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Contemplate the decision to transition. Accepting that you are transgender, a person who does not identify with the sex and gender assigned to them at birth, may be difficult, but the world is getting better and safer for trans people all the time. [1]
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Transitioning is an irreversible, risky, time-consuming, and pricey process. Before committing to seeking treatment, spend time reflecting upon the decision. Keep a daily journal. Discuss the process with a close, trusted friend or members of a support group. [2]
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If you've only felt this way for a short time, then take your time. Why do you think you might want to transition? What's your goal? Most of your life will be the same after transition, with the same problems, and perhaps a few new ones you can't imagine yet. Try experimenting, or socially transitioning, before undergoing anything medical.
Consider whether physical transition is really necessary. Many (most?) people are not 100% comfortable with every detail of the personal and social roles and behaviors that might be expected of them based on the body they were born with. But you should feel free to live how you want to, wear what you like, engage in whatever activities you enjoy, and love whomever you choose without having to alter your body.

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Conduct research. Read and learn as much as you can about the transition process. Educate yourself on the benefits, risks, and cost of transitioning. Research the different procedures, prepare yourself to combat discrimination, and estimate the amount of money required to complete your transition. You can gather sources from a variety of places and through different means. Surf the web for information—use keyword searches like "LGBTQ," "male-to-female," or "transgender." Find books and journals at your local library—search by subject in the library catalogue. Members of your support group may also have excellent suggestions. Use them as resources! [3]
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Just because other people are trans doesn't mean you'll connect with them.If your town or city does not have a local trans support group that suits you, consider joining an online support group. If a group has lots of "shoulds" that don't feel right to you — what a trans person "should" be like, what your priorities "should" be, etc. — pay attention to your feelings. Transition is about being yourself, not conforming to someone else's ideals.
Each transition is unique, specific to the individual. You may not require extensive hair removal therapy or you could choose to forego breast implants after receiving hormone replacement therapy (HRT). Even though you may not wish to undergo all of the medical procedures, it is still essential that you educate yourself on the entire process. Your knowledge will help you make an informed decision. [4]
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Come out to your support system. Deciding if, when, where, and how to come out to family and friends is stressful! Like transitioning, coming out is unique to the individual. Your method of coming out has to be right for you! If you feel more comfortable one-on-one, tell people individually; if you prefer to tell everyone at once, gather your close friends and family together. It is not essential that you inform each and every person you know. Be honest with those that are closest to you. Share your story. Ask for their support. Give them space and time to digest the news. [5]
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Try making some LGBT+ friends. Networking with the LGBT+ community can build your support network. Your LGBT+ friends can offer insights and advice that straight and cisgender people wouldn't necessarily know. Reach out, and find some people who have similar experiences to yours.

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Start talking to your insurance firm and saving money. Transitioning is extremely expensive. Some insurances cover parts of the process, but never all of the processes. Ask your insurance company if they will cover therapy, HRT, hair removal, breast implants, or vaginoplasty? If you do not have insurance or your insurance does not cover the treatments and procedures, don't panic! Work with a financially savvy friend to develop an estimate and prepare a savings plan. Once you have an estimate, start setting aside money for the out-of-pocket expenses. [6]
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On average, a Vaginoplasty costs $20,000.00. Laser hair removal can cost anywhere from $25.00 to $150.00 per hour. [7]
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Hormone Replacement Therapy costs between $5.00 and $85.00 per month—this treatment is continued for the remainder of your life. However, this is comparable to cis women's' hormonal birth control. [8]
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The length of the transition process is often determined by your financial situation. [9]
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Start working out and exercising your feminine voice. Experiment with finding your feminine pitch, tone, and resonance. [10]
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Practice transferring your chest voice to your head voice—in other words, speak in a falsetto, or "Minnie Mouse" voice. As you master that, move on to more advanced vocal exercises, such as consciously controlling the muscles surrounding your voice box and Adam's Apple. [11]
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Placing two fingers under your Adam's Apple and lifting up will raise your pitch. Over time, your muscles will pull the Adam's Apple up. [12]
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Seek a qualified therapist. According to the HBGDIA WPATH Standards of Care, you must see a Gender Therapist prior to receiving hormones or undergoing surgeries. Ask your friends in the trans community to recommend a therapist. Browse the internet in search of a therapist experienced working with members of the trans community. Commit to the therapist that makes you feel at ease. However, there is also the option of locating an informed consent clinic such as Planned Parenthood.

