DEALING WITH ADVERSE REACTIONS
Should a parent complain ‘I had a son!’ or ‘I had a daughter!’, tactfully replying, 'No Mum / Dad, you had a transsexual baby' can be helpful.

If confronted with the oft-cited, ‘You have a perfectly healthy body and shouldn‘t have it mutilated!’ there is a valid reply: 'My body and mind might be healthy but they are not compatible. They must be brought into harmony. I am not just a body. Good health means whole well-being. It‘s not possible to alter my mind to suit my body; my mind has to do something about my body. The mind must win any battles, or I would end up like a vegetable.'

The following came from a shrewd parent: We try to help people who are blind, people with incurable diseases, people who suffer the physical and psychological traumas of war. Not fifty years ago we used to put epileptics into mental asylums. You go through life and you don‘t know who you will be meeting. You may shake hands with a thief, a murderer, or a rapist. You might even invite them into your home. People with a gender conflict have done nothing, yet you treat them like outcasts.

On telling them of one's transsexualism, an understandable reaction from onlookers may include the word shock. A point few people consider can be expressed by replying, 'Yes, it came as a shock to realise this was not something that only happened to other people. The person most shocked was me.'

Calmly asking as a genuine question, 'What do you know about my condition?' can help the more bombastic bigot realise how little they do know about it.

Bullies get their kicks from seeing they have upset people; don‘t let your upset show. Allowing a bully to see they have offended you acts as a cue for them to do so again. Showing fear or humiliation has the same effect. Good advice is: relax, don‘t lose control, don‘t let fools upset you. Smile. This way, they tire first, they don‘t get their kick, and they learn a lesson. Rise above them.

If someone offends your dignity with regard to transsexualism, it‘s a mistake to ask them, ‘Do you have a problem?’ Their reply is likely to be, ‘Yes, you!’ (Bully 1: You 0) Why not open their eyes and stretch their mind by saying, gently and happily: Did you know that every male has had a sex change? Science proved years ago that all babies start out female. That‘s why men have nipples and the scar from their original female parts. Sometimes that goes wrong in the womb. The body changes, the brain doesn’t. It’s all been discussed on the television lots of times. Didn‘t you see it? (All genuine facts.)

Few women and even fewer men do not stand up for themselves verbally when strongly insulted. It is not wrong to be annoyed, but it is never wise to show anger. Anger creates a vicious circle, stimulating more anger in both parties. Always destructive, anger is a sign of weakness. You have as much right to feelings, privacy, and peace as anybody: stay calm. Serenity makes you feel more secure and happier.

In a community of people, e.g., at work, one person might decide to tell everyone else about your condition. They might do so spitefully or with the best intentions believing they are helping you. The only person who can get your story right is you. If you definitely know a person has been broadcasting private information about you, the following strategy can be expedient but needs to be said softly, even with spiteful people: How would you feel if I discussed your medical history and anatomy with other people? I am entitled to privacy and respect too. You wouldn‘t like it if we all discussed your body or that personal problem you had.

ON THE NHS AND CRITICS
Bigots are fond of saying ts-born people should ‘not’ have NHS treatment. Asking them why not is the best way to help them appreciate that they don‘t know ‘why not‘. Even more effective is: How would you feel if my condition were contagious and you found you had caught it?

Opposition to NHS treatment of ts usually takes the form: ‘Some people have ... ’ followed by a list of potentially fatal diseases. It is worth pointing out that statistically most patients seen by most doctors are non priority cases, quite a large proportion of whom haven‘t any illness. Pregnancy is usually a chosen state, is rarely life threatening, and is monitored only in case problems may arise. Ask whether all maternity units should therefore be closed down. Further, the NHS rightly spends a lot of money supplying spectacles, cosmetic dentistry and many other non priority facilities.

Statistically, most patients treated by the NHS do not have life threatening illnesses. Statistically, a great many people treated by the NHS every week could have chosen not to be unhealthy. Those requiring treatment as a result of injury during sporting activities, drunken driving, fighting or criminal activities, those who are pregnant and many more patients are effectively in a chosen situation. Transsexualism is not chosen.

In fact the only reason anyone says ts should be excluded from NHS treatment is their certain knowledge that they cannot suffer from it them self.

The origin of the word disease is: dis (= not) + ease (= comfortable).

Dis-ease means not comfortable with your pain, ulcer, bad leg, transsexualism. The NHS exists to help people become at ease with any of these. A thought provoking response for bigots who speak of fatal diseases is: If you suffer an ailment which is not life threatening, won‘t you want it treated?

THE BEST WAY TO BE INVISIBLE IS NOT TO TRY TO BE INVISIBLE
If you find people are staring at you, take stock of yourself. Are they staring because you are staring at them to see if they are staring at you?

People stare at a person who looks very stern. Probably so do you. If you keep your countenance cheerful when all about you is grim, you will find fewer people will stare and more people will respect you. No-one likes a sour puss; everyone likes a happy person.

SO RELAX
An easy but effective relaxation technique is to assume a comfortable resting position, looking straight ahead. Move your eyes (not your head) slowly downwards until you are looking at the tops of your cheeks. Keep trying to move your eyes down further. At first this will feel slightly uncomfortable. Nevertheless, continue looking downwards as far as your eyes will go. Let your eyelids droop. Keep looking down hard at your cheeks ... zzzzz.

