A legal change of name also is involved. Persad has services available to work with employers in such situations. If top management agrees, things usually can go smoothly - that is, other employees will go along if the company policy is clear. Most of us avoid a restroom like a plague because we are afraid of the reaction of others, even though with stalls there should be no difficulty. But you don't want to face someone becoming hysterical about it.
Women changing to men undergo hormone treatments to suppress their breasts and to grow beards.
At any point, the gatekeeper therapists can halt the process. It can be done locally, but many prefer to go elsewhere, with Montreal especially popular. Clearly, no one spends that much money lightly. Peace of mind, say people in these categories - becoming the gender that their urgings, their pain all along told them was their destiny. Divorce frequently follows, but it's not always the case.