Let’s chat about something real today. The Ugly Truth: Transitioning – whether male to female, female to male, or anywhere on that spectrum. I’m talking straight to you, like we’re grabbing coffee and spilling the tea. If you’re considering this path, or know someone who is, buckle up because
I’m gonna lay it all out – the highs, the lows, and especially the stuff that doesn’t get glamorized on social media. This isn’t to scare you off; it’s to help you see the full picture so you can make a decision that’s truly right for you. And hey, if after reading this you decide it’s not your road? That’s 100% okay. No judgment here.
First off, let’s talk money – because transitioning ain’t cheap, and it can sneak up on you. Depending on what you go for (hormones, surgeries, voice training, hair removal, wardrobe overhauls, legal name changes, therapy sessions), you’re looking at costs that can easily climb into the six figures. We’re talking $20K+ for top surgery, another $30K-50K for bottom surgery if that’s your goal, thousands for electrolysis or laser hair removal (which hurts like hell and takes forever), and don’t forget ongoing hormone prescriptions that add up monthly.
It might spread out over 5-10 years or more, but that’s years of saving, budgeting, or going into debt. I’ve heard from so many who started small and ended up realizing, “Whoa, this is a marathon, not a sprint.” If you’re young or just starting out in life, think about how this fits with your career, housing, or other goals – it’s a big financial commitment that could reshape your whole future.
Now, the physical side? Oof, it’s no joke. Yeah, the end result can feel amazing if it’s what you want, but getting there? Pain city. Electrolysis feels like getting zapped a million times (and you might need hundreds of hours for full body hair removal). Laser? Similar vibe, but add in burns or skin issues if it’s not done right.
Surgeries? Recovery from facial feminization, breast augmentation, or genital reconstruction can mean weeks or months of swelling, bruising, limited mobility, and straight-up agony.
Hormones might mess with your energy, mood swings, or even fertility if you haven’t banked sperm/eggs beforehand. And that’s not even touching on potential complications like infections or revisions. Your body goes through a lot – it’s transformative, but it’s tough. If you’re someone who hates needles or has a low pain tolerance, really sit with that.
But the emotional pain? That’s the sneaky one that hits harder than you expect. Media and online spaces can be toxic AF – one day you’re celebrated, the next you’re dealing with trolls, debates about your existence, or feeling like a pawn in someone’s political agenda. It tests your patience and resolve every damn day. Then there’s the loneliness.
Oh man, this one breaks my heart. From the hundreds of trans folks I’ve talked to – especially beautiful trans women who’ve put in the work – almost all say the same: sex? Easy to find. But real, authentic love? A committed partner who wants to hold your hand in public, introduce you to their family, build a life? The dating pool shrinks dramatically. Stigma is real – people worry about what others think, or they fetishize you without seeing the whole person. Geography matters too; if you’re not in a big, progressive city, options dwindle even more. Add in mismatched interests or deal-breakers, and it can feel isolating. I’ve seen strong people crumble under that weight, wondering if they’ll ever find “the one” who loves them without caveats.
Family stuff? Unpredictable as hell. Some get lucky – parents, siblings, or extended fam who rally around with open arms. But for so many, it’s rejection city. The ones you thought would bail on you end up being your rock, and the “supportive” ones ghost or judge. Holidays get awkward, relationships fracture, and you might lose that safety net. It’s emotionally exhausting to navigate, especially if you’re already dealing with dysphoria or mental health stuff. Therapy helps, but it doesn’t erase the hurt.
All this to say: If you’re reading this and nodding along, feeling seen in your struggles – you’re not alone. These are real hurdles that can make the journey feel overwhelming. But they’re also why you gotta take your time. Transitioning is a massive decision, and depending on how far you go (like surgeries or long-term hormones), some changes are irreversible. You can’t always “go back” to square one – physically, emotionally, or socially.
The road is full of detransitioners who rushed in, influenced by trends, peer pressure, or even well-meaning friends who affirmed without asking the hard questions. Suicidal thoughts or external hype can cloud judgment, and without someone gently pushing back – “Hey, is this really for you? Let’s unpack why” – it’s easy to regret later.
Pushing back isn’t hate; it’s care. It builds your resolve and forces you to dig deep: Am I doing this for me, or because of trauma, societal vibes, or something else? Explore therapy (with a neutral pro, not just affirmers), talk to detrans folks’ stories, journal your whys. Test small steps like social transitioning or reversible changes first. If it feels right, go for it with eyes wide open. If not? That’s valid too – maybe therapy, self-acceptance, or other paths light you up more. No shame in pivoting.
At the end of the day, your body, your life, your call. Just promise me you’ll think it through, surround yourself with balanced voices, and prioritize your long-term happiness. If this resonates, drop a comment – let’s support each other.
You’ve got this. 💪❤️
Dr. Gwen Patrone
7 Responses
gwen, firstly I need to commend you on your recent posts – uncomfortable reading for some, I’m sure, but we ignore reality at our peril.
For many of us – myself included – CDing provides much needed relief from the pressures of our ‘normal’ lives. This hit home to me when, a few days after a serious family crisis, I was able to spend a night away from home. I’ve related the story in one of my posts here but suffice to say that spending an evening as ‘her’ pushed the unfolding situation at home completely out of my mind. The following day when I had to revert, things all came crashing back down to earth as i faced reality once more. What many people forget is that cross the line permanently and all of the negative baggage in life can no longer be left behind and has to come with you.
