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FTM MTF Some transgender people express gender in very traditional or overt ways to better "pass" as the gender with which they identify. Don't get me wrong, I'm very happy with the results of what is happening, but the process of re-emerging from this chrysalis is a painful one. Yesterday, I went in for my first testosterone appointment. This "gatekeeping" model can create additional challenges. Non-physician prescribed hormones are relatively common due to a lack of access to health care, an inability to afford physician visits and routine laboratory tests, a preference not to see a physician, or a preference to avoid or an inability to afford psychotherapy, which a physician may require prior to prescribing hormones. Slouch or intentionally gain weight to add mass to their midsection, altering their feminine contour. We welcome outside contributions.

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Facing that and a society that discourages female voices made everything even more difficult. Wherever you are and however you look, you are still the same person. Write to Katy Steinmetz at katy. Sign Up for Our Newsletters Sign up to receive the top stories you need to know now on politics, health and more.

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I speak at many mental health and sex education conferences and I am very well received.

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