ABSTRACT
Typically, the first medical help transgender people desire is to be placed on cross-gender hormones, that is, estrogen for birth-assigned males transitioning to female, testosterone for birth-assigned females transitioning to male. ‘Top’ surgery for transgender women is breast augmentation, and is optional and chosen only by those women who feel the breast development they have attained through hormones is inadequate. Minors who come out as transgender can now avail themselves of puberty blockers and early use of cross-gender hormones, with parental consent. Transgender adults often face institutional bias, particularly if they are economically disadvantaged and must rely on social services. The inability to ‘pass’ puts transgender people, especially women, at risk of physical assault. One study of post-operative transgender women found high rates of sexual satisfaction, especially with the ability to become aroused and reach orgasm. Transgender adults may face barriers with institutions such as rehabilitation centers, shelters, or prisons that segregate people by gender.
