Category: Mental Health

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Friends & Family Mental Health Transition Support

How to Support a New Trans Person

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Transitioning genders is complex, emotional process, especially at the beginning. Most trans people have a circle of friends and family that want to support them, but struggle to understand what and how to do it best. Certainly, transitioning is growing more common, but most people still don’t have direct experience supporting a trans person. And that’s ok – we’re all in this process together.

So I wanted to write a post for everyone who is looking for advice, particularly someone at the start of their journey. I’ll talk about both the “Dos” and the “Don’ts”, as often times meaningful support is as much about what you do not do as it is about affirmative actions or words.

Things you can say and do

Tell them you love them. This is the first and most important thing you can do. Specifically, tell them you love the person they have been, and you’ll love the person they are becoming.

Someone sharing their true gender identity with you is an amazing act of trust and vulnerability. This person, who has gone through a lifetime of shame, trauma and general unhappiness, is opening up to those they love, and your first job is to love them back. They are likely terrified of the response and rejection they’ll get from you and everyone they know, so affirming this first is the most important thing you can do.

Ask how you can help to support them. Transitioning genders is a really complicated, expensive and challenging process. There are a thousand things that need to be done, learned, processed and shared. Asking how you can help is a powerful act in of itself; even if there is nothing specific you can do, the simple act of asking means you embrace and support their decision. This is incredibly affirming, and there may be some specific things that you can help with.

Ask questions about their experience. Trans people have spent a lifetime hiding a large part of who they are. Taking the time to ask questions about how they’ve felt, what their hopes and goals are, and what they’re feeling right now is a powerful form of love and connection. This is your chance to learn about a whole new part of someone you care about, so take the time to explore with them.

Offer to guide them. Being newly trans means having to learn and do almost everything in a new way. From buying clothes, to getting a haircut, to going to the doctor; almost every single day-to-day experience is new and can be really stressful to have to figure out on your own. Just like a native guide in a foreign country, you can help navigate the unknowns and provide a sense of comfort.

Educate yourself. Last, and not least, you can take the time to read about trans experience and learn about things like pronouns, dysphoria and the process (HRT, FFS, GRS, so many terms to learn!) This will help you to understand and connect with, at least a little bit, the trans journey, and will probably help to allay some of the fears and concerns you have.

Things not to say or do

Don’t assume and apply a trans stereotype. Being trans means different things to different people. Unfortunately, we don’t have a lot of great examples in society right now of what a happy, successful trans person looks like. Most cis people assume that transition means turning into a drag-queen, or at best an awkward mess of a person. Don’t assume you know what the end goal of transition will look like, or mean, because you are probably wrong. Most trans people don’t even know themselves – transitioning is as much about exploring as it is about reaching a particular destination.

Don’t ask whether they’ve thought about the impacts (to life, family, career, etc). This is such a demeaning question. Especially for someone coming out in adulthood, the obvious answer is: “yes, of course I have”. We’ve spent a lifetime thinking about the impacts, and being afraid to be our true selves precisely because of those imagined fears. The fact that this person has decided to be open with you about their gender identify means that they have already decided the pain of hiding themselves far outweighs any transient negative impact on the rest of their life.

Don’t talk about your own fears. Right now, this is not about you. You may be feeling a lot of things, maybe its fear for their safety, or fear that they’ll be unhappy, or fear that it will reflect badly on you as a parent, spouse, etc. These are all real feelings, but you need to recognize that sharing them, at this moment with this person, is not appropriate. Trans people have spent a lifetime being defined by other people’s fear, and there is nothing more frustrating than having a conversation about their experience and goals be turned into one about you. I highly recommend you seek out a therapist or counselor if you’re feeling like your fear is overwhelming.

Don’t compare them to a gender ideal. Look, transitioning genders is awkward. We know that better than you ever can. It takes years and can require hormones, surgeries and lots of practice with new skills. Sometimes, the most well-meaning compliment can actually be really demoralizing, like the dreaded “Wow! You look like a real woman!” Or “You’ve made so much progress, you hardly look like a man anymore!” Instead, try a simple “You look great!”

This is by no means an exhaustive list, but I hope it helps to provide some general tips you find helpful. And finally, please remember that the most important thing a trans person wants to be seen and loved for who they are, and who they will become.

I’d love to hear if you have your own suggestions in the comments.

