The very first step in transitioning is changing your name, although you don't have to.
The first BIG step is horomones. What are horomones? Horomones are a medicine taken twice a month that slowly help transform you into the opposite gender. They can be taken as injections, pills (note: it is possible that taking pills can destroy your liver), gels, creams, or patches. No form of taking horomones is more effective than the other, although some can take longer. These changes tend to happen more rapidly for younger people than older people. A psychiatrist has to give you permission before you can get the horomones. The transition can take from 3-5 years to complete. Your insurance may cover the transition, but you might want to check, just incase, because there are side effects...
Here's what the horomones do for transwomen:
You will expirience sterility, shrinking of the testicles, diminished strength, less hair growth (as in body hair; chest hair, facial hair, etc.), formation of breasts, loss of erection and ejaculation, smoother skin, redistributed fat, and all other physical changes a girl acquires during puberty.
The side affects that can be accquired are:
-Benign pituitary tumors
-Tendency for blood to clot, causing:
-Deep vein thrombosis
-Pulmonary embolism (possibly fatal)
-Worsening of depression (if you have depression)
-Increased sensitivity to stress
Here's what the horomones will do for transmen:
You will expirience: sterility, increased hair growth (as in body hair; facial hair, chest hair, etc.) voice deepening, larger clitoris, increased sex drive, increased aggression, balding patterns, increased acne, increased energy levels, increased appetite, more easily developed muscle, and all other physical changes a man acquires during puberty.
The side effects that can be accquired are:
Also, there is "top surgery" and "bottom surgery".
Top surgery is the reconstruction of the chest. There are a couple of main surgeries that transmen could get depending on the size and condition of their chest. Keyhole/periareolar is for ones with smaller breasts (below B cup). For transmen with larger breasts they usually do double mastectomy with nipple/areolar grafts.
"Bottom surgery" comes in much more different forms, although many transmen don't get the surgery done.
One of the surgeries is hysto-salpingo-oophorectomy which is the removal of the uterus, fallopian tubes and ovaries. It may allow transmen to go on a lower dose of testosterone. Although, if you get it, you will have to be on hormone replacement for the rest of your life.
There is also metaoidioplasty which is the release of the clitoris (the maxium size is about 4") from its anchor on the pelvis. This allows it to hang lower and seem more like male genitals.
Some people who have gotten metaoidioplasty also get urethral lengthening, which is used with tissue from the vagina. There is also scrotoplasty, which is inserting silicone "testes" into the outer labia and fusing them together.
Then, there's phalloplasty which has two types; one uses skin and nerves from the forearm and grafts that onto the enlarged clitoris. The other way is conducted with skin from other areas of the body (such as your shoulder or thigh) but both of these surgeries result in a scar.
Also, multiple surgeries are usually required to allow the neophallus to actually look like a penis. The phallus cannot become erect on its own. There is also a high possibility of graft rejection and loss of genital sensation, or even blood clots that can cause the death of organs (including the heart).
Although the side effects may sound huge or life-threatening and such, if you've made up your mind, after the horomones you're pretty much ready for the transition.
Although it can vary depending on what state or country you're in, you usually have to be 18+ or have parental permission (I believe the minium age is 15?) to get the treatments.
These treatments usually cost between $7,000-$100,000 (and yes, that includes all the fabulous new clothes you will probably buy).
I hope this will help you answer any questions you had about the transition. If not, you might want to try checking out some of these websites: