How to Cope with Not Being Able to Transition

Get started on the road to finding support with this guide on living with gender dysphoria

Last Updated: November 22, 2022 References

There are various reasons you might not be able to use hormones and/or have surgeries at this stage of our life. Maybe, you're dealing with money issues, poor accessibility, remote location, not having gender therapists nearby, strict government policies, being a little unsure about your gender identity, medical concerns and other medical conditions, or simply not wanting to transition physically. That does not mean you are totally helpless and there's nothing you could do. This guide is for transgender people who are in this difficult position but don't want to remain closeted either.

Part 1

Part 1 of 3:

Taking Care of Yourself

1
Explore who you really are. ^{[1]
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Research source}^{[2]
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Research source} Browse online catalogues and pictures, do some fun quizzes or watch videos to find out what you really like, what your style is, what kind of people you're attracted to and what kind of people you identify with.
- Learn to make a distinction between people you find sexually attractive and people you notice because you'd like to look like them.
- This limbo you're in is a perfect time to do some exciting soul-searching and learn to know more about yourself.
- Picture your ideal self in your mind. What kind of person would you really like to be? What skills would you have? How would you look like? Where would you live ideally? What things is this person able to accomplish? How are they different to you at the moment? What steps can you take right now to start going in that direction? This might include exercising/working out, developing new skills, changing jobs, or getting more social. Even if you are unable to tackle your gender right now, you are always able to improve yourself and your life in some way.
- Think this journey as a way to make yourself better on all levels as a person. Gender can hugely affect things but gender isn't everything. Are there things you are not happy with yourself at the moment? You can work on depression, social anxiety, anger issues, and self-esteem; expand your comfort zone little by little, try new things, quit smoking, sort out your relationships with people, and develop as a person. Even if gender is on hold, you can advance in other areas of your life. Try to be a better person than you were yesterday, and don't compare yourself to others.
- Only the sky's the limit for what you can achieve! Explore yourself, let go of bad traits/habits, and develop new life skills. Become a completely new person who is able to do all those things you wouldn't dream doing before!
2
Take good care of yourself. No matter what you do for gender expression, you need to take care of yourself, just like anyone else.^{[3]
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HelpGuide
Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources.
Go to source}^{[4]
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Research source}Eat and drink regularly, get enough sleep and take care of your physical well-being. If you feel dysphoric about going to the gym, you can always exercise at home.
- Remember that you can dance, do some weight-lifting or aerobics or some similar DIY exercising, or just simply take walks outside.
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3
Come up with creative solutions to express your gender and battle dysphoria.^{[5]
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Expert Source

