Editorial

Being A FtM Transgender Person (Pre and Post T)

Samael McCormick

Before we delve into the social aspects of being a FtM (Female to Male) transgender person, it could be helpful to explain some of the medical aspects regarding transitioning and intertwine them with both my own experiences and the experience of a friend.

Typically, the first step in transitioning is coming out socially. Whether it be to friends, family, or even the community you live in, the biggest- and sometimes scariest- part is the first one. Personally, I publicly came out on July 18, 2018, to my “finsta” (a private Instagram). I decided to add the post in, even though it’s kind of cringy. 

“COMING OUT STORY!!!: I found out what this was in like the 7th or 8th grade, and ever since that day I feel like I have known who I am. I spent a long time pushing it down and denying it because I wasn’t comfortable with the realization and how far it strayed from the belief of the bible and how it wasn’t made to be god’s will, but I’ve recently become very comfortable with myself so I decided to come out to my spam! I know it’ll probably get around and I don’t really mind, I expect it to. I trust the people on here but sometimes y’all can’t help but spill that tea so!! I’m trans! I’ve known for a long time. (yall can stop reading here because it’s mostly just about whack stuff the juice is over) I’ve been so comfortable in my body and I recently got a binder!! I feel like it makes me look more masc which makes me really happy. I don’t know what else to say about it but hopefully, u see me the same! if not that’s okay, we all have our own opinions even if they are wrong 🙂 I don’t expect people to start using my preferred name or pronouns so yall ain’t gotta trip, I wasn’t even going to come out till college but I felt like it was a good time. much love, asher (also please don’t be upset if we are close and I didn’t tell you, it’s still very hard for me to come out to people I’m close with but feel free to ask me questions I love u)”

This was a momentous step for me, but was also so relieving- I had so much support and a weight was lifted off of my shoulders. It’s insane to look back at this kid and think “wow, that was me”. I’ve been out to my mom since I was about 16 and recently came out to my dad over this past winter break. Merry Christmas! I’ve presented fully as male since coming to Menlo, going by Sam and he/him pronouns. Being here has taken a positive toll on my mental health because of this alone- plus the amazing support system I have on campus. 

As for my friend Jordan, 

Jordan didn’t really feel the need to come out on social media or anything, after I came out we started talking about it, and he came out to me. Soon after, Jordan started T (he was 18-19 at the time) and came out to his family and girlfriend but didn’t feel the need to post about it. 

The second step that most take is starting HRT, otherwise known as Testosterone, or “T”. I wasn’t really allowed to start T while on my parent’s insurance, so I got my own and should be starting in July! Some insurances require steps before starting, like seeing a gender therapist and being diagnosed with gender dysphoria. I was diagnosed with GD in November of 2019 when I first started going to see my gender therapist. Jordan, surprisingly, didn’t need to see one and was granted his T usage after meeting with his doctor and talking to her about the situation. 

With the usage of testosterone, there are some changes that will happen physically. The most common/noticeable change is the ones regarding the voice. When you start T, your vocal cords become thicker, which leads to the change in octaves.  There’s a high chance of having bad acne, as your skin becomes more oily. You sweat–a lot–more, your scent changes, you have an increased appetite and metabolism, even the shape of your body changes as fat is distributed to different areas. A really useful article that I found for what to expect (if you are interested in learning more) is posted at the bottom of the article.

After being on Testosterone for 6-12 months (depending on the provider) top and bottom surgery becomes an option. Top surgery is not always an option for all transgender people, but until then, most try and wear “binders” which are chest-flattening pieces of clothing worn to minimize/flatten the chest area. Binders have been especially useful to me, and I’ve been wearing them for about 3 years now. 

Going back to the topic of top surgery–one must have a letter from a mental health provider to even be seen for a consultation. Jordan is having trouble with this part, as most providers are booked for months in advance in regards to these types of situations. I have to be on T for a certain number of months before I’m able to even consider getting my letter, but it will work out and I am sure time will fly. 