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Mental Health Transition Support

How to Have ‘the Conversation’ with Your Spouse

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This is a post I’ve been meaning to write for a long time, but I’ve put it off because it is about one of the most difficult topics: telling your spouse you are transgendered.

I waited until about 6 months into my transition to tell my wife. Partly this was because I wanted to be really, really sure this is the path I wanted to take before making the ask of her. Partly it was because of timing, and trying to find the right time and place to share something this big.

I’ve written this from the perspective that I know; as someone who was closeted, and for whom this was the first real conversation about their gender outside of therapy. Each person’s story is different, but hopefully this will present some helpful ideas no matter what your background.

Being realistic

The hard truth is that a lot (most?) of these conversations lead to a divorce. Though we’ve all read about the best case scenario where a wife is unconditionally supportive, or even excited about the possibility of being in a lesbian relationship, this is not a likely outcome. For many women, being married to another woman is a deal-breaker, and something they just can’t or aren’t willing to do. Even if divorce isn’t the immediate outcome, you may be starting a process that inevitability results in the end of your marriage.

No matter the ultimate outcome, ‘the conversation’ will inevitably lead to changes in your relationship and a lot of big feelings. Even the most progressive woman will probably have a hard time being her best self when learning that her spouse is trans, nonbinary or otherwise different.

As we all know, there is a lot of bad information and stereotypes about what it means to be trans. And unfortunately, you’ll be battling against these stereotypes (especially with older women or in less progressive places of the country). It can be a really frustrating; the person you are trying to become isn’t necessarily what your spouse imagines, or is afraid of.

Though you can’t predict how your spouse will react, you definitely can do some specific things to make the conversation go as well as possible.

Lay the relationship groundwork

Sharing something difficult with your spouse is always easier if you have a solid foundation of communication, trust, love, and compassion. This is especially true when you’re talking about existential issues like gender and sexuality. If you have underlying issues in your marriage that are unresolved, this conversation can act as the trigger to bring those up as well; rather than honestly sharing, you’ll find yourself trapped digging up old hurts.

If you have the option, I highly recommend you go to couples therapy before you come out to your spouse. A year of couples therapy can give you both the tools and trust you both need to have a really difficult conversation.

Another factor is timing. Unfortunately, you can’t always chose the best time and place, especially if its something your spouse brings up. But, if you have the option, chose a time and place where you both are rested and relaxed. After work at the dinner table with screaming kids is probably not the best time 😉

Be clear about your ask

Often, the first question your spouse will ask is ‘what can I do to help?’ or ‘what do you want from me?’ It is worth putting a fair amount of time into considering this question before you have the conversation, and a therapist can be a really valuable resource for helping you think through.

One of the key decisions to make is whether you want to try and stay together, or are you looking for a separation. If you want to stay together, its also worth thinking about what you need from your spouse to accommodate your new identity. Are you comfortable with a slow transition, or are you looking for sudden change and acknowledgement of your new identity?

Unfortunately, there are a lot of stereotypes and misinformation about trans people, and you’ll be battling against those. The more clear you can be about your specific needs and ask, the more likely it will be that your spouse can focus on what you actually said rather than their own fears of what transness means.

Your ask should be as specific as possible, and focused on actions rather than feelings. Rather than say ‘I need your support’ or ‘I need you to love me’, think about specific things your spouse can do to support you and your transition. ‘Help me find clothes’ or ‘give me feedback about how I look’ or ‘go to therapy with me’, are all things that can give your spouse a sense of agency in the transition.

The thing to avoid is making big, unfair requests, like ‘stay with me’ or ‘love me for who I am.’ Though you may desire those more than anything, it is putting your spouse in an unfair position – you’ve had a lifetime to wrestle with your identify, while your spouse has likely just been introduced to the idea. It will take them a long time to fully process everything, and big emotional requests will like just make them feel defensive.

Make it about them

This might sound weird, but hear me out. One of the key messages that people often forget to communicate clearly, and repeatedly, is that this decision is about being a happy, healthier person for those that they love.

The reality is that transitions are scary, awkward and filled with uncertainty. Your spouse will naturally think about those downsides, so its your job to reinforce the positive aspects and desires for transition.

If you can, try to think specifically about the benefits – why will your transition make life better? How will it help your mental health? What are the specific issues in your relationship that your transition will improve? This may not be sufficient to save your marriage, but it will certainly help your spouse to understand some of the motivation for your transition.

Have compassion

You have had a lifetime to process your gender identity, and have obviously reached a point of acceptance if you are considering talking to your spouse about it.