Inge Hansen, PsyD
Transgender & Diversity Specialist
Expert Interview. 19 November 2019.} You can find lots of options online. Bind or stuff your bra, have a nice gender-affirming haircut and wear clothes you feel comfortable in as much as possible. If you are very depressed, remember to take good care of yourself, and if possible, talk to a therapist about it. Exercising is a great tool to cope with depression. ^{[6]
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Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources.
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- For girls these might include buying feminine clothes, shoes and underwear, stuffing your bra, tucking, dealing with being fully naked, trying out makeup, experimenting with wigs, shaving or electrolysis, letting yourself be more feminine and have more feminine manners in general, working on your voice, buying breast forms, or playing with apps that can change your face from male to female.
- For guys these can mean binding, packing, dealing with your period, dealing with being fully naked, getting a manly haircut, working out, learning more masculine mannerisms, buying clothes from the men's section, working on your voice, hanging out with other guys more, and growing your body hair out.
- To help with passing, you can pay attention to how other men and women around you act in different situations. What are they doing with their hands or their legs? Sitting in a café and observing others is a great tip! Are there some things you'd like to drop from your behavior or some features you'd like to add more? Just changing the way you sit can make a difference to you and others.
- For some, "passing" can be an ugly term. You don't have to change anything about yourself or your behavior - just do it if it makes you feel better.
- The most important thing is to be yourself, after all. And not all trans people ever go on HRT. Some are still able to pass as their preferred gender regularly. Passing is about looks to certain degree, but it is also about the cues and vibes you give out, and the way you move and carry yourself. There are people who don't pass at all pre-everything, and then there are people who pass most of the time. Even if you don't pass, you can still dress and behave in a way that feels comfortable to you. That will make people interact with you more according to your behavior than looks.
4
Try to love your body and yourself. ^{[8]
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Research source} This is a challenge for some, but you can feel dysphoric about certain body parts without hating everything about your body and yourself. Even if you do undergo some surgeries in the future, your head, hands, legs, feet, height and all the other parts will stay the same!
- You could try to look at your body as being right and yours, with just some medical issues you'd like to change. The parts you don't like don't have to determine your whole person. It is natural for a cis-woman who doesn't have breasts to want them, but it doesn't mean she hates her body for it.^{[9]
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  BreastCancer.org
  Patient-focused nonprofit organization providing resources for those affected by breast cancer
  Go to source} .^{[10]
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  Research source} Men can have gynecomastia which means they develop breasts, but survive it.
- Some people are born with conditions or suffer accidents that affect their outward appearance but it doesn't have to affect their inner sense of self. They can still accept the fact that they look like that and they still can be proud and full of life. Don't view yourself as flawed, but unique.
- If you have problem with your genitals, remember that there are intersex people who have ambiguous genitalia. They can still be proud women, men or non-binary people.^{[11]
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  Research source}^{[12]
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  Research source} You could have also been born with a micropenis. ^{[13]
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  Research source} Every person's genitals are different, and the fact you'd have liked to be born with a different set doesn't mean you should hate yours and not enjoy them. Try not see yourself as a "woman with a penis" or as a "man with a vagina," but rather as a whole human being who just happens to be that way.
- You also have the right to enjoy sex even if your genitals cause you dysphoria.
5
Stay fit. The better you feel about yourself the easier it is to also learn to love your body. Doing some pleasurable exercise will enhance your mood, help with depression and negative feelings and help you reconnect with your body. ^{[14]
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HelpGuide
Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources.
Go to source}^{[15]
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- If you are a guy, doing some weightlifting, even a little, can make a dramatic effect on your self-esteem. Did you know that women are as capable to have muscle mass as men? ^{[17]
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  Research source}Testosterone won't suddenly turn you from a skinny twig to a Schwarzenegger, so it might be a relief to hear that you are able to look "manly" even without it!
- Find something you really, really enjoy doing! It can be anything from golf to dancing to trampoline. You might like horse-back riding, or just walking your dog.
6
Try not to compare yourself too much to others. Looking at pictures of cis-people or trans people who have been on hormones for a while can make you feel desperate and overwhelmed. Avoid it!
- Remind yourself that they only look like that because they are on hormones, and you'd look exactly like that if you were too.
