Transgender Woman

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Transgender Woman
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Published: 18:12 BST, 28 July 2020 | Updated: 02:09 BST, 29 July 2020
A transgender woman has revealed her incredible transformation photos after undergoing 14 months of hormone replacement therapy and facial feminization surgery. 
Natalie Zamani, 28, from San Francisco, took to Reddit last week to share images of herself before and after her transition, writing: 'So it’s kinda been a wild 14 months!' The senior engineer has known she was trans since she was a teen, but kept her gender identity hidden until last year. 
'I was 27, I had a great job in tech, a lovely relationship, and had built up confidence in my life. Life was good, but yet I was still not at home in my body,' she told Bored Panda . 'I realized I couldn't outrun my identity and expect to live a full life.'  
Amazing: Natalie Zamani, a transgender woman, shared photos of her transformation on Reddit 14 months after she started hormone replacement therapy 
Hard to handle: The 28-year-old from San Francisco was assigned male at birth and 'learned early on' to suppress her feelings about her gender identity 
Her 'before' photo shows her sporting short hair and a neatly-trimmed beard. In her 'after' pictured, she has smooth cheeks, shoulder-length curly hair, and a bright smile. 
Zamani, who was assigned male at birth, said that growing up she 'learned early on' that she had to suppress her feelings about her gender identity, but her 'girly tendencies' would still come out. 
When she started to go through puberty in her early teens, she was 'disgusted' with the changes to her body and 'miserable' that she couldn't do anything about it. 
'I did research and found that there were other people like me, who had chosen to do something about it. That it was possible to transition,' she said of learning what it was to be transgender. 
Difficult: When she started to go through puberty in her early teens, she was 'disgusted' with the changes to her body. It was then that she learned what it was to be transgender 
Painful choice: Zamani feared she would have to live in the margins of society if she came out and made the difficult decision to keep her gender identity hidden
Making a choice: The senior engineer started hormone replacement therapy last year after realizing she needed to embrace her gender identity to live a full life
'But what I found in all but a few cases was that people who had transitioned lived difficult lives on the margins of society, unless they were lucky and strong enough to live in "stealth" and had that privilege by virtue of being able to just blend in and hide.'
The idea of 'going stealth' and starting a new life far away from her loved ones seemed 'both incredibly lonely and difficult' to her.   
Zamani made the difficult decision to keep her gender identity hidden while living as happily as she could, but she realized last year that she would never be fulfilled if she continued to hide who she was.  
'The acceptance of trans people had totally shifted during my lifetime, and I didn't face life at the margins purely for being openly trans,' she explained. 'I had to start living my life. I drove to Planned Parenthood a few days after that realization and started hormones.'
Changes: Zamani officially started living as Natalie in April amid the pandemic, and a few months later, she underwent facial feminization surgery
Happy: 'This is the most like me I’ve ever felt,' she wrote on Instagram after the surgery
She officially started living her life as Natalie in April amid the coronavirus pandemic.
In June, she had facial feminization surgery, which refers to a broad range of procedures to modify and soften masculine facial features to make them more feminine.  
Zamani shared a smiling photo of herself on Instagram two weeks after the surgery to say that even though her face was still swollen and bruised, she is so happy with her appearance. 
'This is the most like me I’ve ever felt,' she wrote. 'And I can’t overstate how good it feels to be me right now. I’m immensely privileged that I get to have this necessary, but incredibly expensive procedure, and that I get to feel this way. 
Support system: Zamani is grateful to have the support of her family, friends, and 'amazing partner,' saying none of this would have been possible without them
All smiles: Zamani said her journey has been incredibly difficult, but it has also helped her grow into the person she was meant to be
'But I’m so thankful I held out long enough to get to this place of enormous comfort and happiness, and that I had the support network to do so too.'
Zamani told Bored Panda that her journey has been incredibly difficult, but it has also helped her grow into the person she was meant to be. 
She is grateful to have the support of her family, friends, and 'amazing partner,' saying none of this would have been possible without them.    
'Over the past 14 months, I've grown into the person I truly am and started to find an inner love that was never there before,' she said. 'I've only been out and presenting as me for a few months now, and didn't start doing so until the pandemic had fully hit, so I'm very excited for what my life has in store once I can start experiencing all that life has to offer out in the world as the real me. 
'I'm so happy I held out through all of the pain and difficulty for this moment.' 
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I am a woman. For this, I am called a liar.
I’m transgender, meaning the gender that was assigned to me at birth doesn’t match the gender I identify with. For most of my life, I couldn’t articulate this feeling in a coherent way.
I started struggling when puberty hit, around age 12. I watched as my body turned what felt to me grotesquely masculine, and my mind began to feel as though it was in a fog of testosterone. My brain was like a Camry someone had tried to fuel with diesel — it wasn’t meant to run on testosterone. I wished I could be like the other girls in my class. Something just seemed right about who they were, how they were.
I sank into a depression that lasted for years. I didn’t understand why. I tried therapy, anti-depressants, anti-convulsants, and anti-anxiety medications. They didn’t help. I finally gave up trying to fix it. I thought there was nothing I could do.
At age 26, after years of repressing these feelings, the dissonance between my mind, body and life itself became too much to handle. Every morning I woke up feeling more shame and anxiety than ever before. I took up smoking, a habit I’d kicked nearly two years prior. I couldn’t sleep without drinking, and I often drank until I couldn’t walk. Still, the feelings persisted. I considered suicide.
Then in late May of 2012, I came out to my girlfriend of 5 years, pouring my heart out, doing the best I could to explain the toll that ignoring this has taken on me. It’s a hard thing to put into words.