But its really important to have compassion for the difficult position your spouse is in, too. In sharing your gender identity, you have just upended not only their plans for the future, but also their understanding of your marriage up to that point. This is an incredible amount of change and uncertainty, and any spouse would be understandably overwhelmed and need time to fully process.

More than anything, your spouse is likely feeling a lot of fear. Fear that their life as they know it will end. Fear that the person they thought they knew is fundamentally different. Fear for you and what you are likely to encounter as you transition. Fear for your children (if you have them). Depending on your spouse, that fear can come all at once, feel overwhelming, and trigger defensive mechanisms like anger.

The fact that your spouse feels uncertainty, fear, doubt, anger, or anything else doesn’t invalidate you or your experience, and you shouldn’t feel shame about triggering those emotions. But it is a reality you’ll have to deal with, and showing compassion and understanding for whatever your spouse is feeling will go a long way towards rebuilding your relationship.

Be patient

In an ideal world, the conversation will end with a clear and unambiguous ‘I love you and I’ll always be here as your partner.’ Unfortunately, that is rarely the case. Your partner is going to need time to process, and this will likely be the start of a number of intense conversations before you come to some sort of closure and resolution.

Be patient with your partner, and try to give them the space they need to process without withdrawing. If they are feeling a lot of fear, withdrawing will only feed into the narrative that your marriage is disappearing.

These are incredibly difficult conversations, and require you to confront the very real possibility that your marriage will end. Give yourself, and your spouse, time to carefully consider what this means, and what is best for both of your individually and together.

Do you have any tips on having the conversation? Is there anything you wish you had done differently?

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Health Mental Health Transition Support

Building A Team to Support Your Gender Transition

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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.

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Health Mental Health

Where are you on the transition spectrum?

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Anyone who has worked to change their gender identity has gone through periods of self doubt. There are very few, if any, people who undergo a gender transition and feel immediately and completely sure of their decision 100% of the time. One of the hardest and most insidious forms of doubt comes from comparing the self you are and want to be with an external ideal of the gender you are moving towards. Sometimes, this is from being unable to change the parts of you that you want to leave behind; other times, its feeling like a fraud because you want to keep some of the ‘guy’ or ‘girl’ attributes you like.

As a trans person in my 30s, I struggled with this a lot (and still do from time to time). There was a tension between the ‘male’ parts of me I had grown to love and the external ideal of what it meant to be a ‘woman’ or ‘feminine’. Sometimes, it felt like a binary choice – either completely change everything about me to match a ‘feminine’ ideal, or I was a fraud.

I love trucks, woodworking and building things; not traditionally feminine activities (at least as I was raised). Emotionally, I am warm but a bit a reserved (thanks dysfunctional Aspergers family!) For a long time I felt torn; in order to be a real woman did I need to give these things up? Did keeping them as a part of my life somehow make me less of a woman?

Are you struggling with doubt? First, let me tell you that doubt is ok, and doesn’t mean you are on the wrong track. Second, whatever you decide is right for you, you’ve still ‘transitioned’. Third, you are a beautiful, whole person just the way you are. Any changes, however small, you choose to make to yourself in order to improve your mental health are significant and important.

There are many types of transition

Transition is complex, unique and individual, just like genders. In the same way we now recognize that people integrate different parts of gender into their identity, we also can accept that transitions fall into a broad range of experiences.

Why is this important? As you progress on your own gender transition, it is easy to get caught up in the same pattern of comparing yourself to an external ideal, just a differently gendered one. There is no ‘perfect’ female you have to be, just like there is no perfect ‘male’ ideal that you probably felt unfairly judged against.

I believe in a very broad definition of a gender transition: changing any part of your external appearance or actions to better align with your internal identity.

This can mean a lot of things. Some people embrace transition as an opportunity to completely change who they appear to be on the outside, including their names and gender pronouns. Others take a less aggressive approach, changing some parts of their appearance but ultimately keeping the majority of their current identity. Whatever you decide to do, there really is no wrong answer: transition simply means bringing your outward self into better alignment with your inner self.

It’s the journey, not the destination

The most important benefit from transitioning, I believe, is the process rather than then end result. In order to begin a transition, you first have to acknowledge to yourself and others that who you feel like on the inside is different than the person perceive you on the outside. Next, you have to have an affirmative picture of what you want to be to better reflect that person on the inside. Finally, you have to put it into action, and actually go through the process of evolution and change.