- Comparing is a trap: Every cis person will feel down, too, if they spend their time looking at models and celebrities. Remind yourself what the normal people around you look like: your family members, friends, coworkers... Are they all hot and muscular or thin and flawless? Probably not. Compared to them, you might actually be very good-looking!
- Try to accept your body. This can be easier said than done, for anyone, let alone for some who doesn't feel at home in their own skin. However, it is still a good goal to shoot for. Work with a therapist on ways you can address gender dysphoria.
7
Find a gender therapist. Even if you don't plan to medically transition, a knowledgeable therapist can help you through this and cope with dysphoria and depression. You can talk to them about your feelings and fears and explore your gender identity.
- Find a Supportive Therapist if You Are Lesbian, Gay, Bisexual or Transgender can help you make sure you get supportive professional help. There are also therapists who are willing to do online sessions via webcam so this might be an option for people living in remote areas.
- If you don't have access to a gender therapist or can't afford it, turn to other online support. ^{[19]
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- Some local LGBT centers offer free counseling, you might just not be aware of it! You can also contact centers in other areas, and communicate via email, phone, or webcam. In addition to strictly LGBT related centers, there are also places that offer short-term counseling for free for everyone and crisis management. You should really look into options that are available to you. You might be surprised. If you are not able to access a real gender therapist, you might be able to contact other mental health support or meet up with a social worker or counselor, even for free. Remember to contact as many services as you need to get help! Don't give up just yet if the first option doesn't work out.
8
Focus on something else entirely. Try not to spend all your time fretting about this. Instead force yourself to focus on other things: old and new hobbies, learning something new (like a language or an instrument), playing with children or animals, watching TV, listening to music, singing, dancing, hanging out with friends, clubbing... Anything that will get you distracted will do!^{[20]
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HelpGuide
Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources.
Go to source}
- The less you think about your gender struggle, and the more you focus on other things, the better. You'll feel less anxious about it when you remind yourself that it's only a tiny part of who you are as a person. ^{[21]
 X
 Research source
 Hoffman-Fox, D. (2016). You and Your Gender Identity: A Guide to Discovery. Colorado Springs, CO: DHF Press.}
9
Learn to ground yourself.^{[22]
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Hoffman-Fox, D. (2016). You and Your Gender Identity: A Guide to Discovery. Colorado Springs, CO: DHF Press.} When anxiety hits and you feel really hopeless and depressed, it is good to know how to overcome that feeling. Because that is what it really is: a feeling. It will pass. And it oftentimes does not reflect the actual reality. Your situation seldom is as hopeless as you perceive it to be when you really feel down.
- Stimulate your senses! Smell something (perfume, a flower, deodorant), taste something (something strong-flavored or something you really like), listen to something (nature sounds or music), touch something (a fabric, a teddy bear), stimulate your vision (by looking at beautiful photographs or pics you were happy in or pics of baby animals). Keep something at hand all the time! Using your senses will reduce anxiety in a heartbeat.^{[23]
 X
 Research source
 Hoffman-Fox, D. (2016). You and Your Gender Identity: A Guide to Discovery. Colorado Springs, CO: DHF Press.} Keep doing it until you are calmed down.
- Schedule worry time.^{[24]
 X
 Research source
 Hoffman-Fox, D. (2016). You and Your Gender Identity: A Guide to Discovery. Colorado Springs, CO: DHF Press.}^{[25]
 X
 Research source} Set up a time for each day (5-10 minutes) when you will tackle your worries and anxiety. During that time you will only concentrate on your worries, nothing else, until the time is up. During the whole day you will not let yourself worry - each time you think of a worrisome or negative thought, you will firmly state to yourself, 'I don't have time for this right now.' Instead write that thing down to be dealt with during the actual worry time. This exercise frees up lots of mental energy usually spent on worrying and teaches you to control your mind and anxiety. You can decide to do a self-care activity right before and after the worry time. That will make you feel even better. ^{[26]
 X
 Research source
 Hoffman-Fox, D. (2016). You and Your Gender Identity: A Guide to Discovery. Colorado Springs, CO: DHF Press.}
- Try out meditation or deep breathing exercises.
- Come up with things that will make you instantly feel better when you do them (such as being with friends, listening to music, dancing, going outside, playing with your pet, reading, watching comedy, exercising etc.) Keep a list at hand and when you feel anxiety building up, refer to this list and start doing those things. Soon you'll forget about your anxiety.^{[27]
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 Research source
 Hoffman-Fox, D. (2016). You and Your Gender Identity: A Guide to Discovery. Colorado Springs, CO: DHF Press.}
- You are able to control your mind and your thoughts if you just practice enough! You don't have to suffer from anxiety attacks, extreme dysphoria, and negative and self-deprecating thoughts. You can overcome this.

