Medical Transition in India

Transition is not an all or nothing type of deal and you should pick and choose what aspects are right for you at each point in your journey and not hesitate to drop certain aspects or take a pause/change your path (with help from qualified specialists, as needed) if a choice or direction doesn't feel right and any point of time.

Remember you're doing this for yourself, and not other people's expectations of what you should do or how you should behave based on your label (labels only describe your current situation and we should never let them define us - or let others constrict/stereotype us with them)

One good way is to use an exploratory approach where you first start out with non-permanent/temporary changes and then escalate to permanent ones when you get a better understanding of yourself, taking your time with everything - for example (for Trans-feminine people) you may first shave off your body hair and see how it feels for a while, and then try waxing or epilation, and finally go for laser for permanent hair removal once you know being body hair free is right for you. Similarly with any other aspect of transition.

There is no set path and everyone's transition journeys are unique, and people only take the steps that are right for them.

Some common steps may include

* Social changes (coming out, gender affirming name, etc)
* Presentational changes
* Voice Training
* HRT
* Top surgery
* Bottom surgery

Trans-feminine / trans women specific:

* Facial Feminization Surgery
* Permanent Hair Removal

## Path for medical transition

A typical path for medical transition is to first get your diagnosis and a letter of support for HRT from a Psychiatrist, and then take that letter to an endocrinologist to get you started on HRT after testing your physical well being (liver health, etc), and then typically after an year of being of being on HRT you can go to psychiatrist for a letter of support for bottom surgery, if so desired

1. Psychiatrist evaluation
2. Fertility Preservation (if you'd like)
3. Endocrinologist consultation
4. Surgeries - Bottom/Top/Others

Medical transition (and transition in general) can be a long and slow process, but the results can be life changing for a lot of people when done right, and life threatening when done wrong, so always try and undergo any medical procedures only with qualified medical professionals

### Psychiatrist evaluation

The goal for your sessions would be to go over your history from your early childhood to the present date and assess if you do have gender dysphoria or gender incongruence, while also testing to see if you have any history of psychiatric illnesses as well.

This is all done in accordance with the international WPATH standards of care and you may get a DSM5 diagnosis of Gender Dysphoria/ ICD11 diagnosis of Gender Incongruence at the end.

They will ask you various questions around your history and you'll just have to recall and tell them about it honestly to the best of your recollection.

It may help if you journal your experiences especially with gender so far, so that you can recall and express the same more easily during the sessions

Depending on your case history it may take between 4-6 sessions on average for them to reach a diagnosis but the whole process can take between 1-6 months or even longer depending on your particular case. Though all this again depends on your psychiatrist, and there are some known to complete their diagnosis in a single session.

At the end they will educate you about further steps and on the risks and what to expect with HRT, etc - be sure to ask any questions, etc you may have

These sessions can cost between 500 INR to 2000 INR per session depending on the psychiatrist, but with the right doctor, they will be worth it - think of it as a one time investment for such a life changing journey. Some doctors may be willing to charge lower fees in certain cases

Once the evaluation is complete, they may give you a letter of support that you can then take to an Endocrinologist

### Endocrinologist

An Endocrinologist can prescribe cross-sex hormones - the hormones will slowly change your body and it may take up to 3 years or more for their effects to fully manifest and reach a stable point - PLEASE AVOID SELF MEDICATION if possible as it could really permanently damage your body, & only take prescribed doses

Please note that once you start cross sex hormones, you will typically need to take them for the rest of your life/until your old age continuously as stopping them could lead to higher chances of osteoporosis, reversal of transition progress, etc. And hormones can cost upwards of INR 1000-5000 per month

Then it's usually recommended that you stay on cross-sex hormones for at least an year before going for bottom surgery if desired/required, and you may need an additional psychiatrist evaluation and letter of support for the same at that point of time

### Additional reading

* https://transgenderindia.com/frequently-asked-questions-about-transitioning/
* https://transgenderindia.com/how-can-i-self-medicate-my-gender-transition/
* The forum at https://transgenderindia.com/talk/ can be a good place to find trans\* friendly medical professionals
* https://transfemscience.org/articles/ is a highly recommended resource on the research & science of trans-feminine HRT

#### Other topics under Gender Identity

* Non-Binary 101
* Resources on the basics of all things Trans\*
* A guide to questioning your gender
* Legal Name and Gender Change in India

### A few medical professionals specializing in gender dysphoria and transition care

A good place to find professionals & reviews about them in your area or online could be via the search function on the TransgenderIndia Talk forum

**Note**: Online consultation can be just as good as or even better than offline, you get your diagnosis & then later prescriptions that are valid everywhere, even with the government for legal changes later; And they generally accept a wide variety of payment options, including UPI. Not to mention being able to consult them from the safety & privacy of your home or another safe space.

#### Psychiatrists who consult online

https://transgenderindia.com/talk/d/7559-hi-all/6

> Would recommend Dr.Kalra who has been working wid our communities for 10+ years. He works in Monash Gender Clinic, Australia. He does online Skype consult. His contact details +61401646935. Note - someone here in dis very forum has had a bad experience wid Dr.Kalra. But generally he is very gud wid our communities. I have seen many folks get Der gd referral letter from Dr.Kalra.
>
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> Dr.Siva Prakash Chennai offers online consultation. Secretary number is +919360363676. You can get more information from d above number. - https://transgenderindia.com/talk/d/10269-online-psychiatrist/2
>
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Dr Hema Tharoor, Chennai - https://transgenderindia.com/talk/d/3691-psychiatrist-in-chennai/2

#### Endocrinologists who consult online

* https://transgenderindia.com/talk/d/7198-dr-dheeraj-kapoor-reviews-fees-procedure - Dr Dheeraj Kapoor, Kokilaben Hospital, Mumbai
* Dr Chitra Selvan from Ramiah, or Dr Pramila Kalra, also from Ramiah - msrmh.com - https://transgenderindia.com/talk/d/5923-online-endocrinologist/46
* Dr. Debmalya Sanyal - https://transgenderindia.com/talk/d/5923-online-endocrinologist/58
* Dr Arvind Kumar from Dwarika New Delhi

### Approximate timelines

Note: Your own timeline will vary (& quite possibly significantly differ from these) based on a variety of factors