Hi Alice!
Thanks for sharing your story with us (and your transition pics, you look great!).
I do have quite a few questions for you. I hope you don't mind me basically grilling you for your experience (please don't answer anything you're not comfortable with answering). You're a perspective I don't often get a chance to have any insight on, so I'm trying to make the most of your willingness to share.
Hello! And thank you (although it's difficult for me to see that)
hopefully once the swelling goes down from all the stuff that was jammed in my face on Thursday I'll be starting to see in the mirror what I've always seen in my mind.
I wouldn't have offered to share if I minded, so don't worry. I know transwomen are a relatively rare breed who aren't usually as easily identifiable as transphobes seem to think, and that (for obvious reasons) most of us tend to avoid probing questions - so I realize a lot of cis people have well-intentioned questions/genuinely want to understand us better but don't really have any sources of information beyond the very generic stuff you find online.
Which is why my almost compulsively-oversharing ass has volunteered to share. So with that in mind:
(N.b. Because I tend to waffle, replying to this all at once would make for a VERY long post. So I'll do it piecemeal)
1. How was the process for transitioning for you? (both mentally and physically) Where and how did you find help and information? What difficulties did you run into? You also mentioned out-of-pocket costs, what did these look like and how far did Medicare cover you? Do you think it should cover more?
I'm very early on in my transition - I only started HRT/came out (did everything all at once. Very dramatic. Very dumb), so I'm still finding out haha.
Mentally
Mentally it's been unreal. I was diagnosed with bipolar at age 19 and haven't really been properly euthymic at m/any stages since then. The ranging mood storm and tidal waves of affective instability which have been ever-present for a decade... turned to an idyllic duckpond within about 3 weeks on HRT. Now, because I started HRT and started living as a woman full time at exactly the same time, I have no idea which triggered what - I'm guessing it's a mix of both. The way I experience anger has completely changed - it takes longer to seriously annoy me and my responses to it are far less... testosterone-y.
The one downside of plummeting testosterone levels is that the AMAB (Assigned Male At Birth) brain's cognition goes to sh** without it. I've been quite the scatterbrained ditz (and someone who already has ADHD being extra ditzy is... so bad it's almost funny). But that will fade.
Physically
I've been utterly dumbfounded with how quickly my body is changing. I come from a family of competitive male swimmers, and was/am very much built like one - broad shouldered, and an absolute rectangle from armpits down to very narrow hips.
I have a waist now. And like, enough hips to actually hold women's jeans up. And the beginnings of a boot. And thighs that jiggle, with a way smaller thigh gap than I started with/most AMABs have. Like, to the point that the girl I'm dating (who knew me pre-transition) looked at me in confusion one day and went 'When the hell did you become an hourglass, and how has oestrogen never done that to me'
As for breast development, we're moving into territory that even I'm hesitant to get into *too* much, but suffice to say that I feel like zero to proper A cup in 3 months ain't bad.
Difficulties
Not 100% sure which difficulties you're asking about - you mention some specific ones in later questions so I'll answer those then
Out of pocket expenses
New Zealand doesn't have Medicare, so I'll just list what I've had to pay for thus far (basically all of it)
- Psychiatrist for the gender dysphoria diagnosis (no longer needed in my region to start HRT, which is great - changed just after I started) ~$250
- Endocrinologist appointment for HRT $175
- Pills mercifully only $10 total for a 3 month supply
- Laser hair removal face (theoretically entitled to, but you have to fight the sh*t out of the social services people and that takes forever) and chest $1800 total. Am about a third to a halfway through those courses
- White light IPL facial hair removal (for all the white/blonde/red/light brown hairs laser can't hit) $180/session, will likely need 6 or so
- Entire new wardrobe and shoes and stuff has been at least $700, more like $800 if you include makeup and skincare stuff
- The semi-permanent hair extensions (the flowing black hair did not grow out of that short blonde cut in 3 months haha) were $800 to buy/have put in. Then $150 or something to dye. And then I need them moved up (because the hair they're attached to obviously grows, and they slip slightly) and recoloured every 2 months, which takes literally 4 hours (I have 2 full packs of them in hahah) and so costs about $250 a time. Honestly, the hair has been my biggest passing asset so far by a LONG way.
- The total for the cosmetic work to my face is already sitting close to $10,000
(I would *love* to go into all the stuff I've had done, the evidence/rationale behind the various bits of it etc if anyone would actually be interested. But that'd be a fairly lengthy post of its own)
- Oh, changing my name was something like $80. I actually found the process of legally changing it very easy, it's the 'getting every agency and company you're associated with to update your name' part that's hard. I also think it's hilarious that changing gender marker on your birth certificate takes months of family court hearings, but when getting a new driver's license I just ticked female and now that's an official govt record.
Obviously easier access to funded laser hair removal (and not just the face) would be nice. Having speech therapy referrals not take 5 or 6 months to go through would be nice. Not having to pay a couple hundred bucks to get your HRT (i.e. to see the endo or special interest GP) would be nice.
My main complaints are surgical though:
- MTF (male-to-female, not a term I particularly like, given that those are *sex*-based terms and I am trans*gender*, but it's a commonly used one and the short acronym is handy) bottom surgery, i.e. vaginoplasty until recently came with a wait list of upto 30 years. They proudly tell me that's down to 10 years now, as though that's timely provision of healthcare. It isn't my biggest concern so I'm not *that* worried about the wait, but for some it's agonizing. I think it's over $20,000 privately, and you'd probs have to go overseas for it
- MTF top surgery (sorry FTMs out there, my knowledge around your service provision is a bit limited) i.e. breast augmentation is... theoretically available. But there's no real pathway, guidelines, criteria etc so I gather it depends on how pushy your doctor is willing to be and how receptive the local plastics department is. What I've heard informally is that the wait is 2-5 years depending on where you live. Privately, about $15,000 - 18,000 for implants, or for a smaller lift autologous fat grafting is more like $8,000 - 10,000
- Facial feminization surgery. THIS is where my rage is directed. The government explicitly states that this is 'cosmetic, not gender-affirming'. Not gender-affirming. The thing you interact with the world with, that you see the most and forms a huge part of how you view yourself. The thing with a decent amount of sexual dimorphism, so one of the biggest stumbling blocks to 'passing' (not to mention putting you at pretty high risk of getting violence'd. Society does not like non-passing transwomen).
The thing that caused such severe and prolonged dysphoria that I attempted sewerslide over it more than once.
That's 'cosmetic, not gender-affirming', and therefore there is NO public funding for it. There are next to no plastic surgeons in New Zealand who will touch a transwoman's face (believe me, I've asked enough of them), and overseas the average cost of FFS is $20,000 - 40,000 USD.
I don't have $30 - 60k NZD, so I took out a depressingly large loan (I've got a givealittle page, on the off chance anyone wants to help me repay it) and I found a dermatologist brave enough to be like 'I can list the differences between male and female faces, and you know which bits you hate. So between us we can come up with a plan to non-operatively/chemically sculpt and feminize your face'.
That's been about $10,000 so far. And I do need two minor surgeries (like, under LA type minor, but still several thousand each) as well as a projected $8,000 more in injectables over the next year to make sure the changes are permanent.
So yeah, being trans is expensive. I'm the happiest I've ever been, but also very broke and relationships with the likes of my parents have suffered greatly.
Which is why all the people who go on about how transwomen just want access to women's bathrooms for nefarious purposes are hilarious. Plenty of cis men manage to do those things without going through all of this hahah