Part 2

Part 2 of 3:

Interacting with Others

1
Be out if you want to. Even if you're not being able to access hormones etc. that doesn't mean you have to be closeted. You are entitled to be yourself and say out loud that you are transgender (or a boy or a girl). People might not see you as your true gender, but that doesn't mean you should hide and be embarrassed of what you are.
- Remember that not all trans people even medically transition, and it is not a requirement or proof of being transgender. Do not start to think that your situation means you are not really trans. Not being able to transition is not the same as not wanting to.
2
Do not conform so much you lose yourself. If possible, be proudly who you are and walk and talk and dress as you please. Don't watch out for mannerisms or appearance choices and try to be as genuine as possible.
- Remember that people are generally blind to some things like haircuts: It is a big deal for you, not to them. If you are a "guy" to them and grow your hair long, they can't know you did it because you want to look like a sexy woman. Many cis-women have extremely short haircuts.
- If you have to make compromises (like for work), acknowledge it to yourself when you make them. They may be necessary, but they're likely temporary. Don't let the compromising eat away your personality and sense of self.
- Try to bend the lines whenever possible, and aim for choices that make you feel comfortable (or even a little rebellious). If you need to wear a suit type of outfit to work, maybe you can get that from the women's section or vice versa, or add some accessories that make you feel better about yourself. Remember that people can be blind about this: they'll see a man in a suit or a woman in a jacket; only you know that you're actually dressing in the clothes of your preferred gender. You could at least wear affirming underwear or socks.
- Whenever possible, treat yourself with something nice like a new piece of clothing, accessory, some makeup or gift. Even if you're tight on money, don't lose your sense of self.
- Even make-up can be bending lines: Many men use it nowadays and many women don't. No one will know your reasons behind it.
3
Keep supportive company. Hopefully you have family members or friends who do support you. Spend as much time with them as possible. Avoid people who bring you down or don't respect your name and pronouns. They can have a gnawing effect on your self esteem. Good, supportive friends remind you there are people who can see you as you truly are. The more you surround yourself with this kind of company, the better! .^{[28]
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- If you don't have supportive people in your life, turn to online friends and support groups. They can fill the void and you'll realize there are others in the exact same position as you. Don't hesitate to contact people or make an account. Support from others can transform your life. You won't feel alone anymore.
- Many places have LGBT centers or support group gatherings. If in any way possible, consider joining a group. Seeing others like you, who are also pre-everything, is extremely validating. If you don't get support anywhere else, you will be amazed how you feel when you are truly accepted and respected as yourself. Visiting a center can be the first step you can take to battle the isolation you are feeling. There are others like you, even nearby!
4
Don't isolate yourself. You are probably already suffering from isolation as it is very common for LGBT people ^{[30]
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Research source}^{[31]
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Research source}, let alone for trans people who are unable to transition. You may feel that you are completely alone in the world and that no one is able to see your true self. Taking the first step to reach out for help can therefore feel absolutely overwhelming. If you have faced discrimination or transphobia in the past, you may be unable to trust others easily. Remember that:
- Your perceived state does not reflect the reality. Even if you don't know that yet, there are others like you, and thousands of people have been where you are right now. Every trans person has experienced the pre-everything state at least for some period of their life. Others only transition in their 60s and still come out just fine if they just don't lose hope.
