A Trans Girl's Guide To Medically Transitioning

iStock / nito100

iStock / nito100


You’re a trans person considering medical transition and you need a few tips on how to get started? 

Well, it’s your lucky day!

From my life to your computer screen, here’s a trans girl’s guide to medically transitioning as efficiently and stress-free as possible.

It’s been 3+ arduous, exciting, confusing, scary, and rewarding years of me trying to crack the code that is the American medical institution. And while things have been far from easy, I wouldn’t trade my time spent on chasing after my happiness, and my contentment in myself, for anything in the world. 

Now, I’m not gonna lie. The road toward living authentically hasn’t been easily paved for girls like us. There will be hoops to jump through and hurdles to overcome. You may experience some occasional transphobia or general rudeness from those “professionals” who have predisposed beliefs about your body and your choices. You may get told one thing, and have to go through 5 or 6 other steps to get to that point only to have a door slammed in your face. 

It’s tough.

But that’s, like, the fun of it all! Fighting to get to that sweet spot in your transition of just *being*, holds major BDE. And always remember that there is no finish line. This is no race. You get out of a transition what you put into it, so take your time, babe! 


I have one thing to say: therapy. Get into it, girls! Time to identify your traumas and develop healthy coping mechanisms!

Many people are aware that transitioning involves some form of therapy, whether it’s related to your gender identity or overall behavioral health. But, a lot of people are unaware that therapy acts as the first step in starting your transition.
Going to therapy is the key to receiving letters of recommendation for HRT, gender-affirming surgeries, name changes, and more. 

Many states offer free/affordable or sliding scale gender therapy that’ll put you on the right track to getting that coveted hormone prescription. You just have to be willing to talk to someone about your concerns. 

Psychologytoday.com has a unique database that allows your to filter your search for therapists in your area. I would highly recommend finding trans-friendly medical professionals who’ll steer you in the right direction. 

And if they refuse to give you the help you need, guess what you can do?

Find another therapist!

There are many therapists that’ll try to cast judgement and use restrictive ideologies to keep you from transitioning, but those fools don’t get the final say. 

There are loopholes for everything, so take every closed door as a sign to seek an open one. 

Socially transitioning

If you are in a position in which you simply cannot afford the cost of therapy, try socially transitioning first. While it does help in getting things started, going to see a professional isn’t the end-all-be-all. 

If you are in a safe and comfortable environment to do so, play with your appearance! Experiment with your exterior! Do everything that you can to transition, up until the point of taking hormones (because that’s just the icing on top of the cake, anyway).

Before I was able to move out and kickstart my medical transition, I would buy clothes that made me feel good. I told my friends to respect my newly-minted pronouns. Everyday, I took the steps I needed to take in order to feel even 0.5% less dysphoric, because I knew that these things would improve my self-esteem. 

Don’t be afraid to do whatever it is that you need to do to feel confident in yourself. 

Hormone Replacement Therapy

If you’re anything like me, getting on hormones is *the* moment you’ve been waiting for. 

I remember watching hundreds of “___ month Hormone Update!” videos on YouTube, longing for the day that I would be able to experience the bliss of watching my body turn from a cage into more of a home. 

And while going on HRT is in no way a requirement for being trans, there are cheaper alternatives for those who feel it’s necessary in keeping dysphoria at bay. 

So, once you get your letter of recommendation, head to an endocrinologist. 

Do not self-medicate. 

Do not self-medicate.

Do! Not! Self! Medicate!

Seeing a doctor can be expensive for those without insurance, but please go about your transition safely. Like I said, there are loopholes for everything, and you don’t have to go to the highest-rated hormone doctor in your city to get quality care.

I actually started taking hormones through my school’s clinic. There, they did all my bloodwork, talked me through my options, and gave me a prescription which I could then take to a local Walgreens to fill. Due to my lack of insurance, I did have to pay out of pocket, but there are a few organizations/groups that sponsor people’s transitions to cover expenses like these.



And in some cities and states, like New York, there are programs in place that are designed to fully cover the cost of medical transition. Tap into those resources, request to be apart of queer-friendly Facebook groups, and reach out to others in the community who can point you in the right direction. 


Undergoing gender-affirming surgeries might be one of the hardest things to tackle as a trans person. From finding trans-friendly doctors, to finding insurance companies that’ll help cover your procedures, this entire process is a real doozy. 

And while, admittedly, I don’t have the answer to getting everything covered, there is one tip I’ve learned to keep hope alive in the face of adversity: appeal the s*** out of whatever decision doctors/insurance companies make against the progress of your transition.

Now that I think about it, a lot of the steps in my medical transition have felt like the college application process. I have had to write letters, present documentation, and prove to several institutions that I deserve whatever it is that I’m asking for. 

The system is designed to make things hard for trans people seeking medical help, but that doesn’t mean it’s impossible. 

Look into what your insurance will cover, and what they won’t. Chances are if they cover the cost of one procedure, you can collect recommendation letters and doctor’s notes to make a case for why you need extended coverage.  

Don’t take “no” for an answer

The ins-and-outs of medically transitioning are complex, but simple at the same time. It can definitely be a headache, (I got one just thinking about all the things I’ve had to go through) but it’s worth it in the end! Remember that transitioning is an on-going thing, and that whatever dream isn’t manifesting for you right now, can absolutely be your reality in the future. 

Stay strong :*

Ivana Fischer is the Culture Editor of WUSSY and a film and media enthusiast who specializes in cultural studies. You can find her across all socials @iv.fischer