A Guide To MTF/MTN Transition
By Annie Brown.
We all should have the right to access health care without discrimination and barriers to care. This, of course, includes gender affirming health care. Considering state and federal attacks on LGBTQ+ folks and the lack of accessible information on gender affirming care, information is power. There are many different ways individuals may choose to (or have access to) transition. Remember, there are no steps required to validate your gender identity; however, you may choose to engage in one or more of the following to affirm your gender identity.
Social Transition is the process of aligning social and personal life with gender identity. This may include:
Coming out to friends, family, and work. See here for more information: Trevor Project - Coming out handbook
Changing your clothing or hairstyle to affirm gender identity
Changing your name and/or pronouns to affirm gender identity
Tucking is a technique used to make the groin area appear flatter or smoother. It is important to follow safety guidelines to reduce risk of skin irritation, pain, or urinary issues. To learn more about common methods for tucking, see more information here: Tucking Guide
Breast forms are used to create the appearance of breasts. There are many shapes, sizes, and materials that breast forms come in. To learn more, see this link: Breast Prosthesis
Voice training may help to develop a more desired pitch and speech pattern. See more information here: Gender-Affirming Voice Training
Legal Transition is the process of changing legal documents, like birth certificates and driver’s licenses, to reflect the correct name and gender marker.
Utah has made this process quite complicated, and the steps must be completed in a specific order, as detailed here: Petition for Name/Sex Marker Change.
The process requires a letter of “evidence of care,” which can be obtained by a physician or therapist, including our Arches clinicians.
There is a $375 filing fee required when an individual is petitioning for a name or gender marker change - fee waivers may be available based on income level.
See attached document for more details: Instructions for Name Change.
This process may take a couple of months to complete. Be patient - we know it’s hard!
Medical Transition involves medical interventions to modify physical characteristics to
better align with one’s gender identity. This may include:
Hormone replacement therapy helps individuals to achieve a physical appearance that more closely aligns with their gender identity. Estrogen is the primary hormone used in MTF hormone therapy to promote the development of secondary sex characteristics, such as breast growth, body fat redistribution, decrease in body hair growth and muscle mass. Individuals may take testosterone blockers to increase effectiveness of estrogen and support decreases in body hair growth and muscle mass. There are multiple methods of hormone administration including injections, tablets, and patches. Learn more here: Hormone Therapy Information
Hair Removal may include electrolysis or laser hair removal. See here for more information: Understanding hair removal options
Voice Feminization Surgery adjusts vocal cords to raise pitch in order to create a voice that aligns with one’s gender identity. It is often paired with voice therapy. See more information here: Voice therapy and surgery information
Facial Feminization Surgery refers to a variety of procedures to alter facial features in order to maximize individuals experiences of gender congruence. Learn more here: Facial Feminization
Breast Augmentation involves use of implants or fat grafting to enlarge or construct breasts. Body Feminization Surgery involves the use of liposuction, fat grafting, and/or skin excision to change the shape of the body in order to affirm gender identity. See more information here: Breast Augmentation
Tracheal shave is a surgery that includes the reduction of the thyroid cartilage (adam’s apple). Learn more here: Tracheal Shave
Bottom Surgery refers to procedures that alter internal and external reproductive organs. Utah requires a letter from a qualified mental health professional documenting a gender dysphoria diagnosis. Per insurance requirements, the letter must be dated within 12 months of the surgical consult. Our Arches therapists are able to provide these letters. Utah requires a letter from a qualified mental health professional documenting gender dysphoria. Some common surgeries include:
Vaginoplasty is a surgery that creates a vaginal canal alongside a vulva or
external genitalia. Some surgeons require genital hair removal prior to surgery to
prevent internal hair growth.
Vulvaplasty is a surgery that includes the creation of a vulva, clitoris and labia majora using tissue from the penis, scrotum, and associated skin and tissues. Some surgeons require genital hair removal prior to surgery to prevent internal hair growth.
Labiaplasty is a surgery that includes the creation of the labia minora and clitorial hood. This surgery is often preformed following a vaginoplasty or vulvaplasty.
Orchiectomy is a surgery that removes the testicles
Scrotectomy is the surgical removal of the scrotal sack tissue
Check this link for more information: Guide to bottom surgery Legal Transition For Transgender Utahns
Resources For Medical Transition in Utah
Different insurance companies offer varying coverage for gender-affirming care. Some carriers are more permissive and cover a broader range of care. One provider may cover everything from FMS to bottom surgery and beyond, while others may only cover bottom surgery. Other carriers may not cover gender-affirming surgery at all.
If you have a good relationship with your employer, it may be worthwhile to ask them to choose a policy that supports transgender individuals. Your employer may be willing to shop for the right plan, but they may not know what to look for or understand how important coverage is for trans folks. If you have a partner, it can also be helpful to compare the coverage on their plan with yours to find the best options.
We recommend researching your policy and provider before beginning care. Understanding your coverage in advance can reduce stress and prevent financial surprises.
Some gender affirming clinics in Utah include:
Salt Lake City Gender Affirming Hormone Therapy
LGBTQ+ Health at Intermountain
Find Your Community
It can feel isolating to navigate this journey on your own, but you’re not alone. Finding a supportive community can help manage anxiety and stress. Sharing space with other transgender and non-binary folks can help you normalize your experiences.
You can also ask other folks for advice and share resources. You don’t need to reinvent the wheel, and many people have overcome the same obstacles you’re facing. We encourage you to look to others and see what has worked for them. It can save you time, money, and stress to learn what has worked for other folks in your community.
Here are some organizations that bring transgender Utahns together:
Events | Under the Umbrella Bookstore & Cafe | A Queer Little Bookstore
For a more detailed guide to MTF transition, check out the Gender Confirmation Center’s Guide to Transition.
It’s okay to take your time. Transitioning is a process. At Arches Healing & Growth, we’re here to help.