Ask clients about your potential therapist's rates, practices, schooling, and level of acceptance.
Ask your potential therapists lots of questions. Inquire about their interest in gender therapy and how many of their clients received recommendations for HRT and surgery.
Informed Consent only requires that you sign document stating understand what HRT will do to you and that you want to begin the treatment. An endocrinologist will confirm your liver and kidneys are healthy enough to take the medications and prescribe them if you are.
If your therapist is not a great fit, don't be afraid to switch to a new counselor! [13]
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Receive a diagnosis. Over the course of a series of sessions, your therapist will evaluate your individual situation issuing a diagnosis. After determining that you have consistently experienced symptoms such as disgust with your genitals, a desire to remove signs of your biological sex, and or a certainty that your biological sex does not align with your true gender, your therapist will likely diagnose you with Gender Dysphoria.

You must experience these symptoms for at least 6 months.
Be honest with your therapist and yourself. [14]
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Gender dysphoria does not mean that you are diseased or broken; it simply means that you are not content with living as your assigned sex. [15]
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Expert Source

Inge Hansen, PsyD Clinical Psychologist

Expert Interview. 19 November 2019.

Doctors write this down so they have justification to give you the pills, therapy, and/or surgery you want or need.
Gender dysphoria sometimes centers around certain body parts, and other times it is more focused around the roles, behaviors, or general appearance with one's assigned gender. [16]
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Expert Source

Inge Hansen, PsyD Clinical Psychologist

Expert Interview. 19 November 2019.

Gender dysphoria does not necessarily mean a sad mood. If you have been feeling depressed or anxious, tell the therapist. You may benefit from treatment for that as well.

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Develop a treatment plan. After diagnosing you with Gender Dysphoria, your therapist will provide you with treatment options. The goal of your treatment should not be to alter how you feel but to help you cope with your feelings and alleviate your distress. In addition to continued therapy, your therapist may recommend that you undergo HRT, which will be administered and supervised by a general practitioner or endocrinologist. [17]
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If you have not yet gone through puberty, your therapist may prescribe puberty blockers. [18]
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Complete your social gender role transition. If you express a desire to have a Sexual Reassignment Surgery, SRS, you must complete your social gender role transition before your therapist will approve the medical procedure. During this period of transition, you will live in your gender identity for one to two years. This will allow you to experience life as a woman. You will dress, go to the office, attend family functions, exercise, and go grocery shopping as a woman. After living through a range of events, your therapist will help you determine if a SRS is the right option for you.
While undergoing this process, continue taking your hormones, removing any body or facial hair you don't want, and finding your feminine voice. [19]
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National Health Service (UK)
Public healthcare system of the UK

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Receive Hormone Replacement Therapy. HRT's purpose is to make you more comfortable with your body. The hormones will alter your body to align with your gender identity. [20]
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Expert Source

Inge Hansen, PsyD Clinical Psychologist

Expert Interview. 19 November 2019.

As a man transitioning into a woman, your endocrinologist or your general practitioner will prescribe you an estrogen hormone regimen. You must receive HRT consistently. Once started, HRT should be continued indefinitely, even after you have undergone a sex reassignment surgery (SRS). HRT can drastically alter your body and for some, HRT is an adequate treatment for their Gender Dysphoria. [21]
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National Health Service (UK)
Public healthcare system of the UK

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However, HRT does not change the size of your hands or the pitch of your voice. It shrinks your testes, but does not remove them. Therefore, others may seek additional forms of treatment to get their desired results.

Familiarize yourself with the risks of HRT. [22]
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Expert Source

Inge Hansen, PsyD Clinical Psychologist

Expert Interview. 19 November 2019.

Expect shrinkage of muscle and redistribution of fat. [23]
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National Health Service (UK)
Public healthcare system of the UK

Go to source

Always take the lowest effective dosage of hormones. Taking too high of a dosage will actually slow down the transition process.
Your general practitioner or endocrinologist should monitor your HRT. Schedule regular check-ups! [24]
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Whether and when to take HRT is a deeply personal choice. You should take hormones if you've fully researched your options, feel that hormones are a posi
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