By that October, after months of working with a therapist specializing in gender-related issues, I had begun hormone replacement therapy. Simple enough. I took medication to reduce the testosterone in my system, the very hormone that had nearly destroyed me, and I gave myself a weekly injection of estradiol, one of the more common forms of estrogen found in pubescent and post-pubescent women.
A few months later, I’d begun to experience the physical and mental impact of the hormones, and with it a new sense of clarity, peace and happiness. The chronic aches in my joints and pains in my stomach that had been a staple of my life since puberty dissipated. My mind and body began repairing themselves. It’s as though my brain was meant to run on estrogen my whole life.
Why am I like this? Honestly, I don’t know. There are a number of theories rooted in medicine, one of the most prominent being a 2006 study , published in the journal Psychoneuroendocrinology , by Schneider, Pickel and Stalla.
The study suggests that the amount of testosterone a fetus is exposed to in utero is directly linked to one’s likelihood of being transgender. In other words, prior to my birth, I may have been exposed to too much or too little testosterone while in my mother’s womb, causing my brain to develop differently than that of the average baby boy.
No matter the cause, this is, and has always been, a part of me. If I could have, I would have chosen to be born congruent, mind and body. I didn’t choose this, but I’m making the best of what I have.
I am a woman, but on such a frequent basis, I’m told this is not true. I’m told that I’m “genetically” or “biologically” male. I’m told that I’m not a “real woman.”
I have to ask: What constitutes a “real woman?”
How am I not one? Is it because of my chromosomes? I don’t think that’s fair, as neither you nor I know what my chromosomes even are. Someone who makes this argument assume they’re XY, but I don’t even know that for certain, as I’ve never had a karyotype test . It’s probably a safe bet that my detractor hasn’t had a karyotype test, either. Even if I do have a Y chromosome, that doesn’t mean anything. There are a number of women with Androgen Insensitivity Syndrome, sometimes giving them an XY set of chromosomes, which, typically, would be associated with men. Are they not women? In fact, there was even a recent case of a woman with XY chromosomes who gave birth to a daughter with -- you guessed it -- XY chromosomes.
Additionally, a September 16, 2013 article in the New York Times (“DNA Double Take”) examines recent studies on the DNA of women. “In 2012, Canadian scientists performed autopsies on the brains of 59 women. They found neurons with Y chromosomes in 63 percent of them.” 63 percent!? Wow. A separate study, conducted at the Dana-Farber Cancer Institute in Boston, discovered that 56 percent of the women they investigated had a Y chromosome, based on a sample of their breast tissue. This goes to show that being a woman is about more than whether you have two X chromosomes.
Is the reason that some disqualify me from womanhood related to the fact that I can’t birth a child and don’t have a uterus? If so, do they also reject the womanhood of infertile women or those who have had a hysterectomy? It’s true that I wasn’t born with a uterus, but neither was Jaclyn Schultz, Miss Michigan 2013 . As a result of Mayer-Rokitansky-Küster-Hauser syndrome (MRKH), she was born perfectly healthy, with the exception of her missing uterus (which also resulted in an inability to menstruate). 75,000 women in the United States have MRKH. Are they “really men?”
Is it the fact that I wasn’t “socialized as a woman” that excludes me from womanhood? Is it that I was “socialized as a man”? Well, so were these girls in Afghanistan. They were “raised as boys” until they were well into their teenage years. Are they not women?
Let’s move on to the most obvious objection to my womanhood: It would take sexual reassignment surgery (SRS), also known as vaginoplasty, for me to ever have a vagina. So that “makes me a man”? Tell that to women born with vaginal agenesis , a condition present in 1 out of every 5,000 female infants, where a child is born without a fully-formed vagina. This condition may require surgical intervention (i.e. vaginoplasty) in order to create a vagina. Does this negate their femaleness as well?
None of these factors (chromosomes, reproductive organs, socialization, genitals) cancel out the fact that the girls and women I mentioned above are, in fact, girls and women. I sincerely doubt that most people would so much as question the womanhood of the women I described. After all, it’s not their fault that they were born with anomalies. How am I any different? I didn’t choose to be transgender.
I don’t want “special treatment,” I just want to be respected as a human being, as deserving of dignity as anyone else. I want to be able to exist in the world without the core of my identity, something that I grappled with for more than a quarter century, being dismissed by someone who couldn’t possibly understand what it’s like. I want to be able to go to work without worrying about being fired for who I am. I want to be able to use the restroom without fear of being beaten or accused of having malicious intentions . Like everyone else, I want the world to see me for me.
Is that really so much to ask, to be treated like everyone else, to have the same rights and protections as everyone else? From a legal and public accommodations viewpoint, that's really all any of us are asking for.
Being transgender is a medical condition. Like so many other conditions, if left untreated, you're bound to wind up the bearer of a host of related symptoms. Depression, anxiety, suicidal thoughts and actions are what you often get when you try to suppress your dysphoria. Without treatment, which, for me, came in the form of hormone replacement therapy, I might be dead.
I know who I am, what I am. I am a woman, and that’s the truth.

Estrogen Treatment for Transgender Women and Transfeminine People

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Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases.


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Lauren Schlanger, MD, is a board-certified primary care physician. She is an assistant professor at the Alpert Medical School of Brown University.

Transgender women and transfeminine people are people whose assigned sex at birth is male, yet they exist as women. Transgender people represent a group that includes not just transgender women but also non- people who have a more feminine gender identity than the one that is expected for their recorded sex at birth. The term "transfeminine" is an umbrella term that encompasses both transgender women and feminine people of nonbinary identity. Many transgender people experience what is
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