How to Become a Woman: Male to Female Transition

This article was co-authored by Inge Hansen, PsyD and by wikiHow staff writer, Danielle Blinka, MA, MPA. Dr. Inge Hansen, PsyD, is the Director of Well-Being at Stanford University and the Weiland Health Initiative. Dr. Hansen has professional interests in social justice and gender and sexual diversity. She earned her PsyD from the California School of Professional Psychology with specialized training in the area of gender and sexual identity. She is the co-author of The Ethical Sellout: Maintaining Your Integrity in the Age of Compromise.

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You’re ready to finally step out into the world as a woman, and we’re here for it. Your transition from male to female may take years to complete, but you can achieve big changes in just a few months. We’ll guide you through all the steps of mtf transition, and we’ll help you decide which ones are right for you. What are you waiting for? Let’s get started!

Hormone therapy often begins with testosterone blockers, like spironolactone, then moves on to estrogen. The medications change your skin, body shape, hair growth, and sex drive. The changes can start in as soon as 3 weeks.

Hormone Therapy

• If your insurance requires pre-authorization, ask your doctor to fill out the template, then send it into your insurance.
• If you get insurance through work or school, you may need to ask your employer or school to remove exclusions against transgender treatments before you can get coverage. [2] X Research source Send this letter to your employer or school if you need to get your medical treatments added to your insurance benefits.

• At your appointment, talk to your doctor about your health history and your fertility concerns.
• Your doctor will explain all of your options to you to help you pick the right treatments for you.
• Medically speaking, you can start hormone therapy as young as 16 years old. [4] X Trustworthy Source Cleveland Clinic Educational website from one of the world's leading hospitals Go to source

Ask for a diagnosis if you need one for treatment. Some doctors only provide gender-affirming treatment if you have a diagnosis of gender dysphoria from a psychiatrist. To get a diagnosis, visit a psychiatrist with experience treating LGBTQ+ individuals. Then, you can take their recommendation to your primary doctor or endocrinologist. [5] X Research source

Gender dysphoria does not mean that you are diseased or broken; it simply means that you are not content with living as your assigned sex. [6] X Expert Source

Inge Hansen, PsyD
Clinical Psychologist Expert Interview. 19 November 2019. HRT's purpose is to make you more comfortable with your body. The hormones will alter your body to align with your gender identity. [7] X Expert Source

• This process is called sperm cryopreservation. It’s a super easy process where you masturbate to produce sperm. After that, you’ll pay about $100 to $500 a year to keep your sperm frozen. [9] X Trustworthy Source Johns Hopkins Medicine Official resource database of the world-leading Johns Hopkins Hospital Go to source

• Pills
• Creams
• Patches
• Injections

Expect changes to your skin, hair, and body shape in 3-6 weeks. After you start HRT, your skin will feel smoother, and your body hair should start thinning out. Additionally, you’ll start to grow breasts and develop a curvier physique. At the same time, you might notice your testicles shrinking, and you could have erectile dysfunction. Look for changes in about 3 months, though the full effect will take 1 to 3 years. [11] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source

• There are some risks to HRT, including blood clots, gallstones, weight gain, elevated liver enzymes, heart problems, high triglycerides, high blood pressure, and diabetes. [12] X Research source
• Whether and when to take HRT is a deeply personal choice. Take hormones once you've fully researched your options and feel that hormones are a positive next step for you. Additionally, make sure you’re okay with the fact that the effects may not be fully reversible. [13] X Expert Source