Each of these steps requires an enormous amount of self-reflection and growth. Regardless of where you end up, you’ll have done a lot of hard work engaging with and accepting who you are.

Its important to discover what is driving you from the inside. What is it you like, what is it you want? What attributes are you looking for, what makes you happy?

Finding an answer, any answer, that works for you is what matters, not meeting some external ideal. Ultimately, gender transition on its own isn’t going to make you happier; the hard work of identifying, accepting and embracing who you are as a person is what leads to happiness.

The gender transition spectrum

In my work as a coach, I find there are generally 3 motivations driving people who are exploring a transition.

  • Gender curiosity: wanting to explore alternative aspects of gender, primarily to decide what you like and don’t like.
  • Gender affinity: already identified aspects of a different gender you like and want to move towards. Think of the things about your identity (or desired identity) that give you pleasure and make you happy.
  • Gender dysphoria: specific aspects of your current gender identity or body that you want to move away from. These are the things that cause you distress that you want to change or remove.

Rather than isolated categories, you can think of these as different parts of a broad spectrum of motivations. Some people feel dysphoria much more strongly, but without affinity for a different gender; these people tend to move in the non-binary/androgynous direction. Others feel a strong sense of affinity without overwhelming dysphoria; they tend to transition later in life. Finally, those that feel strong dysphoria and affinity to another gender make a full transition earlier in life.

Each one of these is valid, and many people experience different aspects of these motivations at some point, or all together.

Practical implications for your transition

Though theory is nice, I’ve found there are a few tangible benefits this approach can have for making sense of, and peace with, your transition experience.

  • Name it to tame it – the old therapist saying actually has some value. Having a framework through which to view and structure the blob that is ‘transition’ can be really helpful in both understanding which motivations are affirming/positive vs dysphoric/negative.
  • Be free to be creative – because every transition is different, and every person’s collection of dysphorias and affinities is unique, transition can mean whatever you want it to.
  • Take it slow – figuring all this stuff out takes a lot of time. In my own experience, over time some things I though were dysphorias turned out to be more subtle. Likewise, affinities turned out to be short-term preferences rather than long-term needs.
  • Do what makes you happy – do and be the things you love, regardless of how you think others will categorize them, and whether or not they fit into a particular ideal. The goal is to be happy, not confined.

Lastly, you are perfect just the way you are today, and you will be perfect no matter what you decide to be in the future.

I’d love to hear, does this map to your experience of transition?

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Mental Health

The benefits of transitioning genders later in life

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I started my transition when I was 35, after having two kids and an established career. Though this certainly added some complexity to my journey, it also gave me experiences that I wouldn’t trade for anything. I think the benefits of later transitions are often overlooked, as people focus on the downsides of aging rather than the benefits.

Gender dysphoria is really hard, and for some, transitioning as early as possible can have dramatic mental health benefits. But for many who don’t have the option or opportunity to transition as a teen, a later life transition is full of unexpected benefits and upsides.

A different kind of beauty

We all want to have the youthful glow and energy of a pretty 20-something girl. And that’s just not possible if you transition later in life. On the other hand, and I hear this a lot, a later transition doesn’t mean you will always look like a man in women’s clothes.

Certainly, aging has its downsides. Once you hit your thirties or fourties, you’ll have to deal with things younger trans women won’t, like male-pattern baldness and a generally slower metabolism. But estrogen has a powerful impact on your body no matter what age you are, and generally, if you’re body transitions well as a twenty-something, you’ll look great transitioning as a forty-something too.

Femininity and youthful appearance are tied in our culture to an unhealthy degree. Many trans women assume that the only way to be a beautiful woman is to look like the pictures of young female models; this is exactly the same negative body image stereotypes that cause cis women and teens so much emotional trauma.

Looking great and feeling great at any age is possible, regardless of when you started your transition.

Coming to terms with yourself, not your gender

Because I transitioned later, I had a couple of decades to spend coming to terms with who I was outside of my gender identity. This made my eventually transition a lot easier, because I had a much better and healthier relationship with myself.

One of the hardest parts of transitioning is how damn awkward it is. Because you have so much to learn and re-learn, you are constantly making mistakes and not meeting your own expectations and desires. If you struggle with self-doubt and insecurity, this can be a really awful process. When I finally did transition, I was able to be much kinder and gentler with myself than when I was in my twenties.

