Trans woman (sometimes referred to as MtF) is a term which describes someone who is both a woman and transgender/transsexual. They may be referred to as transfeminine and/or transfian. Trans woman typical refers to an AMAB male-to-female, however it can also include any AGAB and any gender-to-gender.
Some trans women wish to transition in order to change their sex characteristics and gender expression to become more feminine.
While MtF may be used for trans women, some trans women prefer to use the term FtF (female-to-female) as a way to say that their gender identity was never male.
Tucking
Tucking is the act of maneuvering ones genitalia to negate the appearance 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 antiandrogens (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 redistribution (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 woman 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 permanently 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 testicles. As these are the main source of testosterone in AMAB individuals, an orchiectomy usually means one can stop taking testosterone 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 scrotum, with the glans of the penis being turned into a clitoris.
Vaginoplasty
Construction of a vagina using tissue from the scrotum and penis. It is combined with urethroplasty 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 reduction
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.