What is it about ?
A transgender person is someone who does not recognize the gender (sex) given to them at birth but who identifies with the opposite sex. The person feels like they are of the opposite sex and wants to be in the body of the opposite sex. The person suffers from the fact that, due to his sexual characteristics, he is not considered a representative of the sex with which he identifies.
There are many theories about the cause of this phenomenon, ranging from psychosocial theories to biological theories.
How to recognize it?
You have a strong desire to belong to the opposite sex. The sexual characteristics of your body seem foreign to you and you deeply want to change them.
A transgender person therefore has nothing to do with a transvestite. A transvestite does not want to change sex permanently.
How is the diagnosis made?
The diagnosis is made by a unique and multidisciplinary “gender” team, made up of psychologists, endocrinologists and psychiatrists. This team also includes lawyers and specialists, such as otolaryngologists, plastic surgeons and urologists. Outpatient examinations usually take several months.
What can we do ?
If you are suffering from the fact that you do not identify with the sex of your birth, and you want to end up in the body of the opposite sex, it is possible to modify your physical characteristics and your sexual organs to resemble those of the other sex. This facilitates your integration into the social role of the opposite sex. The objectives and possible interventions are discussed and planned with you.
If you feel the time is right, you openly live out your chosen gender role and choose a new first name for your new identity. Social transition is intertwined with physical transition.
International recommendations generally say that a person should test their chosen gender role in real life continuously for about 1 year before their gender is officially recognized. After this period, we assess whether you want to change your legal sex designation (birth certificate, identity number, … adapted to the new gender). The physical transition can then begin.
Most treatments that result in permanent changes (mainly surgery) are reserved exclusively for adults. In some cases, hormonal treatments can also be started in minors.
How does the transition process (gender reassignment) take place?
After a thorough psychiatric examination, you are usually referred to a gynecologist or endocrinologist for hormonal treatment.
To have male characteristics (female to male transgender (F -> H)), the male sex hormone (testosterone) is prescribed.
To have the feminine characteristics (male to female transgender (M -> F)), the female sex hormone (estrogen) is prescribed.
Hormonal treatment that permanently changes sexual characteristics can be started from the age of 16. In younger children, we can consider inhibiting puberty.
Most F -> M transgender people undergo breast reduction, which is, in many cases, the only surgery required.
If, despite hormonal treatment, the breasts of an M -> F transgender are not developed enough to pass for female sex characteristics, breast augmentation may be performed.
Hormone therapy will only slightly modify the voice of H -> F transgender people. Most of them are oriented towards voice therapy. If the voice does not feminize with conservative methods, vocal cord surgery may be considered.
Hormone therapy has little effect on body hair. M -> F transgender people generally require the removal of male hair (by means of laser hair removal, for example). Hair removal is generally reimbursed. Electric hair removal can also be performed by a private beautician, but is rarely reimbursed.
A small group of M -> F transgender people go through facial surgery to feminize a too masculine nose, jaw or forehead.
Genital reconstruction is usually done at the end of the transition process. The operation may consist of removing the uterus and ovaries in women or removing the penis in men. Then the desired genitals can be reconstructed. There are different surgical techniques. The wishes and constitution of the person determine, among other things, the technique to be applied. H -> F transgender people more often choose genital reconstruction than F -> H transgenders.
Psychosocial support and follow-up
A gender reassignment is a stressful process and some transgender people need psychosocial support during the transition period.
There are regional and national organizations offering educational, emotional and psychosocial support, for example in the event of legal problems or discrimination. Transgender people often find support among themselves and on online discussion forums.
The follow-up in a specialized center becomes less frequent after the first phase of evaluation and stops gradually at the end of the individual care plan. The general practitioner or the gynecologist can follow the hormonal treatment for life.
Certain factors can have a negative impact on the quality of life of transgender people, such as complications from physical interventions, the inability to receive all the necessary treatments, possible discrimination or the lack of support from those around them. Even so, very few transgender people regret their transition.
Want to know more?
Are you looking for more specialized help?
- Approved family planning centers in Wallonia and Brussels – LoveAttitude
- Mental Health Services – The Social Guide
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