No operation (yet)
Are you still in doubt about whether or not to have genital surgery, or are you on the waiting list? In the meantime, you can take certain steps towards your transition. Even without surgery, there are things you can do to adapt your body that will quell your gender dysphoric feelings. Such 'non-medical' options include penile prosthetics. Perhaps you also need social and/or mental support. Here, we provide relevant information and tips on all these subjects!
Important decision
Opting for genital surgery is an important decision, and one that has many consequences of mental, physical, social and sexual significance. Genital surgery also carries the risk of medical complications.
If you are considering genital surgery, it may help your decision to think about the impact of your genitals on your gender identity. Consider external features, such as being able to urinate standing up, or having feeling in the genital area. What do you think or hope that genital surgery will do for you? Is it a choice that will suit your life as it is at the moment? Will you be able to count on support from friends and family? Genital surgery can have a major impact on your life. It is therefore important to discuss such a choice with those around you.
There are several masculinizing genital surgeries you can undergo. To get an understanding of the possible treatment options and care path, you can watch Amsterdam UMC's animation video.
Official change of gender without genital surgery
Since 2014, Dutch law allows the gender to be changed on a person’s birth certificate without them having undergone genital surgery.
Non-medical option: penile devices and prosthetics
There are many non-medical penile devices and prosthetics in various sizes, with various functions. Devices that are known as ‘packers’ are worn in underwear to give the appearance of having a penis. There are also devices that enable you to urinate while standing up (i.e. female urination device, or ‘stand-to-pee device’ (STP)). There are also devices that not only enable users to urinate standing up but can aso be used for penetration, but these are often rather expensive and not always functional. It would be better to purchase two different devices for these purposes.
Penile devices and prosthetics are available online, under a variety of names, such as FTM packers, penis padding, 'stand-to-pee' devices (STP) or erection rods. In the Netherlands, many different products are available from the Internet (e.g. https://www.trans-missie.com/nl/ ). Tip: Look for suppliers who are trans themselves or have affinity with trans people; these products are usually more specifically for trans people. Furthermore, pay close attention to colour and size (centimetres or inches).
Hormone treatment
Hormone treatment with testosterone will cause physical changes. These changes can be permanent; such as a lower voice.
Effects
Certain effects of hormone treatment are permanent, such as a lower voice. The extent and duration of changes vary from person to person and are related to genetic predisposition and duration of therapy.
In addition to voice changes, hormone treatment can cause certain physical changes:
- Body fat and muscles: the way fat is distributed over body and face will change. In addition, muscle mass and strength will increase.
- Body weight: the changing composition of the body (less fat, more muscles) may cause a change in body weight.
- Facial and body hair: hair growth will occur on the face (moustache and beard growth) and body hair increases (abdomen, arms and legs). In addition, testosterone is responsible for the development of male-pattern hair loss (MPHL). Whether this occurs and how rapidly it develops depends on your genetic predisposition.
- Menstruation: menstruation usually stays away after taking testosterone. The timespan within which this happens varies from person to person.
- Fertility: the use of testosterone may reduce your fertility. If you stop taking hormones, fertility may be restored.
- Genitals: the clitoris will grow (by 1 to 6 centimetres).
Sexuality
Sexuality is important to many people. You learn more about your genitals by discovering what is sexually important and pleasurable to you. Your sexual life depends not only on genital surgery, but also on many psychological and biological factors. The things to consider include whether you would like to have or already have a partner, and whether you would want to talk to your partner about your sexual desires .
Sex drive (libido) depends on the hormone testosterone — regardless of gender. Hormone treatment can therefore cause changes in how you experience sexuality, as your testosterone levels increase. This may cause an increase in libido. Hormone treatment may still allow you to have erotic sensations and orgasms, although in a way that is different than before the hormone treatment.
This text was edited on 7-10-2022
Next Step
We recommend that you go through all the information step by step to get a complete picture of the different treatment options and the process around them!
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Fertility
Are you starting hormone treatment and/or genital surgery? Then it is important to first consider any future wish to have children of your own and to preserve your fertility.
