gender nonconforming

We hope every time you open up to someone about your truth they respond with love and kindness. But we also want to make sure you're prepared in case they don't, and give you some practical strategies and tools to look after yourself if that’s what happens. With that in mind, here's a new, totally non-exhaustive, step by step guide to coming out.

They call it “feminization surgery,” but that’s a bit of a misnomer. More accurately described, it tends to make the features of the face finer and more delicate, and people of any gender can have delicate features.

In vaginoplasty, which may require multiple surgeries, depending on the surgeon’s preference and your case, your existing genital tissue is creatively recycled into a vagina, set of labia, and a clitoris.

If you’re equipped with a clit and some labia and you’d like a penis (with or without testicles), you’re looking at either a phalloplasty or metoidioplasty. The procedures have different advantages and disadvantages that you’ll want to consider before making a decision.

In this procedure, the surgeon removes the testicles with or without the scrotum. This procedure stops the production of testosterone, which allows patients to adjust their doses of anti-androgens and estrogen.

If you’ve got a uterus and you don’t want one, you’ll be spending some personal time with a gynecological surgeon.

Depending on how old you are, where you live, and the specifics of your situation, you may start with “blockers,” also called puberty blockers or puberty inhibitors (or, more formally, GnRH agonists). These drugs do pretty much exactly what it sounds like they do: they block the release of hormones from the pituitary gland, thus putting a pause on puberty.

If you’re a little older, or you feel confident and ready to transition after being on blockers and your doctor thinks it's reasonable to do so, you may start taking estrogen and an androgen blocker if your body would otherwise naturally produce testosterone. You may hear estrogen referred to as a “feminizing hormone” or “female hormone,” which is a term I dislike because you may not necessarily be taking it to achieve a “feminine” body if you’re nonbinary or otherwise gender nonconforming, and lots of people who aren't women produce estrogen naturally. You can just call it estrogen!

If your body is longing to pump out some estrogen and you’d rather it didn’t, your doctor will start you on testosterone therapy. Estrogen blockers are also available, but they aren’t widely used — usually your testosterone will be enough to do the trick. You may also hear testosterone discussed as a “masculinizing” or “male” hormone, but it doesn’t have to be either of those things for you unless you want it to be.

After social transition, many people face the question of whether they also want to pursue medical (hormones) and/or surgical transition. In this post, we’ll be discussing hormones — our following post will delve into the nitty gritty details of “the surgery” (starting with the fact that there’s not just one).