Top 10 lists seem to be everywhere these days... so I'd like to continue that trend, but on an important and complex subject. Based on my experience (about a dozen years post-M2F transition), here is my personal top 10 list of things I think someone embarking on gender transition should know. I hope this is helpful to my readers.
1. It's all about a new life. This cannot be stressed enough. Transition isn't just a big change -- like a move to a new city, or taking a different job. It is the start of a brand new life. This is one of the most beautiful and profound things any human being can ever experience. You will (in all likelihood) choose a new name, form a new identity, and re-do almost every aspect of how you integrate with society. In the process, your relationships with others will undergo upheaval and your sense of age and time will be markedly changed. There's probably no way to really convey the experience in words, but if you think of it as truly being born into a new life, you'll be better prepared.
2. You will learn, to a degree of certainty that few others ever will, who your true friends are and who really loves you for who you are. Many people, surprisingly, do not truly know their friends, their family members, or even their significant others. The reason is that the true mettle of those relationships has never really been tested. But transition will do that, in no uncertain terms. You will learn for sure who is willing to love you as you truly are, and who isn't. And this answer may come in surprising ways. Sadly, people you have always counted on may reject and abandon you, and yet deep, life-changing support can spring forth from the most unexpected places. This is part of the larger world of decreased predictability that those post-transition often face. If you learn to expect the unexpected, you'll handle it better.
3. Transition is different for everyone. There is no one way to transition. How it is felt and carried out is highly personal, and reflects one's unique background, goals and individuality. Often it is a long process and requires patience. Some people proceed to different extents, including medically. Recent changes in legislation in a few locales, for example, have made it easier to get a legal gender marker change without the extent of reassignment surgery that used to be required. Whatever one's path, it is a private decision that should generally not be the subject of casual inquiries ("Have you had bottom surgery yet?"). Yet these questions still happen, and we should realize that those asking aren't necessarily trying to be insensitive; often they're just curious.
4. Carefully evaluate how your job will handle your transition, and consider moving to a more accepting work environment in advance, if you think it will maximize the chances for support. Your company or employer may have policies on the books that explain how the process will be handled, especially in a large company that has encountered it before. You might be able to discreetly check those policies and see how they apply to you. For other situations, it will be more difficult but common sense often helps. Knowing the laws in your locale is important too. Changing jobs -- or moving to places with better legal protections -- to facilitate a transition is not always easy or practical, but it may be an option if one is motivated and the right things fall into place.
5. Think about how much social support you will have in your new life. Having some degree of social support post-transition is important. Each person will have to evaluate what that support will be, and how they will access it and integrate their new identities with society. Perhaps it will involve joining an accepting church, or seeking out new activities, or forming new bonds (or re-kindling old ones) with friends or supportive family members. In extreme cases, it may even involve delaying transition until a supportive environment can be found. However it's done, it is an important contributor to long-term happiness.
6. If you blend in with "cisnormative" or cisgender standards (both physical features and your overall presentation) you'll more likely be accepted in a broader range of environments. This is a complex and sometimes misunderstood issue, but it holds largely true. In 2016, we still very much live in a gender binary world -- though with degrees of fluidity in between, and one that will hopefully become less rigid and more accepting of non-binary people in the future. Based on a range of attributes -- physical (facial and body structure, overall size), voice quality, manner of dress, and overall presentation -- people tend quickly and instinctively to slot others into the gender binary, with those outside of it risking some degree of rejection. It's likely programmed into us -- based on our deeply innate tendency to categorize, and prefer those that are similar to ourselves -- and unfortunately it's hard to change. This can seem unfair, since some who want to medically transition will naturally have a more favorable starting point than others. And so, if and how they fit (or choose to fit) into the binary, and where they're capable of ending up, is something for would-be transitioners to realistically think about. This doesn't mean that a successful change can't be done by those that are unable to, or choose not to, blend in with "cis" standards. But from the standpoint of current societal acceptance, it will be at least somewhat harder.
7. Any significant personal problems will likely carry over into your post-transition life, so address them. It's very important to transition for the right reasons. If done properly, it can deal with the rather specific issue of gender identity, and those in that situation often feel it instinctively and know when the time is right. But transition should not be counted on to cure a broader range of personal problems, which could include (for example) depression, loneliness, alcohol or other addictions, employment issues, or self-doubt. If you have any of these or other significant challenges, it would be important to address them, with whatever resources are appropriate. Otherwise, they will tend to carry over into your post-transition life and lower the chances that you will adjust successfully.
8. If you can, seek and pay for the best gender transition care possible, because it's so much better to do it right the first time through. What constitutes the most appropriate medical care is of course a personal judgment that is up to each individual, but it should be thoroughly researched in advance. It is one instance in life where it may be good to seek the best possible care (both somatic and psychological), even if it means paying more or traveling farther to access the resources. Of course this is not always easy or convenient, but the goal here is to lower the risk of a suboptimal outcome that must later be corrected.
9. Be courageous, and realize that stepping outside your comfort zone is a natural and necessary part of the process. There will be a time when you present your true self in public for the first time, or when you transition on the job. You will need to come out to your family and friends. Depending on your path, you may submit to long and uncomfortable operations or other medical procedures. What this means is that at times, you may be downright scared -- and that's OK. By its nature, transition requires you to get outside your comfort one -- early and often. It's hard, but there really is no other way. Maybe we sometimes wish otherwise, but growth and achievement in life are rarely possible without pain, sacrifice, risk, hard work, and courage. As an analogy, think of the scaffolding around a building under construction; it may be ugly and inconvenient, but someday it will be removed and a beautiful new structure will greet the world.
10. Last but definitely not least, be joyful and have fun! There is no question that transition is challenging, as evidenced by points 1 through 9 above. But speaking from experience, if transition is done right, and for the right reasons, be assured that it can give you joy and a sense of fulfillment that you never imagined. It is an opportunity for you to really be yourself -- and there's nothing else like it in the world. Look upon a successful transition as both a privilege and a gift -- one that enables you, quite literally, to have twice the life perspective that everyone else does. So get out into the world, find what you enjoy doing, be yourself, and live life to the fullest!
