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Hormone Therapy

After a diagnosis of transsexualism, an individual (identified female at birth) who has a male brain sex, is treated with the hormone testosterone. This is the hormone chiefly responsible for the physical changes in boys and men who physically produce their own testosterone.

Testosterone administration under medical supervision for treatment of transsexualism produces gradual changes over a period of time similar to natural male puberty.

Masculinising effects of testosterone usually include:

  • A permanent deepening of the voice
  • Cessation of menstruation
  • Increased strength and energy, lower sleep demands, increased alertness and a slightly higher body temperature
  • Oil and sweat glands become more active which may result in acne (treatable by conventional methods)
  • Slightly altered body odours
  • Increase in weight, and redistribution of excess body fat (away from hips, buttocks and upper thighs, on to the waist and torso)
  • Growth of facial and coarser body hair, similar to other male members of the family
  • Male pattern baldness is a possibility depending on the family's tendency to baldness.

Testosterone will not alter height, size of hands or feet, or bone structure.

Some people report mood swings or heightened feelings of aggression. On the other hand many report the opposite - that the relief experienced through hormone therapy and other rehabilitative steps, results in a calmer, happier, more sociable demeanour.

An Overview of Surgeries

The first thing you need to realise about surgery is that for males it is not just "a surgery" but a series of surgeries. There are a number of options, and a growing number of techniques being performed around the world.

Chest Surgery

This is the surgery most often, and perhaps most urgently, required by men. In this procedure the incisions and reconstruction are carried out with the intended result of a contoured, male-looking chest.

Surgery to Reproductive Organs

Many men undergo complete hysterectomy (removal of the uterus, fallopian tubes and cervix) as well as oophorectomy (removal of the ovaries). Competent gynaecologists routinely perform these operations, though men undergoing such procedures may feel more comfortable accessing the services of someone with a demonstrated awareness of transsexualism, such as a doctor who has treated other transsexual men.

Lower surgery

Some men undergo surgery to reshape genitalia, such as procedures to lengthen the urethra or create a phallus. Currently all options for lower surgery are expensive and carry a high risk of infection and other complications. None of the current methods can produce a totally realistic or fully functioning penis.

Dr David Hunter-Smith, plastic and reconstructive surgeon, offers a more extensive description of lower surgery here.

So He's Having Surgery

Ideas for helping your loved one at this time:
  • In advance of surgery, you could assist him to research techniques and surgeons, discuss questions to ask, accompany him to medical appointments if he would like you to.
  • If money is an obstacle to surgery parents who can financially afford it might lend money for this purpose. Assistance might also be needed to cover loss of income during the recuperation period.
  • Encourage him to live healthily, such as eating a balanced diet and giving up smoking, prior to surgery. This will assist the healing process.
  • Offer a lift to the hospital, be there when he wakes up, visit, send cards, phone him so he knows you care.
  • Look after his pet cat, dog or goldfish.
  • Offer a place to stay with you while he recovers from surgery.
  • Stock his freezer with healthy meals. Help with household tasks especially those involving heavy lifting, or run errands as required.
  • Allow him to talk about his feelings, share in his happiness.

Citation — Elizabeth (2004). Stand by your man (and stay sane in the process!).

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