Gender Affirmation Process (Reading)

When someone identifies as trans, they may want to undergo the process of gender affirmation (or transition), which means acquiring the visual characteristics, physical features and the social role that is in accordance with a person’s gender identity. Transition thus has three main aspects:

• Social – change of name and pronouns; adjusting visual expression; performing the desired gender role
• Physical/medical – hormone replacement therapy (HRT), surgical changes (gender affirmation surgery – GAS)
• Legal – change of legal gender marker and legal name

There is no right way to transition, transitioning in all three aspects doesn’t mean someone is a “real trans” or “better trans”.

There is a lot of variation in trans persons’ desires and needs regarding transition, a lot of them desire/need social and legal transition, but no or very little medical procedures (such as hormone therapy and gender-affirmation surgeries). This can be the case for trans persons feeling comfortable in their bodies with very little dysphoria.

The three aspects are not independent, they infform the decision to transition in highly complex ways. The reasons for physical changes are different and very individual: while some want to address physical discomfort, for others it is more important that others perceive them and react to them in accordance with their gender identity – thus physical transition helps them with the social aspect.

But the transition process has many other factors  besides one’s gender identity: while some undergo medical transitions for  psychological or health reasons, many won’t because of some obstacle (fear of surgery, health problems, legal restrictions, etc.). Unfortunately in some countries, those who want to change their gender legally, have to undergo surgical sterilisation – thus the desire/need to transition legally can strengthen the desire/need to transition physically.

Everyone’s journey is different. Transitioning can be an overwhelming process with many dilemmas and even grief: these difficulties do not mean someone made a wrong decision about tranisitong, but are natural parts of the process, in which proper psychological and emotional support makes a big difference. It is worthwhile to note that transitioning can be – or can be helped to become – a joyful and freeing experience too.

Further resources

You can learn more about the gender affirmation process from the Volume 7 of the Standards of Care, available in 18 different languages.  https://www.wpath.org/publications/soc

The World Professional Association for Transgender Health (WPATH) have created Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People based on the best available science and expert professional consensus. The overall goal of the SOC is to provide clinical guidance for health professionals to assist transgender and gender-nonconforming people with safe and effective pathways to achieve lasting personal comfort with their gendered selves, in order to maximize their overall health, psychological well-being, and self-fulfillment.