beautiful butterfly

Transsexual people face a unique set of emotional health issues. Living in a body that feels foreign, and being perceived widely as a gender that feels wrong and unnatural is enormously challenging. In addition, the process of transitioning to the other sex brings up a myriad of specific challenges, some anticipated and others harder to predict.

Transsexual people typically take cross-sex hormones throughout their lives and they may also undergo surgeries to change their bodies. Both the hormones and the surgeries can have specific health effects that need to be acknowledged and monitored to maintain the good health of a transsexual person.

Persons who are contemplating the process of transitioning from male-to-female (MTF) or female-to-male (FTM) may encounter a range of emotional reactions both in themselves and among those around them. Some of these reactions may be anticipated and prepared for; others may be unanticipated and difficult to manage.

From a very early age, our culture makes a large and specific set of assumptions about individuals based on perceptions of gender. Sex role socialization is a powerful force that our culture uses to define "appropriate" and "inappropriate" boundaries and activities for each gender. Transgender individuals often experience anxiety and stress as they attempt to fit into a gender role that may match the outward appearance of their physical body but not their emotions or their more internal sense of their gender.

Relief

The decision to transition is often the result of a long and difficult process. Many transgendered individuals identify a sense of great relief that comes with finally being able to acknowledge their true selves and live in the body and gender role that is most natural for them. Transgendered people often feel enormous satisfaction at watching their bodies change with hormone treatments and surgeries, and at being seen by others as they feel themselves to be inside.

Although societal acceptance of transsexual and transgendered people is far from complete, there is a growing and active community of transgendered people, both MTF and FTM, particularly in the coastal areas of the United States. There are also increasing numbers of books and online information and support for people transgendered people.

Difficulties

The transitioning process can also bring with it a new set of difficulties (and sometimes dangers) that result from the reactions of acquaintances, loved ones and the larger society to the transitioning process.

New problems that may arise include:

• Employers and colleagues who are not prepared for, understanding of or sympathetic to the issues of transgendered individuals. Many individuals find themselves either fired from their jobs or facing workplace hostilities that force them out of employment. The risk that individuals will experience acts of hostility and even violence directed against them is real.
  
  
• Family members and friends who are not able to understand or accommodate the change process. Many transgendered persons begin the transition process long after they have married and raised their own families. Spouses, domestic partners, parents, children and close friends may be confused by the transition that is occurring and will need education and support to help them deal with what is happening. Some relationships end; others are able to survive the transtioning process. Sometimes children remain emotionally close to the transitioning parent; at other times children have taken years to reconcile with the transitioned parent, if they ever come to terms with the issue at all.

Most importantly, the person who is in the midst of transition her or himself may be surprised at the feelings that emerge during the process. Being able to identify and work with a counselor or therapist who has expertise in transgender issues is critically important as the individual begins to explore the realities of becoming more fully themselves. Individuals socialized and seen their whole lives as male may experience significant difficulties as they begin to live and function as female, and visa versa.

The journey across the gender divide is rarely an easy one. The combination of physical and emotional issues that can emerge can make the transitioning process a time of increased stress and risk for symptoms of depression, substance abuse, and anxiety.

Despite this reality, most transgender individuals report that the joy they experience in becoming more fully themselves makes the journey worthwhile.

Transsexuals are persons who identify so strongly with the other sex or gender (biologic females who identify as men and vice versa) that they change their bodies, through hormones and sometimes surgery, to look and feel more like the other sex. Following transition, transsexual people often function quite normally in society in their sex of reassignment, and often those around them do not know that they were born the other sex. They may be straight, lesbian, gay, or bisexual -- gender identity is neither the same as, nor is it necessarily related to, sexual orientation.

Biologic females who transition to live as men are also called transgendered (transsexual) men or FTM (female to male). Biologic males who live as women are called transgendered (or transsexual) women or MTF (male to female).