I’ve fallen into the euphoria trap many times myself over the years but thankfully I’ve matured enough to take a more balanced view these days. If someone believes that their life will be better or more fulfilled by transitioning, then who am I to judge? Equally, though, there are too many onlookers who are only too happy to be cheerleaders, ignoring or even supressing the basic question ‘are you absolutely sure about this?’. I was on the receiving end of abuse on another forum for daring to suggest that if we listened to detransitioners, it’d help improve the diagnostic procedures for gender dysphoria; sadly detransition is an inconvenient truth for those captured by the ideology.
Your point about the ‘neutral pro’ is well made although I fear that these are rather thin on the ground. if you’ve not come across him before, look for Az Hakeem on YouTube as he has a very different perspective to most gender professionals in this regard.
Uncovering the inner woman and allowing her to flourish has been a revelation for me. I’ve experienced levels of happiness (much of it due to the positive reaction of others I have interacted with) that elude me in my normal life and I yearn for more. But I’ve come to realise that that would come at a price I’m not prepared to pay and I don’t mean the financial price here. So I accept the compromises and cherish the times when I can walk away from the pressures of life for a few hours.
Your text is extremely honest and necessary. Many people only see the aesthetics of the transition, but you show what’s really behind it: the cost, the pain, the fear, the losses, the silences… and especially the loneliness that nobody posts on Instagram. It’s incredibly courageous to put all of that into words — and it’s precisely this truth that helps other people make conscious decisions, without romanticization and without pressure.
And, at the same time, reading your strength, your lucidity, and the care you have for those who accompany you, made me want to see you write about the other side as well:
the rewards, the breaths, the relief of finally existing as you are, the moments when everything was worth it.
Not to counterbalance the pain, but to show that the journey is complete — made of shadows, but also of light.
I think many people need to hear this from someone who speaks with so much truth.
Translated from Brazilian Portuguese by Google
Gwen,
Does the question basically come down to what does transition mean to us as individuals ? I recall the stages of finding the REAL ME , not all need counselling or therapy but I had no choice . At the start the conversations felt as if we were talking about a third party , we can’t be talking about ME surely ! We have to dig deeper to consider why we need to dress and appear as a female .
Before we even consider the road to hormones or possible surgery we have to believe in ourselves , only then can we try and explain to family and close friends . It took me while to rationalise the need for hormones and possible surgery and it did help to have friends who had taken those steps . I knew I could get most of it done through the NHS , I couldn’t afford it otherwise because I had to support my family . Having the freedom to full time proved that I could happily live as Teresa without placing a burden on the NHS . Physically I hadn’t suffered the pain you have but mentally the pain was unbearable , it’s hard to know where to find the strength somedays to carry on .
I’m now resigned to the fact I will never have a close partner again , At my age I’m OK with that , I have far more good friends that fill most days .
As for going back , despite not taking hormones or having surgery there is nothing left in the male locker besides I now have an official name change , everthing I legally own is registered with F and boy does that feel good .
We can never fully know what losses we will encounter until we almost take the step too far , I didn’t know until I set up my new home as Teresa , as it transpires I lost far less than I expected , my divorce would have probably happened anyway .
Gwen,
I am so glad that you wrote this piece. Your tough love on the financial implications is especially important, as most of us have had a head start on the other issues before transition is even a distant hope.
Before I made any moves, I read at least a dozen accounts of transgender women who had written about their experiences. I found nearly every one to be disheartening and depressing. The most common problem seems to be that people make a decision to transition without taking into account the needs and feelings of those around them, and without understanding the cost. They wake up one day and say I know who I really am and they immediately want to fix their internal problem. Given that reality, I’m actually surprised at how few detransitions there actually are (and based on what I have read, it seems like it’s much more common with young trans men than older trans women). Still, I can’t imagine having surgery within even a year of realizing who you really are. Buyer beware is definitely an apt warning, especially since each human is unique and is both fearfully and wonderfully made. Changing how one is made is a giant leap into a void.
That’having been said, my own experience has not been anything like what you have said, in terms of financial and (added) emotional cost. I have not elected to do any surgeries. My costs are hormones (less than the cost of 10 drinks per month!), my doctor (another 10 drinks) and my therapist (about 15 drinks). Eliminating alcohol from my diet is enough to pay for my treatments!
For me, the ongoing relationship issues with my beloved wife are the most challenging. I get up every morning reminding myself that I have to be better than the best spouse, not because she has threatened to leave me, but rather from my own sensitivity to the trauma that I have caused her. Very few of us (if married or in a long-term relationship), have someone who is equally happy with either a man or a woman. Those unicorns are already prepared for what transition will bring. Every other spouse/partner will be traumatised, and we need to be sensitive to that.
I won’t go on, because I want your post to stand for itself and to give people a taste of what may be ahead for them, depending on how they approach their transition.
Thank you for raising these issues.
Lisa
b/ 4 the surgery etc I would hope that each person has a clear understanding of what they hope to gain after the process.For example if you are older the pluses seem less.and what about when you you recognized you were TG? If those feelings were right there out of the starting gate that’s one thing But if they are due to outside influence etc later on that’s a different thing altogether.
Emily ,
That’s why it’s a long process in the UK if you go the NHS route , surgery is an expensive business they need to know it’s right decision .
Being recognised as transgender doesn’t bother some people , I’m not comfortable with it , at times I have to be careful in conversation .
I’m in a place where things are shifting more and more in my everyday life. A lot of what you wrote mirrors the questions I’m sitting with. The emotional weight, the impact on relationships, the fear of moving too fast or too slow. That part feels incredibly real right now. It’s a good reminder to keep slowing down, checking in with myself, and making each step a conscious one.