- Not having anyone to turn to is a miserable state. If you are not out to anyone, consider confiding in some trusted individual. There are almost 8 billion people on this planet - contact as many as you need to find that support. Your personal experiences might have been bad in the past. That does not mean that the majority of people are unable to accept transgender people.
- If you feel isolated, being alone in the world can make your current struggles that much more difficult. It's crucial that you reach out for help if you feel like this. Find trans support sites and groups online you can contact. Other trans people can give you invaluable insight and advice on how to cope with life and your process. That can't be stressed enough.
- Avoid mental traps like 'trying to cope on your own' 'it's too embarrassing to tell anyone' 'I just can't contact anyone' 'no one will understand' 'I'm completely alone'. If you find yourself feeling/thinking like this, it's crucial you try to get some help! There isn't a situation that can't be improved. The first time you reach out can be overwhelming. But when you just take that first step in some direction, it will get easier after that.
- If you are embarrassed by your situation, find one person or hotline you can confide in. Once you get it all out for the first time, the power the shame has over you diminishes dramatically. The more you open up and tell people about your situation and your struggles, you will find that others have gone through similar and you are not as alone as you thought you were. Start opening up little by little.
- Many places offer local trans or LGBT support groups. Attend these if you in any way can. If you find it extremely hard to interact with people in general because of your body/gender, you will find that these groups are safe spaces where you can be yourself and also respected as such. The isolation, humiliation and shame will lessen when you notice there are people who are able to take you seriously and appreciate you as your true self.
- The first step to combat isolation is to make that first contact. It might be easier to do online or via email if you have social anxiety.
- Every step you take will create other steps naturally as well. Each new person you contact will expand your social network. The more people you know, the less isolated you'll feel. Don't be shy to lean on others for support when it gets tough. Your new contacts will support you through the tough times. It is very relieving to have someone to talk to when you need it - even if just online.
- The internet is your best friend here! You can contact anyone anywhere in the world! If you are living in a remote area or one that is anti-LGBT, you can find your community and like-minded people online. You can also contact support centers in other countries.
- Just don't suffer alone! There are lots of people out there ready to help. No situation is so tough there isn't a way out of it. You just need to make the first move yourself by reaching out for help.
5
Try to reflect your genuine self. The best way to be recognized as your true gender, even unconsciously by people, is to be as genuine as possible. Don't be ashamed of who you are and act exactly like you would at home (if it's safe, of course). Even if you don't look like how you'd ideally like to be perceived, people tend to treat others according to their behavior and personality, not looks..^{[32]
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- Act like a confident and cool dude, and you'll be perceived as one regardless of your gender. Act feminine and hang out with the girls talking girl stuff, and you may find yourself invited to their private pajama party.
- The more confident and genuine you are in your own skin, the less awkward people will feel about it, no matter how non-conforming you may look. Walk straight, shoulders back, head up high and use a dashing smile to win people over! People are naturally drawn towards confident "leader" types - regardless of what they are wearing.
- When people have seen you the whole time as your true self, and if you someday medically transition, it won't be much of a shock to them.