You are not your gender, and affirming your gender identify doesn’t magically solve all your problems. If you transition early, you still have a lifetime of work ahead of you; learning to love yourself, building a family, navigating professional life, and finding how to be happy.

Transitioning later just means you’ve changed up the order in which you can address some of those things, and ultimately make your transition a little easier than it otherwise would have been.

A powerful support network

One of the benefits of getting older is having a strong network of friends and loved ones who you can rely on for support. I can’t imagine going through my transition without these people; my family and friends have been a constant source of support and validation. Certainly, there are those people who fell out of my life after transitioning, but generally my strongest relationships only got stronger.

The thing is, as you get older, you realize that nobody stays the same. We’re all changing all the time, and one of the great joys of life is growing together with the people you love. By the time I was 35, I was a very different person than when I was 20. I think in some ways, this made my gender transition easier for my friends and family; they had already seen me at my best and worst, and this was just a new chapter on my journey.

A sense of perspective

As I said above, gender isn’t everything. It took a lot of years, but finding out how to love myself, regardless of what I looked like on the outside, was key to my eventual transition. And when I finally did transition, I was confident in the things I wanted to keep and the things I wanted to change.

To put it another way, transitioning for me was about making the life I already had better. Through years of work and self-discovery, I was actually happy, even with the body of a man. I had, and have, a loving wife and two great kids. My choice to finally live life as a woman was about finally removing one of the last barriers that was keeping me from truly enjoying and being present for the great things in my life.

If you transitioned later in life, I’d love to hear about your experiences in the comments.

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Exercise Lists Mental Health

How To Cope with the Lows of Your MtF Transition

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Some days suck. For a variety of reasons, or no reason at all, you’ll feel lonely, inadequate, ugly, fearful, listless, or unmotivated. You won’t have the energy to practice anything, and it will feel hopeless anyway. The worst days are when you question yourself or your choices, and wonder if it all would have been easier if you’d continued repressing your true gender identity.

Sound familiar? Don’t worry, you’re in good company. Every woman who has transitioned has had these days. Transitioning is an incredibly hard process, and there are bound to be some days where you just don’t feel up to the task.

And that is perfectly ok. Some days you don’t have to be up to the task. Some days, it is perfectly ok to dress in your old clothes, forget about bras and makeup, and just watch TV.

Generally when I’m feeling this way, it is for some common reasons:

  1. Lack of sleep: whenever I don’t get enough sleep, my mood and motivation take a nose dive. Everything feels hard, even simple things that I usually enjoy doing. Even an hour less a day can have this impact, and it usually takes a few days to fully recover.
  2. Over-exercise: when I exercise too much and don’t rest enough, I feel really anxious and, obviously, tired. Over-exercise raises cortisol levels and creates that sense of overwhelming fatigue that makes regular things feel impossible.
  3. Hormone changes: I notice that any changes to my HRT regimen can cause a few weeks of pretty bad moods. Spikes, or dips, in testosterone or estrogen can cause both euphoria or depressive feelings.
  4. Alcohol and unhealthy food: I notice that my mood can be materially impacted by what I ate, particularly if I’ve been drinking alcohol and eating really fatty foods. Both can have a really profound impact on my mood, and this seems to be getting worse the older I get. A few drinks and I don’t sleep very well, leading to a rough morning.

And then, sometimes, I’m just having a bad day for no reason I can identify.

If you are feeling overwhelmed, here are a few things you can do.

  1. Take a nap: if you really are exhausted, a nap can do wonders. Especially if I’m in a really bad mood, I find an hour long nap can really make me feel a whole lot better. Don’t sleep too much though, or it might affect your sleep cycle, which can lead to more fatigue.
  2. Take a sick day: mental health is just as important as your physical health. In the same way you shouldn’t hesitate to take a sick day if you can physically function, you shouldn’t hesitate to take a sick day if you can’t mentally function. It is totally ok, and in fact, demonstrates that you care for your whole self, not just your body. Sleep, watch tv, go out to eat, visit a museum; do whatever you need to do to recharge and build up your mental reserves again.
  3. Do some light exercise: it may seem counter-intuitive, but light exercise can actually make you feel more energized. Take a walk, or do some stretching or light yoga; anything that gets your heart rate up.
  4. Lean on your support network: nothing can make a bad day better than a hug from someone you love. Your friends and family are there to help you in times like these, so lean on them. Even if you are estranged from those you love the most, there is someone in your life who thinks you are great just the way you are and will be happy to tell you that if you ask.

