Yavari Caralize, 2017

(Disclaimer: This post is for informational purposes only. I am not a medical professional and am not qualified to give medical advice. This advice is based on personal experience. If you want official medical advice about transition, please talk to a doctor.)

Many systems identify as transgender or have system members of many genders sharing day-to-day responsibilities. This article is for groups considering transition, whether it’s physical, social or both.

We actually came to terms with being trans around the same time we realised we were plural, back in our late teens and early 20s. A number of us had been feeling dysphoric over the years, both about social roles and bodily appearances, and we ended up deciding to undergo physical and social transition. The dysphoria just kept getting worse and worse over the years and it was harder to push it away even though we’d tried for a while. We had similar issues with our plurality, where we noticed things going on in our childhood but thought everything would go away when we got older. Neither the dysphoria nor the sensation of being more than one went away with time – in fact, it all got stronger as the years went by – and we realised we had to do something about it.

We’ve been male-presenting for about eleven years, have been on testosterone for almost nine years, and just had top surgery a couple of weeks ago. We’re mostly happy, though sometimes people will get frustrated at how restrictive binary gender roles are. Our system contains people with several different gender identities and expressions, though most of us are men and masculine or androgynous non-binary folks.

For systems who are considering medical or social transition, here are some things to consider:

• Have some system meetings about what your goals are in transitioning. Make sure to hash out disagreements and come up with the best compromise you can. Most of us are men or masculine/androgynous non-binary so there weren’t too many arguments about starting hormones, getting surgery or changing gender presentations, but every system is different and has a different gender composition. Be sure to come up with a workable compromise if there’s disagreement about what different system members want to do.
• Is your dysphoria physical, social or both? This can affect the changes you want to make. Some systems may want to change their public presentation without taking hormones or getting surgeries. Others may want to take hormones or have surgery without changing their public gender presentation. We did both.
• If you’re interested in starting hormones, look at resources on oestrogen, testosterone, progesterone and other hormones and their effects on the body during transition. Some effects are permanent and some will reverse themselves or stop if you stop taking hormones for any reason. Make sure none of the effects of hormones are deal-breakers for anyone there – for example, testosterone can cause male-pattern baldness. Does anybody refuse to have a receding hairline? Oestrogen can cause permanent breast growth. Does anybody not want to have breasts?
• Some doctors have different policies for prescribing hormones or performing surgeries. Some will prescribe hormones using informed consent, where you sign paperwork saying that you understand the effects of hormones and agree to start treatment. Others may require you to be in therapy or psychiatry. We had our hormones prescribed at an informed-consent clinic, though we were also in therapy at the time. Many surgeons or healthcare systems (either private or public) will want a letter from a mental health professional like a therapist or psychiatrist.
• Do you want to transition to a more traditionally masculine or feminine presentation, or do you want to look more androgynous? We mostly look traditionally masculine or androgynous but we do compromise a bit and let people like Kerry and Lilly pick a few femme or flamboyant items once in a while.
• How do you all want to change the body? Do you want to take hormones? Do you want to get gender confirmation surgeries? Talk these things out so everyone is happy or at least comfortable with the changes.
• Do you want to legally change the system’s name? If so, make sure to come up with a consensus on a name that people in your system don’t mind answering to. Some jurisdictions have restrictions on what kinds of names you can choose if you transition. Also, legal name changes can be expensive depending on where you live, though sometimes you can have fees waived if your income is low enough. You’ll also have to change your name with government entities, banks, educational institutions and workplaces. Deciding to get rid of the dead name in court was easy for us – we all hated it – but it took us a while to get all the paperwork in order.
• If it’s possible where you live, do you want to change your legal gender (that is, changing the gender label on your regional/national ID, driver’s licence, birth certificate and/or passport? Changing some of these can be easier or harder depending on what your local, regional/state/provincial or national laws are. Some places just want a doctor’s note. Some are stricter and may want evidence of any physical transition, and some are even stricter and want proof of sterilisation.
• If you’re currently in the mental health system, does your therapist or psychiatrist know you’re plural? Are they trans-friendly? See if you can work with them to support your transition if you need their cooperation to start any irreversible physical changes. If you’re having a hard time with them, try to explain that you’ve collectively come to a consensus. If they’re still stonewalling and you’re all sure that you want to start physically transitioning, see if you can find a new therapist. Larger cities sometimes have LGBTQ-specific clinics or may have directories that list trans-competent mental health professionals.
• Do you all have any health conditions that may affect your ability to take hormones or get surgeries if you’re interested in physically transitioning? Be sure to talk to a doctor about their effects to make sure you’ll be safe.

I’m not listing these considerations to discourage any systems from transitioning, of course. We did it and I think our quality of life is much better than it would have been if we hadn’t. It’s just important to take into account the effects of any major life change, especially if those changes affect several people. Good luck!