Transitioning early in life: Sarah's advice

In May 2006, I received the following note from Sarah,* a young woman who financed her transition and education as a dancer in Las Vegas.

[* name changed to protect her privacy]

My name is Sarah. I am 30 years old. I started my transition when I was 18, upon moving to the “Big City” of Pittsburgh for college. I immediately began therapy at a local gender clinic there. Four months later, over Christmas break, I “came out” to my family. I was fortunate to receive their support. At age 19, I had began hormones, changed my name, and started living full-time. I had my SRS in Montreal when I was 21. I saw Dr. Ousterhout several times in my early 20’s to have my forehead, nose and jaw refined. I lived in Las Vegas for 8 years. Six of those years were spent working stealth as a topless dancer in a top Las Vegas strip club, which financed all these changes. During that time, I completed two degrees from UNLV, a BA in Psychology and a BSN in Nursing. I am now a registered nurse who works in intensive care, currently earning my masters degree in Anesthesia Nursing back in my hometown.

Things I Would Do Differently

If I had my life to do over again, I would do the following

Confide in my mother at an early age.

My mother knew from the time I was young that I yearned to transition into a female. I think she felt I would come to her with this information when I was ready. But I was convinced for some reason at 5 or 6 that this was such a shameful thing and I absolutely could tell nobody. I still battle those remnants of shame today. I don’t know what one experience or situation convinced me that my gender identity was such a dirty secret. Somehow, I just assumed I would be disowned if I shared it, so I didn’t. Looking back, I feel my gender incongruence was painfully obvious to many family and friends (I played with dolls, engaged in female role-playing with friends as a child, shaved my legs and wore subtle makeup in high school, etc). I suffered miserably with my dysphoria for years, especially in high school when my androgyny and delicate nature was not well received by my peers. I would say that for the first 18 years of my life, I truly endured a personal Hell. My family has been amazingly supportive of my transition. They ended up being my greatest resource. Enough so that I think if I had shared my feelings earlier, it could have saved me a lot of pain in the end. I could even see my mother trying to help me transition if I came to her sooner, perhaps to get hormones or androgen-blockers to soften puberty. I really believe this might have been possible, even 15 years ago and living in a small city.

I would have finished college back in my early 20’s rather than enter the sex industry.

I moved to Las Vegas and became a topless dancer in my early twenties to finance much of my transition, primarily my surgeries with Dr. Ousterhout. I had left university to do so. Once my transition began in Pittsburgh, it never seemed to progress fast enough. Yes, I had cracked the door after so many years of unhappiness, but I wanted that door swung wide open. Plus, being young, I was especially susceptible to that societal pressure to be beautiful. And deep within my heart, I desperately wanted that opportunity to experience life as a beautiful, young woman. I did get that experience. I had had my SRS, breast implants and “the works” with Dr. O. before I hit 25 (See Smartest Things I Did). And while I passed quite easily before, life became dramatically different after these changes. Yet I feel that if I’d just stayed in school a few more years, I would have gotten there in life not much later than that. And maybe I would have avoided a few pitfalls. Dancing tends to exaggerate your vanity, leaves you with that sickness of always wanting more money, and I dabbled somewhat in drugs as a result of the job. Plus, for those precious years in my twenties, I might have had more chances to date more high quality men if not for working as a stripper.

I would have slowed down to explore my options.

Getting what you want doesn’t mean you’ll be happy when you get it.  I vividly recall that urgency I felt while young and pre-op. That compulsion to be “complete” is quite overwhelming. Having lived through it, I wish I could have told myself to relax a bit. My advice to young girls is “you will get there, so do it the right way.” In some ways, I rushed through my transition and multiple surgeries because I thought people (especially men) would love me more. In the end, I just needed to love myself more. Seeing some of my girlfriends have successful relationships with men while still pre-op is a key example. Sometimes I think such a relationship while I was pre-op would have greatly encouraged my own self-acceptance, a process still ongoing for me today.

Realize that surgeries are the easy part of the transition. Adjusting to life as a post-operative transsexual woman is the real, lifelong challenge.

The pace of change on the outside doesn’t necessary mirror the pace of change and adjustment within. This is a lesson I had to learn. We often attribute such magical qualities to SRS and feminizing surgeries, as if they can cut away the pain and insecurities, etc. After my physical transformation was done, I realized how much I had yet to learn. From the outside, things looked fine with me. I am fortunate to pass quite undetectably in my life. Living in Las Vegas and doing the work I did (where you really can’t hide anything), I had to pass exceptionally well. Yet I learned in the real world that there are also prejudices against girls who are too pretty, funny as that might sound. A hyper-feminine appearance can sometimes work against you. Some women can be very threatened by beauty. And men aren’t necessarily looking for the prettiest girl for the long-term. I had to learn how to be gracious and go out of my way to make others around me comfortable, as their own insecurities come up around beauty. I truly believe those of just slightly more attractiveness than average are in the best position, and often have happier lives.

