There are so many varying aspects to what a transgender person might experience when they transition, so it makes sense that a lot of people have questions about what that process is really like. In a recent Reddit thread, Dr. Kate Greenberg, director of the Gender Health Services clinic at the University of Rochester Medical Center, fielded all kinds of questions from users about transgender health. Here is everything you've ever wanted to know about transitioning, but had no idea who to ask.
1. How often does someone regret transitioning?
Though a lot of people might think this happens often, Greenberg says the instances are "fairly low." Greenberg explains: "The World Professional Association for Transgender Health Standards of Care outline the international standard of care for psychological, medical, and surgical treatment of transgender individuals. They strongly recommend collaboration between mental health and physical heath providers, specifically to ensure that this is a successful process with minimized post-treatment regret." However, many transgender people view seeing a mental health provider as unnecessary if they already understand the risks and benefits of transitioning.
2. How effective is treatment at improving the well-being of teenage patients?
According to a recent study from the Netherlands, transgender people who completed gender reassignment starting at puberty felt just as good or better than cis-gender people their age. Greenberg adds: "This is in huge contrast to what we know about general mental health in the trans community, where very high numbers (in some studies, over 40 percent) have been suicidal at some point in their lives."
3. At what age can someone get puberty blockers?
Typically, you can begin taking puberty blockers anywhere from the ages of 9 to 13, depending on when puberty starts.
4. At what age can patients move on to hormone replacement therapy?
Greenberg says that the current standard age is 16, but she hopes the standards will become more flexible so that if patients want to start earlier they can do so.
5. At what age can patients get gender reassignment surgery?
Greenberg says patients can usually get gender reassignment surgery at the age of 18, but as with hormone replacement therapy, the standards are moving toward allowing surgery at a younger age.
6. How expensive is the process of transitioning? Is any of it covered by insurance?
Insurance coverage varies based on where you live, but Greenberg says that in the last five years she's seen a drastic improvement in what is covered by insurance in terms of visits, hormone therapy, and surgery. Greenberg adds that "[Surgical coverage] is still "out of network" and so only covered at 80 percent, typically, which does not cover the cost of transportation, recovery stays near the surgeon, etc."
7. If a transgender individual transitions from male to female, do they go to the gynecologist for their future care?
Greenberg says that transgender patients need trans-specific primary care. She also asks her patients for an "organ inventory" when she first meets them so she can know what surgeries they may or may not have had so that whatever parts they have, she can take care of them as well as possible. Greenberg explains: "A transman who hasn't had a hysterectomy/oophorectomy will need cancer screenings for those body parts as recommended by standards of care for cis-women. A trans-woman who has had vaginoplasty will not need PAP smears, but will need clinical breast exams and breast cancer screenings like a cis-woman. Trans women will always have prostates, regardless of surgery, and so will need screening there. And trans men who've had chest reconstruction still need breast exams, and with a significant family history of breast cancer may also need additional imaging for cancer screening."