Your Gender Transition: What to Know

Social and Medical Guidance From Gender-Affirming Experts

Published March 2022

Transgender is an umbrella term for those whose gender identity differs from the sex they were assigned at birth. For transgender individuals, there is no one "right" way to go about your transition.

"Transitioning means different things to different people," says Becca Sebree, care coordinator for the Northwestern Medicine Gender Pathways Program. "From a broad sense, it means becoming more in tune with your identity."

There are two primary aspects of transitioning: social and medical. Sebree and Rosanne D. Vasiloff, MD, a family medicine physician in the Gender Pathways Program, break down the different aspects of transitioning.

Social Transition

Gender-affirming care is more than hormone therapy or surgery.

— Rosanne D. Vasiloff, MD

A social transition occurs when you live your life in alignment with your gender identity. This might include:

Coming out as transgender to your loved ones and peers
Using pronouns that match your gender identity
Going by a different name
Dressing and grooming in ways that align with your gender identity

"Transitioning is not defined by one set of standards or criteria," says Dr. Vasiloff. "As a physician, I provide you with all of your options, listen to your individual goals and give you a realistic roadmap for your transition."

For some, that roadmap includes a medical transition.

Medical Transition

For transgender men and some people who are nonbinary (do not identify as male or female), medical transition can include any of the following:

Hormone replacement therapy (HRT) to help induce masculine characteristics, such as a deeper voice, facial hair growth, muscle growth and more
Masculinizing surgeries, including:

"Top" surgery (removal of breasts and breast tissue)
Hysterectomy (removal of uterus)
Phalloplasty (construction of a penis using skin from other parts of your body)

For transgender women and some nonbinary people, medical transition may include any of the following:

HRT to help induce feminine characteristics, such as less body hair, more breast tissue and more
Feminizing surgeries, including:

Breast augmentation or implants
Penile inversion vaginoplasty (creation of a vagina by inverting penile skin)
Removal of testes
Laser hair removal

In addition to medical and social transitions, you may have other needs, explains Dr. Vasiloff. Your clinicians can answer your questions and guide your care in these areas, too.

"Gender-affirming care is more than hormone therapy or surgery," she explains. "As your care team, we offer preventive care, fertility counseling, social support, voice therapy and more. We can also provide connections to specialists in medical, legal and social settings."

No matter if you have already started your transition or if you are just beginning to have questions about your gender identity, your healthcare team is here to help you and your support system learn what is best for you.

"If you are questioning, make the appointment," Sebree says. "This is your body, and these are your medical choices. We're here to empower you to make those decisions."