There are several types of top surgery procedures. If one has a small chest, they are able to do the “keyhole” incision, where “a small incision is made under or across the lower border of the areola” (genderconformation, 2020). This is done for people with small chests because, while it can remove the tissue within the skin, it cannot remove any excess skin. The “periareolar” incision is good for people with a medium-sized chest. In this procedure, “a circular incision is made all the way around the edge of the areola to remove chest tissue. A slightly larger ring incision is then made to remove excess skin. The skin is pulled taut toward the center and the nipple is reattached… another vertical incision that extends below the areola may also be necessary to target additional excess skin” (genderconformation, 2020). The periareolar is more common, along with the “double incision” approach. In this procedure, “a horizontal or U-shaped incision is made on the lower border of the pectoral (chest) muscle. The skin is peeled back so that chests and fatty tissue can be removed. Another incision is then made to remove the nipple” (genderconformation, 2020). This is done for people with bigger chests. There’s an approach much like this one, except there is no free nipple graft needed. It means that, while there is less risk, the chest may be bigger than normal after the surgery. This is called the “inverted T (anchor)” incision. This procedure keeps the nipple and areola attached to native body tissue, avoiding the need for a free nipple graft. The final incision is the “fishmouth”, where the incisions are higher on the chest, nearer to the chest muscles. “However, it requires the final areolar position to be in line with the scar, which is not a natural proportion between the areola and the shadow of the muscle, which this scar is trying to mimic” (genderconformation, 2020). This procedure is not commonly done unless by non-binary people because the scar will look less like the outline of a pectoral muscle, as it instead scars straight through the areola. Jordan and I are probably both getting the double-incision as it is the most commonly done. 

Bottom surgery is a little more complicated, and most trans guys don’t always want to get it done because of the complications and the length of the process. Jordan doesn’t want it because of these reasons, while I plan on getting it as soon as possible. Most of the time, those who have severe bottom dysphoria are the ones who choose to get the surgery. There are two types of surgery- phalloplasty and metoidioplasty. The metoidioplasty is the easier route to go because, after taking HRT, the clitoris grows a few inches. In a regular metoidioplasty, this part is moved to an area so that it will resemble a penis. In a “full” metoidioplasty, there is urethral lengthening. There is skin taken from the cheek or lower region that connects to the new penis and makes one able to pee. However, you can’t really have sex if the metoidioplasty is done which is why most trans people opt for the phalloplasty. This procedure involves making the neopenis 5-8 inches bigger by using skin from (most commonly) the forearm, thigh, stomach, or back. 

There are always many risks and side effects when these procedures are done. Some are even unable to have any of these reassignment surgeries. Luckily, things like this are becoming more common and spoken about. I hope that someone was able to learn something from this article, and I hope to be able to share more about my experience and journey as I move forward. 

I have also linked some very useful articles on how it may be easier to start using the correct pronouns for a person, what to do when you misgender a person, and added in some other articles for information. One thing that I would like to add is that, myself personally (and many other trans/ non-binary people) would rather be asked pronouns than assumed. I try and not be impolite as it’s hard to correct someone without seeming aggressive, so hopefully, these will give some insight. 

  • One of the most useful articles I have found that explains A LOT 

https://www.glaad.org/transgender/transfaq

  • When and how to ask about pronouns

https://medium.com/@devonprice/when-how-to-ask-about-pronouns-b7fc24df6653

  • How to start using correct pronouns when someone comes out (this article focuses on they/them pronouns but can be applied to she/her or he/him)
  • How to correct yourself after using the wrong pronoun- Please! Do not be embarrassed. One of the best things you can do is correct yourself. Knowing that people are actively trying to get my own pronouns right feels much better than letting the mistake hang there.

https://www.mypronouns.org/mistakes

  • More information about HRT/ Testosterone

http://www.ftmguide.org/ttherapybasics.html

https://transcare.ucsf.edu/article/information-testosterone-hormone-therapy#:~:text=The%20first%20changes%20you%20will,practices%20and%20common%20acne%20treatments.

  • Top and bottom surgery 

(Top) https://www.genderconfirmation.com/introduction-to-top-surgery/

(Bottom) http://www.ftmguide.org/grs.html