often as cis women (yearly depending on age) as the breast tissue actually is similar and includes the ducts and lobules where breast cancer tends to start.

Obviously, the consequences of getting bad advice here are obvious. Questions like these can and should be answered with the advice of a good primary care doc well versed in the standards of care for trans patients.

A Professional Coach

Managing a career is a tough prospect for anyone, and those transitioning genders face some unique challenges. Having a dedicated career or professional coach can be an important source of support and advice as you attempt to navigate your professional and personal relationships.

I frequently encounter people frustrated that they have to spend a lot of time managing others’ feelings when they decide to transition. This is absolutely true, but honestly, is not really different than what any successful person has to be doing constantly in their career. Managing other people and their emotional reactions (either formally as a boss, or informally as a peer or subordinate) is just part of the game.

What can help is having someone you can vent to and brainstorm with on how to handle those particularly tough relationships that require the most care. At the end of the day, there will always be people who control your success to some degree, and avoiding the conflicts and finding the opportunities within those relationships is what long-term success is built on. A practiced career coach is the person to help you do this, and help you hold yourself accountable to your own goals.

Your Informal Support Network

Last, but certainly not least, is your informal support network. Each person has their own version of this: it is your spouse, children, family, co-workers and friends. These are the people you can rely on for support in challenging times, or just to make you feel good on a Saturday afternoon.

Having and strengthening these relationships during your transition can be immensely gratifying, and is an opportunity to invite the people you love to grow with you on your journey.

Some Practical Challenges

I’m sure reading this, a lot of people will be thinking “sure, sounds great, but how do I find and pay for all these supportive people?” Transgender men and women are often struggling to just make ends meat, and these additional supports probably don’t feel like they’re in the budget.

As I mentioned above, COVID has dramatically changed how we connect with the people in our lives. Finding your support network is a lot easier today, where most therapists, doctors and coaches have been seeing clients remotely for the last year. This opens up a lot of opportunities to seek out those who you may not have considered prior to COVID.

The key thing about finding the right person who can support you is knowing what you are looking for. By far, the most important thing is finding people who you can be open and honest with, and who you feel respect you and your experiences. At the same time, you want people who have different areas of expertise and will challenge you, and not always in ways that are comfortable. The point of building a support team is to expand your source of knowledge and experience, and you can only do that with people who know more than you do about certain things and who you trust to tell you uncomfortable truths.

So how to pay for it? In my experience, most professionals in these positions are willing to be flexible with rates depending on your ability to pay. There is nothing wrong with seeking them out, building a connection, and being honest about your ability to pay. Some may decline, but most will be able to provide fees that work for your unique situation.

I’d love to hear what relationships you’ve found most helpful in supporting your transition.