And lastly, don’t forget: you are wonderful, brave, capable and beautiful. No matter what you feel in this moment, it will pass, and you will feel better. Until you do, be gentle with yourself, and know that its ok to be whoever you are in this moment.

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Mental Health

Take it slow: the importance of pacing your MtF transition

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Transitioning from male to female can be a complex, strange, exhilarating and terrifying experience. Especially if you’ve been living with gender dysphoria for a long time, moving quickly may feel like the only thing you can do to save yourself from the constant, daily trauma you live in.

But a slow, measured pace can often lead to better results in the long term than trying to move through the process as quickly as possible (or even quicker). And in the short term, harassment and abuse as a new trans woman is a real and potentially traumatic experience in of itself.

Taking things slow gives you a chance to acclimate to your new external gender, while also building a sense of self-confidence in your emerging identity and capabilities.

Physical Changes Take Time

When you start HRT, your body begins reshaping itself based on the influence of estrogen. But, just like a normal puberty, it takes years to see the full impact of the changes. At first, you’ll notice some obvious growth (like bigger nipples and breasts), but other changes take a lot more time; the facial softening associated with a feminine look is caused by fat redistribution in the face, which takes a few years to really be obvious.

There really isn’t much you can do to rush this process, and in fact many trans women seek surgery, either FFS or breast augmentation, early on to ‘fix’ issues which may resolve themselves with more time.

In my own transition, I didn’t notice many changes for the first 6 months. By month 12, I looked a bit more feminine and had small AA cup breasts, but still had a lot of masculine features. By month 24, I noticed a big difference in my facial structure and body composition; a smaller jaw line, less defined muscles, and fuller cheeks.

You Have a Lot to Learn

Being a woman in the real world takes a lot of new skills. If your goal is to pass as a female, you’ll need to master a number of new skills, like hair, makeup, clothes, hygiene, and speech (I have a running list of all the things I’ve had to, and continue to learn.)

There simply isn’t enough time in the day to learn all these things in a few short weeks or months. Mastery takes even longer; the difference between a passable makeup job and a good one is the product of lots of trial and error.

Rushing the process can lead to awkward results. In of itself, these aren’t bad and everyone goes through them, but they are hard emotionally. Subjecting yourself to constant criticism (whether internal or external) is really painful and can lead to negative impacts on your overall mental health and happiness.

Taking a slower approach gives you time to focus on one, or a few, things, work through them until you are comfortable and confident. Then you can move onto the next set of skills.

Your Interests and Likes Change Too

As you transition, you learn a ton about yourself. What you thought you liked when you were presenting as a man can, and will, change as you begin to explore living as a woman.

For example, I imagined myself wearing super feminine clothes (lots of dresses and skirts). Once I began to transition, I found I was a lot more comfortable wearing pants and the super feminine clothes didn’t appeal to me in the same way. The only way I could figure that out was by trying lots and lots of different clothes and styles.

Rushing through the process is going to mean you’ll spend a lot of money on things you may not like at all. I made that mistake with makeup – rather than go slow and focus on different parts of my makeup one by one, I went out and bought everything I thought I would need. Turns out, I had to replace most of the products as I learned what works with my skin and face; a little more time and research probably would have saved me hundreds of dollars.

You Don’t Have To Do It All At Once

Coming to terms with your gender identity, sharing that with the people you love, and changing how you appear are all different and distinct parts of the transition process.

I think a lot of trans women feel like all three have to be done at the same time; the minute you decide you want to transition, you have come out to your family and start wearing women’s clothes and makeup. While that certainly is a good path for many, its not the only way.

I was older when I started my transition, and I had a family and career I wanted to do everything I could to maintain. It took me a few years of therapy to really come to terms with my gender identity, and all that time I was still dressing and living as a man. Even after I came out to my wife and family, I continued to outwardly present as a man, while practicing those skills I needed to know to live as a woman.

Finally, once I was comfortable with myself and my ability to be the woman I wanted to be, I slowly started to shift my appearance. For months, I was a bit more feminine each day, until I reached the point where I was seen as a woman more than a man.

This slow transition gave me a chance to feel comfortable and confident in myself. It also gave those I love time to process my changes and have confidence that the emerging me was a better version of the me they had always known.

Even though I urgently and immediately wanted to be a woman, taking it slow was better for my own mental health and those that I care about.

Fast or slow, I’d love to hear your experiences in the comments.