Discovering your place in this world and how you make your peace of it (with family, with your spiritual beliefs, in intimate relationships, in regards to never having children, when and if to tell “straight” friends), is your personal journey. Questions regarding your roles and how to deal with life come up over and over. You will find they do not have constant answers. Sometimes you will go to a new family doctor for a hormone prescription and they will obviously be uncomfortable in treating you. Some men will fall deeply in love with you. Yet when you share your past with them, many will be utterly shaken. Many men go through a process of questioning their sexuality and masculinity, regardless how “convincing” you are or how well you treat them. “Regular” girlfriends you’ve had for years and decide to confide in may suddenly become distant. Many people (granted, the wrong people for you in your life) feel betrayed that you kept such significant parts of yourself a secret so long. Changing one’s sex, for as far as it has come, is still quite shocking to many people. Some do not even know how to comprehend when you tell them. Your credibility or even sanity may be questioned. Some people simply aren’t open to the idea and never will. And that’s okay. In these cases, we must do what we have always done: be ourselves and be secure in the fact we lived our lives according to what our hearts told us.  We also have a great opportunity to educate people. But realize, there may be many turns on the path that are painful. Prepare yourself for them, as they never totally go away.

I recommend everyone research and choose their surgeon carefully.

You will live with your SRS for the rest of your life. And your first shot is your best (or only shot). So do your homework, talk to people, decide what will best serve your needs. Go with an established, well-experienced surgeon. Save up an extra year or two if necessary. It is the best investment you will ever make.

Smartest Things I Did

Prepared myself to lose everything when coming out. 

I finished high school before transitioning. That was my backup plan. I prepared myself at least that much education because I did not know how my family would respond. And I felt I needed to have a high school diploma if I were to survive. Also, I had the phone numbers and addresses of two friends I could go to if need be when I “came out.”  I ended up not needing those friends on that day, but the need to have support at this time cannot be overstressed.

Transitioned at an early age.

I am so grateful to have been able to start living as a woman so young. But yes, this is a double-edged sword. I did get to have many of the experiences other young girls have (being in sororities, having work experience, perhaps a smoother transition into the female role). Yet I was so lacking in life experience, partly because I kept myself so socially isolated in high school.  It took me a good many years after my physical transition to melt seamlessly into my new role. The fortunate part: being in my 20’s, I had plenty of energy and social opportunities to go out and do it. At age 30, I have now been socialized as a female for more than 11 years.  And I feel very secure in that role. I even have sisters or “regular” girlfriends who look to me for advice on life and dating sometimes. That makes me feel like I have arrived as a woman.

My “first time” was with someone I loved.

I took a long step back after my surgery. I needed to heal, both physically and emotionally, from my wounds. It’s almost unreal for the first few months afterwards. For so long, gender issues had been the insurmountable struggle. Then suddenly, you are over the mountain. That takes time to sink in. I know at that time for me, there was also a sense of “now what?”  Indeed, what does one do after making the ultimate change--from male to female? And if you did as I did, focusing all your attention and energy on that goal, it is a valid concern. Yes, now you live your life as a woman, like you always wanted to. But it takes time to just pick up and start going again. Then, there is the issue of amalgamating back into society. And sometimes filling in the gaps of what you’ve been doing over the past year or two to new friends/ acquaintances presents a temporary obstacle. Yet another enigma for me was entering into relationships. . .

Almost a year after my surgery, I made the acquaintance of one very handsome young man. Things progressed innocently, I was 22 and he 21 at the time.  We grew to care very much about one another over a period of several weeks. Eventually, I did tell him my history. He was taken aback by this information. But he remained with me and we continued to date. Over one weekend, about a month later, we made love for the first time. It was my first time. And he was my first love. I genuinely was in love with him at the time. Ultimately, things did not work out between us. We are still friends to this day, however. And looking back, I was glad I waited (almost a year) until I found someone I loved. It was one dream I am glad I let come true.

I underwent FFS.

For any TS who transitions post-puberty, I think of FFS as the gold standard. When done by a qualified surgeon, it will always tilt the scales in your favor. Again, I was a teenager when I transitioned and passed easily before FFS. Yet since facial surgery, I have never felt insecure by the way someone glanced at my face. From a quality of life perspective, the benefits of facial feminization cannot be understated.  While it won’t necessarily make you beautiful or stunning of its own right, it definitely removes the indicators of maleness.

As a side note: my family and friends often expressed great concern over my seeming “obsession” with plastic surgery while pursuing FFS. Most people consider all that surgery to be a sign of body dysmorphic disorder. You may find similar reactions from your loved ones. Take comfort in that you are returning your body to how it would have been had testosterone not intervened. Take the time to explain that to loved ones. Afterall, a disabled person might be able to walk with a limp after one operation. But she would have 10 operations if it meant she could walk completely normally, without anyone knowing she was once disabled. We are certainly no different.

I honored my spirit.

Spirituality is one thing we tend to put last on the list in our society. Yet I found a deep need to honor my spirit through this process, as what we do seems to transcend the body.  Find your spiritual belief and get in touch with that part of you that is more than just flesh. Take time to meditate or pray or write in a journal (one thing for me that was very healing and is a record of my progress over the years). Find purpose in your life and in your journey. This may help you keep pace inside with all those magical changes on the outside. This period of transformation often has “larger than life” moments and a “larger than life” presence may help you integrate all of it.


Send me your thoughts, links, and advice!

If you transitioned in your teens or twenties and have any advice you'd like to share, please contact me , and I'll give it a permanent (and anonymous) home.