Part 3

Part 3 of 3:

Looking Towards the Future

1
Change your name if you can. You probably already have a new name that you go by, but if you don't, find one. You can use an online baby name generator for ideas. You might want to consider changing it legally, too. That way you have a sense of pride in yourself whenever you need to show your documents or interact with people.
- Many cispeople have weird names; there are men named Carmen and women named James already out there. So there's no reason why you couldn't do the same. You are perfectly entitled to change your name (in most countries), so why not go for it?
- You can do this even if you were a little closeted in your workplace. That way at least your name is right, even if your gender marker isn't.
2
Consider legal gender changes. You may be still able to legally change your gender. That depends on where you live, but in some places this is possible. You should find out about local laws concerning this. If this is possible, it might be a tempting idea to know you could actually change your name and even your birth certificate without any medical intervention. In other words, you could live your life as your true gender also legally.
- If you are non-binary and neither F or M fits, there are some countries where it's possible to also have a third gender marker. ^{[35]
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- If this is not possible for you, remember that the single letter doesn't have to rule your world. If you have not taken hormones, it's not even that awkward as to someone who has. Just keep your head high. Hopefully you don't have to show your ID that often.
3
Figure out your future options. Even if you are not planning to medically transition right now, you can find out about all your possibilities for later use. You can figure out which gender therapist or surgeon you'd go to, whether or not you really want to start hormone treatment (HRT), if you'd like to have any surgeries (and if so, which), etc.
- Figuring all this out can take quite some time! Planning this in advance saves you precious time if someday you decide to take that route.
- It can also help you mentally when you know you are doing something concrete about it, even if you are not able to act on it at the moment. When you do have enough money or access to treatment, you already know all this and can start right away.
4
Focus on the things you do have control over. Not being able to transition can negatively affect all aspects of your life and make mental health issues worse. However, just getting on HRT won't suddenly get rid of all of your problems. Things like depression, anxiety, social anxiety, being homeless, being unemployed, having other medical issues, a low self-esteem, being isolated, not having friends or a spouse won't solve on their own. Think about ways you can improve your life in general, despite being transgender. What positive steps are you able to take right now?.
- Planning on your transition and steps you'll need to take for that can give you a sense of purpose in life in itself.
- Do you have mental health problems that you could work on? Could you access a therapist or medical help to deal with these? Consider contacting LGBT centers or other (possibly) free support systems. You can also turn to self-help guides online. A knowledgeable therapist can be a tremendous help. But you are also able to take steps in the right direction on your own.
- If you suffer from low self-esteem or self-deprecation, you can challenge this by learning positive thinking and combatting negative thoughts. Scheduling your worries and keeping a gratitude journal can help a lot. Learn to jot positive things down every single day! Anything goes, however small. Make this a daily practice and weekly read through what you've written down. It will enhance your mood. Learn to treat yourself with respect and practice kind inner dialogue. If there's one thing you can have control over in life, it's getting rid of constantly putting yourself down and belittling yourself. Cultivate self-love instead. Treat yourself like your own best friend.
- Are you having problems with housing, finances, employment or studies? Could you consider applying for a job, switching jobs, or learning a new profession? Would you like to study something new? If you are unable or unwilling to get a job or interact with people in a school environment, there are always options such as self-employment, studying on your own, and online courses.
- If you are battling with social anxiety, you can work on diminishing your isolation, contacting new people online, making new friends at a support group, and generally expanding your comfort zone. Set small steps for yourself, a little goals to achieve, such as attending a group for the first time, or making a phone call.
- All these steps you are taking to better your life are also making your transition easier in the long run. They may not seem related at the moment, but after all all aspects of your life are intertwined. If you are working for a better mental health for example, and developing new healthy coping strategies and making your mind stronger, you are gaining crucial life skills that also help with your transition.
- It will make you feel better when you know you are going forward regardless and your life is constantly improving.
- Take the control back to yourself. You control your life and are able to affect its course! You can always learn to make the best of your current circumstances. There is a way out of every situation.
5
Don't lose hope. If you plan to take hormones or have surgeries later on, you already know that day will come sooner or later. If you don't plan to, you need to learn to not hate yourself or your body, but to be proud of who you are as your unique self! Remember that not all trans people transition medically, and it's totally okay.
- It is your decision to make, so take pride in that decision and acknowledge why you're making it. There's no right or wrong way to be transgender or to transition. Also social transitioning (that you start to live as your desired gender openly) is transitioning.
- If you feel suicidal, contact the Trans Lifeline ^{[36]
  X
  Research source}, Trevor Project ^{[37]
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  Research source} or similar support. If you really feel desperate, don't hesitate to contact emergency help immediately.
- Your life definitely matters. You will do some great things in the future.

Expert Q&A

Question

How do you calm down dysphoria?

Inge Hansen, PsyD
Transgender & Diversity Specialist
Dr. Inge Hansen, PsyD, is the Director of Well-Being at Stanford University and the Weiland Health Initiative. Dr. Hansen has professional interests in social justice and gender and sexual diversity. She earned her PsyD from the California School of Professional Psychology with specialized training in the area of gender and sexual identity. She is the co-author of The Ethical Sellout: Maintaining Your Integrity in the Age of Compromise.

Inge Hansen, PsyD

Transgender & Diversity Specialist

Expert Answer

Try to find ways to express your gender when and wherever you can, even if it's in private.

Warnings

Do not believe you can change the way you naturally are by closeting yourself forever and not "acting on" this. This leads to a great suffering and depression, as you must pretend everyday something you are not, and you are not able to be your genuine self.

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Don't turn to drugs and alcohol to numb your pain. It only causes greater suffering and you risk losing your job and ending up in an even more dire situation. Instead immerse yourself in a pleasurable hobby or exercise.

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Sooner or later you'll come to a point where you can't take it anymore and you feel the need to do something about it. You can't repress your personality forever. If you want to lead a great life and truly enjoy it, don't pretend but be yourself. You'll find a way to do it one way or another.

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Do not use street drugs/DIY hormones. It is dangerous and can cost your life! There's no knowing what they have in them and how they affect your body. Hormones are powerful drugs and even prescription hormone usage must be carefully monitored. If you feel a compelling need to use hormones, try to figure out a way to contact a licensed doctor and a gender therapist.

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