Trans woman is a term which describes someone who is both a woman and transgender/transsexual. Trans women were assigned male at birth but their gender identity is female. They may be referred to as transfeminine. They can have any sexual orientation.

Trans women are often referred to as MtF (Male to Female). Some trans women refuse to use this label as it implies they weren't always women.

Some trans women wish to transition in order to change their sex characteristics and gender expression to become more feminine.

Tucking

Tucking is the act of maneuvering ones genitalia to negate the appearence of a bulge. It can pose health risks if down too aggressively or too frequently. There is commercially-available underwear to aid in the process which is tight and/or padded to help give the appearance of a flat, uniform groin more similar to cis women.

Hormone Replacement Therapy (HRT)

HRT for trans women involves antiandrogrens (which inhibits uptake of androgens and limits the production of testosterone) and the introduction of sythentic estrogen. Sometimes this is also coupled with progesterone. This impacts the individual on almost every level and many patients report changes in energy levels, mood, and appetite. The goal is to provide patients with a body that is more congruent to their gender identity.

HRT can be administered in a number of ways but is most commonly done as oral pills. It can also be taken by injection, topical cream or gel, and patches. Each method has its own dosing schedule and timeline.

Changes with HRT

  • Decrease in muscle tone
  • Softening of skin
  • Less oil production on skin
  • Fat redistrubition (more in hips and breasts)
  • Decreased facial and body hair
  • Decreased libido
  • Testicular atrophy
  • Decreased sperm & ejaculate production
  • Decreased spontaneous erections & strength of erections in general
  • Widening of pelvis (if taken prior to epiphyseal closure, around age 18 to 25)
  • Decreased hair loss
  • Dry eyes
  • Decreased appetite (or increase depending on whether or not HRT includes progesterone)
  • Breast development

Contrary to popular belief, HRT alone does not feminize trans womens voices if they have already undergone male puberty. This means some opt for vocal training (developing the ability to talk in a higher pitch) or surgery to shave down their vocal chords to permanantly increase pitch.

Irreversible Changes

Pelvic widening, breast development, decreased fertility

Reversible Changes

Changes in muscle tone, fat, skin, hair, libido

Common Surgery Options

Chest Surgery (Top Surgery)

Breast Augmentation

Synthetic filler is injected into the breast tissue or implants (such as saline-filled silicone) are added to increase breast size.

Bottom Surgery

Orchiectomy

Removal of the testicals. As these are the main source of testosterone in AMAB individuals, an orchiectomy usually means one can stop taking testosteron blockers.

Scrotectomy

Removal of the scrotum. Sometimes done alongside an orchiectomy, but the tissue is required for vaginoplasty so some opt not to have one until later.

Vulvoplasty

Construction of a vulva (the entire external area around the vagina, including the inner and outer labia) primarily using tissue from the scrotem, with the glans of the penis being turned into a clitorus.

Vaginoplasty

Construction of a vagina using tissue from the scrotum and penis. It is combined with urethraplasty to shorten and relocate the exit of the urethra.

Other

Electrolysis

Laser hair removal. Common if the individual still grows facial hair or other masculine hair patterns (such as chest hair) but can also be done in other places like legs, armpits, etc.

Facial feminization surgery

Plastic surgery to gave the individual a more feminine face. Primarily impacts the jawline and forehead.

Thyroid cartilage reducation

Essentially trimming down the Adam's apple

Voice feminization surgery

Altering vocal chords (which become thickened during male puberty) to increase pitch. This can involve scarring or shaving vocal chords to make them thinner, cutting down cartilage in the area, or pulling the chords tighter. This is often combined with non-surgical voice therapy to help individuals develop a more feminine voice.

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