By: Plume Community Member (she/her)
- Changing how you socialize and feel seen as a transfeminine person
- Exploring your options for physical changes during your transfeminine gender transition
- Your transfeminine gender transition might be more than hormones
- Gender-affirming surgeries for your transfeminine gender transition
- You are the boss of your own transfeminine gender transition
Every trans person gets to decide what aspects of transition are right for them. It’s important to understand what’s available to you so that you can pursue the components of social transition, surgeries, and hormones that will bring you gender euphoria and help you feel at home in your body and spirit. Transition for MTF folks who are gender non-conforming (GNC), trans women or trans femmes, is very different from our FTM, trans men, and trans masc counterparts.
Changing how you socialize and feel seen as a transfeminine person
Many transfeminine people start with a social transition. Social transition can look like changing your name and pronouns, integrating more “feminine” clothing into your wardrobe (such as dresses, skirts, heels, and blouses), wearing wigs, and wearing makeup and jewelry. Many trans people try out new names and pronouns with a few trusted friends before sharing them with the world.
Even on hormones, our voices do not change, so many people who wish their voices were more “feminine” pursue vocal training. Beginning any kind of transition can bring about deep emotions so it’s recommended that you see a trans-competent therapist for your mental health. Plume offers support groups to our Members, which are safe spaces to share your feelings about your journey.
Exploring your options for physical changes during your transfeminine gender transition
If you decide to pursue a physical transition, you will meet with a medical provider, such as your Plume Care Team. They can evaluate any health risks and prescribe hormones, blockers, and other medications as part of your medical transition.
So you know, Plume follows the widely-accepted and clinically-proven informed consent model. This means that you will be able to access gender-affirming hormone therapy as long as you are “of sound mind.” It’s also important that you are aware of all side effects and complications that your medication may cause. When you begin gender-affirming hormone therapy (GAHT, sometimes also called hormone replacement therapy or HRT), your Care Team will help you understand your care plan and its effects.
If you are wanting to transition as a transfeminine person, your medical provider will likely prescribe you an androgen blocker (spironolactone is most common) and a low dose of estradiol, increasing your dose over time so as not to shock your adrenal system. Too much too fast can be uncomfortable, so follow your Care Team’s guidance and be patient. Within a few months on E, you’ll likely notice changes to your skin texture and your hair growth patterns. By the end of your first year on E, you may look and feel very different! You can learn more about the physical effects of E on the Plume blog.
Your transfeminine gender transition might be more than hormones
Hormones do lighten facial and body hair and slow growth, but they do not cease growth altogether. You may find that you need to shave less, or wax less frequently. You might also notice that your facial hair is finer after 6-9 months on E. Some girls prefer to keep their facial hair, while others can’t wait for their next waxing or threading session.
If you’re interested in permanent hair removal, you may want to begin before you start hormones. Estrogen will make your skin more sensitive over time. This means that hair removal with electrolysis, laser, or other treatments will be more painful after you’ve started GAHT.
Laser hair removal is good for people who have dark hair and light skin. (The laser works by targeting the pigment, so if your skin and hair are close to the same shade, it’s less effective). Laser hair removal is not approved for permanent hair removal, but it does greatly reduce hair growth and lighten the remaining hairs. Laser hair removal feels like an intense pulse of heat on your face as the laser zaps your hair follicles. Some people say it feels like a snapping rubber band. Your aesthetician can adjust the intensity of the laser to your pain tolerance. A lower intensity may mean you need to have more treatments, but you will still see some effects. After your treatment, you may see pink or red dots on your face where the laser was applied. You will need to use sunscreen and protect your face from sweat, sun, and any irritants for about 24 hours.
One aesthetician I talked to let me know that most people notice significant decrease in their hair growth after 4-6 laser treatments. However, she said that the average person needed “about a year”of treatments to see permanent hair growth elimination with laser treatments. On average, people get laser hair removal every 4-6 weeks, depending on how their skin tolerates the laser.
After you’ve finished with laser treatments, you can move onto electrolysis to remove what’s left. Electrolysis is a permanent hair removal option. An aesthetician uses a special needle that is charged with electricity to “kill” your hair follicles. The needle is inserted into your follicle and burns it so that it no longer produces hair. This procedure takes time, and the waiting lists for experienced, trans-friendly aestheticians can be long. However, if you can stand the pain, electrolysis is considered the gold standard for hair removal for trans women. (Some folks even get their insurance plans to cover it!)
Gender-affirming surgeries for your transfeminine gender transition
Once you’ve been on hormones for over a year, you may want to pursue gender-affirming surgeries (GAS). Often, surgeons recommend that you stay on estrogen, spironolactone, progesterone, and/or T-blockers in order to let your body “settle” into its new shape. Your skin will change while you are on E, which can affect how the surgery is done. Depending on whether you are paying out-of-pocket or using your health insurance to pay for your gender-affirming surgery, your plan may require you to be on hormones for a year before they will cover GAS.
Some types of surgery that your transfeminine transition may include are bottom surgery, breast augmentation, and facial feminization surgery (FFS). FFS may include a brow shave, tracheal shave, brow lift, rhinoplasty, hairline advancement, and other procedures, all typically done at the same time. Bottom surgery is a term that applies to several types of procedures, including orchiectomy (removal of the testicles), labiaplasty (creation of a vulva, clitoris and labia), and vaginoplasty (creation of a vagina, vulva, clitoris, and labia).
You are the boss of your own transfeminine gender transition
Some people find gender-affirming hormones and surgeries essential and affirming, while other people don’t need them. As a transfeminine person, you are empowered to make those choices for yourself with the support of your Care Team.
Remember, every trans person gets to decide what factors of transition are right for them. Think of hormones, surgeries, and elements of social transition as many different items in a grab bag. You can take what works for you and leave the rest!
As you move forward in your transfeminine gender transition, the most important thing is to honor yourself and your needs. Whether you seek to look more feminine or simply feel more confident and comfortable, you have many options for gender-affirming care that will help you reach your transition goals. You can do it!
This Plume Community Member (she/her) is a transfeminine creative and freelance writer. She lives in the Pacific Northwest with her wife and dogs.
As the largest provider of gender-affirming care for the trans and nonbinary community, Plume is committed to providing information about many types of information, including questions about hormones like estrogen and testosterone, gender transitioning tips and experiences, and guidance on social transition and self care.
While we strive to include a diverse range of voices and expertise, not everything will be for every person. Each individual’s experience is unique, and the information Plume provides is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Always first seek the advice of your primary and/or specialist physician, the Plume Care Team, or other qualified health provider with any questions you may have regarding a medical condition, your mental health and emotional needs, or your health care needs regarding gender-affirming hormone therapy. If you are experiencing an emergency, including a mental health crisis, call 911 or reach out to Trans LifeLine.
