What can doctors do to help with the gender affirmation process?

The medical process of gender affirmation varies depending on your age. The three basic steps are puberty suppression, hormone therapy and surgery. None of these steps is essential to helping you live as your identified gender, but the purpose is to help you feel more comfortable in your own body. So let’s break these steps down.

Puberty suppression is typically only offered if puberty has started but has not yet finished. For many, this is around the ages of 11 to 13. It’s in the form of a medicine that halts puberty where it’s at, basically preventing continued maturation into a gender you don’t feel comfortable with. This step is also considered to be entirely reversible, meaning once you stop the medicine puberty will continue. Puberty suppression is generally continued for a few years until you decide to proceed with hormone therapy or stop the medical gender affirmation process. 

Hormone therapy is what it sounds like — taking hormones of your identified gender. For male-to-female affirmation the hormone is estrogen. For female-to-male affirmation the hormone is testosterone. In most situations hormone therapy is reserved for ages 15 and up and can continue throughout the rest of your life. It’s also worth mentioning that if you have a uterus you will likely menstruate regardless of testosterone therapy. If you would like to stop your period, there are additional medications that can be administered (such as Depo). 

The final step of gender affirmation is surgery. This is typically offered to adults only but there are a variety of surgeries that can be done to help you reach your desired level of gender expression. 

Just a heads up: almost every doctor will want a diagnosis of ‘gender dysphoria’ made by a psychiatrist before they proceed with any of the above. We can talk about that, and how controversial the term ‘gender dysphoria’ is, another day.