Checklist

This is a step by step checklist of things you should be doing during your transition and things you will NEED to get done.

1.) Get an evaluation and diagnosis of gender identity disorder from a qualified Psychologist.  Feel free to get a 2nd opinion from another psychologist if you have doubts or concerns or if you feel that something isn't right.

2.) Make the decision to transition or not. It's entirely up to you. No one should ever force you, coerce you or otherwise make you feel as though you have to transition simply because you have a diagnosis of GID or Gender Dysphoria. Many transgender people choose to never go through transition, while many others do.  It's a decision that must be weighed carefully and one that takes maturity and wisdom to make.  Don't be afraid to ask questions and never assume that surgery will be your cure all-end all to your problems, because it won't be.

3.) Seek out and select a gender identity therapist and begin counseling.

4.) Petition the court and change your name legally. Once you have done this you will need to update your drivers license, all debtors, banks, utilities, landlords, all three credit bureaus, the Social Security Administration and any applicable law enforcement departments (i.e. Handgun Carry Permits, business licenses, or other special licenses that you may have).

5.) Choosing when and how to tell your family and friends is a delicate matter and one that must be weighed carefully.  I personally lost nearly 100% of my family and 85% of my friends when I came out. It was emotionally devastating, it hurt but I continued forward, I fought through it and I made it.  It is a heavy emotional burden to lose those you love. Be prepared. You will make new friends. They will become your support system and your family.  Either way you go, the earlier you tell them, the better things will be in the long run.  Delaying the inevitable only delays pain and sorrow. It's my recommendation to tell them once you have made the decision to transition.  They will either accept you or they won't.  Hope for the best but prepare for the worst.  Telling them sooner allows you to move forward quickly and to heal if they reject you.  The sooner you put it behind you and move forward, the better of a person you will be in the long run.  But ALWAYS be receptive to them coming into your life should they have a change of heart as sometimes it takes time for them to change.  Bearing ill will and anger towards them is not good for your heart and emotional well-being.

6.) Seek out transgender support groups and surround yourself with like minded people.  Support groups can be good, but they can also be bad. Be wary, choose carefully and always evaluate everything.  I will discuss transgender support groups in another post.

7.)  After 3 months of GID therapy, discuss going on Hormone Replacement Therapy with yor therapist.  He/she should provide you a transition letter at this point as well as as a letter recommending you for HRT.  HRT can be expensive and I have a post specifically dealing with HRT here.

8.) You should be living full time as a member of the gender you identify with.  You should also be seeking out some form of speech therapy to help you obtain a higher pitch and more feminine sound to your voice.

9.) From the time you decided to begin transition to now, you should be growing your hair out.  Learning how to style your hair, getting it cut/trimmed and highlighted as appropriate should be a focus point.  This will go a LONG ways towards you being passable.  Front and side bangs reduce masculinity of the face.  Especially if you have a pronounced brow bone and dark shadows under your eyes.  Find a transgender friendly hair stylist and experiment with different styles, layers, bangs, where you part your hair.  Getting a blow dryer and a flat iron will help very much.  Hair ties, pins and other hair instruments can help you to achieve the look you want.  Be open to constructive criticism from cisgender women, they know hair very well and can help you tremendously.

10.)  At the same time, you should be learning makeup techniques.  Blending can reduce masculinity in the face.  As can contouring.  Difficult to learn on your own, but if you can find someone that is skilled, they can teach you.  Don't over do the mascara or the eye shadow.  Raccoon eyes do NOT look good.  Blending techniques will help the eyes.  There are certain creams that can lighten the areas under the eyes too.

11.)  You should be employed, and whilst employment is difficult for transgender people, here in Colorado it is against the law for them to discriminate against you on the basis of religion, ethnicity, race, disability, sexual orientation and gender identity.  You are legally protected here.  However, Colorado is also a right to work state, and that makes it easier to terminate someone for anything at anytime.  So keep that in mind.  I have a post about Employment here.

12.)  Currently, Colorado has a marketplace for insurance plans.  Those plans fall under the guidelines of the ACA (Affordable Care Act).  Additionally, they also MUST follow Colorado guidelines.  Here in Colorado, all insurers selling on the market are required to offer insurance to transgender individuals that cover gender reassignment surgery.  The plan will specify CO-DOI on the marketplace when you buy it and it will also show up on your insurance card.  This designates that they are subject to Colorado laws.  On 01/24/2017, Cigna approved my gender reassignment surgery.  They denied my breast augmentation as cosmetic.  I believe that under Colorado Law, they discriminated, so I am going through the appeals process with that.  Their own policies state that if you are on hormones for 12 months and have had no significant breast development, then it may be covered.  But the gender reassignment surgery was the important one.  I had my surgery in February of 2017.  I opted to cover the breast augmentation so I didn't have to go back for another surgery and pay more hospital and anesthesia fees.  The plan I had was the Colorado HSA Bronze 5500.

There's a lot of unknowns at this point with the political climate as to whether these surgeries will continue to be covered or not after 2017 ends.  Currently ALL Colorado insurance contracts are guaranteed until Dec 31, 2017.  If you're lucky to have gotten insurance and have a surgery date scheduled prior to the end of the year, be very thankful that you were fortunate to get it covered and completed.  Come January 1st, 2018, all bets are off.  I will closely be following what the Trump Administration does with it's proposal for their healthcare package, and as of yet I can NOT find anything that includes transgender surgeries being covered in their proposal, which is truly sad.  I will have a post specifically on Insurance at a later date.

13.) Living small, spending lightly and saving money should be your primary goals.  Most bottom surgeries done in the USA cost about $22,000.  That's with anesthesia, hospital fees and the procedure itself.  If you are getting breast augmentation done, you can figure in another $5000-$6000.  If you choose to get it done separately at another date, you can figure on paying anesthesia fees and hospital fees on top of that $5,000-$6,000 which can push the costs to $10,000-$12,000 easily just for a breast augmentation.  So keep that in mind.  It's better to get them done at the same time and save thousands than to do them separately if possible.

14.)  Having surgery is one of your last steps.  You should be mentally and emotionally prepared for your surgery.  You should have paid your deposit, have airfare and hotel (if applicable) and you should have someone going with you to help out because you are going to need all the help you can get.  You will also need money for food, beverages (sprite and water), depends (pullups), bed pads and wet wipes. I have a complete list of supplies here.

15.)  The final step if you are fortunate to be born in a state where you can change your gender marker on your birth certificate (Colorado is one of those states thankfully!) is to petition the court by filing a motion to amend your vital records, and get the Order signed by the Judge.  Then you go over to the Dept of Vital Statistics and take your Court Order and get your new birth certificate.


There's minor nuances I've left out of this checklist, but they should all be pretty obvious or are relatively unimportant.  I've covered all the important ones.