FtM Medical Transition 101

Posted: September 13, 2015 in Uncategorized
Tags: , , ,

So what’s involved in female-to-male transitioning?


Generally speaking, transition can be split into two pieces: social transition, and medical transition. In some countries, legal transition could be considered its own unit but in many countries legally becoming your chosen gender is very patchy and complex, and is completely bound up in social transition, so for the purposes of clarity, I’m sticking with these two lumps.


Social transition is what it says on the tin: it’s transitioning as far as society and your social life are concerned. That basically encompasses going about your life like you’re already your preferred gender, as much as possible. For me, this was largely about changing my name, coming out to everyone who knew me, wearing men’s clothes, and adopting a male position in life as much as I could without medical transition.


Sometimes, social transition is enough. Sometimes it’s not, and people choose to also medically transition. That is, they undergo medical procedures to bring their physical body far more into line with their gender than it originally was.


Key point: some transgender people do not medically transition. It doesn’t make them any less transgender, and anyone who says that it does is a dick.


Medical transition is very different for MtF and FtM people, and my experience wholly lies with FtM transition, so that’s what this post will focus on.


Basically, there’s three main steps: hormone treatment, top surgery, bottom surgery. Typically, they’re in that order too.


Hormone treatment is basically being prescribed testosterone by a doctor. It’s known as T generally within the trans community, because it’s a long and clumsy word, and T more or less puts you through puberty. Over time, your voice drops, you grow body hair in places you didn’t before, your sex drive sometimes changes, and in the short and mid term, some people have felt very aggressive.


Top surgery is removal of the breasts and re-contouring of the leftover tissue and skin to create a masculine chest. It’s not quite the same as a mastectomy, but it’s very similar to us laypeeps. The procedure is a major surgery, conks you out for a while, and leaves scars. But hopefully over time the scars fade to the point you can’t see them. Google ‘topless transman’ to see some results.


Bottom surgery is kind of two things: one version is removal of everything feminine between your ribs and your knees, i.e your uterus, vagina, etc. The other version is lengthening of the urethra (can’t spell…) to create effectively a micropenis. Bottom surgery is actually pretty unusual and the majority of transmen don’t do it. Moreover, removal all the ladybits can have major health complications and surgeons can be pretty reluctant to do it unless your dysphoria is exceptionally bad relating to it.


Those are the extreme basics. Each ‘step’ is very complex and individual, can be done out of order, and is wholly dependent on the individual undergoing transition. So here’s a case study: me.


Generally, I can pass okay at the minute. Except in the summer. This is a photo taken in June by the North Sea, so it was cold enough to wear a jacket. Because the problem is that I have a massive rack. Seriously, 30F. And when it came to medical transition, I knew what had to happen.


I was not brought up in a trans-friendly area. I don’t currently live in one. So for me, I needed to be able to switch very fast between ‘looks female’ and ‘looks male.’ In the winter, I already look male, but in the summer, there’s not a hope thanks to my chest. So I opted to have top surgery first. See this post for a rant about how difficult that was!


In November, I will have my top surgery. Some time after that, I will start hormone treatment. And I won’t have bottom surgery. That’s what medical transition is for me. Other guys have had bottom surgery. Some guys haven’t had top surgery. One guy I know isn’t going on hormones because it’ll wreck his singing voice and that’s more important to him than the funny looks he gets now when he speaks.


Medical transition is formed on the basic steps — but the journey through those steps, which ones to take and which ones to skirt around, is entirely individual.






(Major apologies for skipping a week — I went camping, and had no access to the online world. My bad.)

  1. Suites says:

    Hey…I just wanted for chime in about bottom surgery…it works and there are great results. There are a lot of guys who get bottom surgery. Take a look at my blog and let me know what you think https://tboisuites.wordpress.com/2015/07/27/bottom-surgery-my-thoughts-feelings-and-everything-else/
    Good luck on your journey.

    Liked by 1 person

    • Oh I know, my point was more that it’s not necessary to ‘count’ and everyone does things differently. Like for me I just don’t want to, whereas I have a friend who can’t have bottom surgery for medical reasons and he’s really cut up about it, poor guy.

      Liked by 1 person

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s