FIVE O’CLOCK CLUB
Before electrolysis is complete, make-up can be a nightmare. Ask your GP to refer you to the camouflage practitioner in the dermatology department of your local general hospital. These people know their job well. The kind of camouflage needed is not within the training or expertise of most beauticians. Properly applied blemish concealer lasts all day, is waterproof and takes ordinary loose powder (e.g., Almay, Leichner) on top of it. Blemish concealers are best applied with dry finger tips, not a sponge. Application takes time initially, but with practice you can be completely made-up in fifteen minutes.

If facial hair protrudes towards the end of a long day, an electric shaver can be used without removing the concealer, a quick application of ordinary liquid make-up then refurbishing the smooth appearance. Your electrolysist can advise on a suitable shade which should not be too dark. Sometimes water suffices, lightly and sparingly applied with the fingertips, gently smearing the original make-up just a little.

TAKE ONE THREE TIMES A ERR NO TAKE THREE ONCE A ...
If you forget how many tablets you have taken in a day, obtain a small bottle or a 35 mm film canister. At the start of each day count into it the number of various tablets needed for that day, and draw from that supply. Putting pills close to a calendar or diary (but out of reach of children) and making a small mark for each one taken can also help to keep tabs on the tabs.

CONSULTING THE DOCTOR
Between appointments with your doctor it is prudent to make a brief duplicated list of any questions you need answers to, handing one to your doctor at the start of each consultation. In a busy outpatient's department or clinic it is too easy to return home with questions not fully communicated to the doctor.

CONSULTING THE SURGEON
Do not assume the doctor (or anyone else) knows what you are talking about, OR VICE-VERSA, particularly with regard to surgery. One instance where CHANGE will not hesitate to tell people what to do or not do concerns surgery:
 

DR WHO?
In the UK the correct title for any surgeon is Mister, Ms, Mrs or Miss, not Doctor.

YOURS FAITHFULLY
Men tend to sign their name using all their initials while women tend to use only their first initial followed by their surname. Thus, she might be J Bloggs while he might be GPT Bloggs. We may not like stereotypes but society‘s eyes are wide open to them.

FEMININE POSTURE
Most women are very proud of their femininity. However far away the end of the road seems, be proud of yourself, especially of having made the first step to get things right. Standing and sitting properly will help you and your confidence.

Have a straight back (that will make you ache at first), and shoulders back but dropped, not held up stiffly. In front of a mirror, put your shoulders back, pushing your bust forwards, then watch as you relax the height of your shoulders. Hunch them up and drop them again to get the feel of the position. Every time you feel yourself drooping or hunching, put yourself back.

Keep your head erect, don‘t look as if you are hiding. If people look, one tends to think, ‘Oh no! I‘ve been spotted!‘ Look them in the eye and smile. People look at one another for a million reasons and even if you think you have made a mess of your make-up, or your hair is all out of place, the likelihood the gazer assesses you as ts is remote: we all look different. The plainest woman can become enchanting when she smiles.

Sit with your legs together, but not crossed, except occasionally; crossing one‘s legs is bad for the circulation. As a rule, keep your knees and feet together when sitting.

Most of this will come naturally once you let it, but you are having to un-learn masculine habits conditioned-in by others over the years. The postures and movements of your true self are there somewhere, but have been suppressed. Let them out, do not act. Good posture is a useful starting point which gives you confidence.
 

SPEECH THERAPY
GP‘s (and sometimes psychiatrists) can arrange NHS speech therapy, although a self referral by the patient to the speech therapy clinic at one‘s local general hospital is often accepted.

In attempting to change the voice it is important to relax properly; a relaxation technique is valuable. The first requirement is to seriously give oneself permission to really feminize the voice permanently. This can be the most obstinate hurdle of all and is one at which many fail by subconscious choice. It is very important because the person who works very hard to achieve sex reassignment, but only pretends to get their voice right, is failing them self, and this is the singularly most common failing. You can change your voice if you are truly serious and genuine about reassignment.

For the ts>f the next requirement is to remove any deep resonance from the voice. Men tend to speak from the chest, which emphasises the deeper bass notes in the voice. To feel this, place the fingertips lightly at the top of the sternum (the vertical plate-like bone in the centre of the chest), and say a phrase like my Mum‘s monkey makes much mischief, noting the vibrations in your fingertips during the m‘s.

If you can feel strong vibrations at your fingertips then you are using too much chest resonance. Try repeating the phrase, using less of this resonance, until you cannot feel the vibration. The trick is to speak from the upper chest and throat. You will find you can learn to eventually speak from the mouth and throat only. The fingertips of the other hand should be placed lightly on the forehead. Aim for minimum vibration of the sternum and maximum vibration of the forehead. Any words or phrases with ‘m‘ sounds in them may be used to produce the resonance.

Having mastered this, there will be a surprising difference in the voice. It will give the effect of having raised the pitch but in reality the fundamental pitch has not changed; you will have just removed the bass resonance.

Please don’t try to talk in a falsetto voice: it isn’t natural, it doesn’t sound natural, and it can seriously and permanently damage the larynx.

Softening the voice is more difficult and involves controlling the breath, letting air out slowly whilst speaking. Male voices have a quick attack, with a harder leading edge. This means the sound level (volume) rises very quickly for each speech component. The female voice has a much slower attack, literally giving every sound a softer edge or start.

Try saying words like hap, hat, hack, letting the h start quietly and slowly, following with a quiet a sound. Repeat this several times, then try without the h, repeating ap, at, ack. Aim to make the a sound as soft as it did when it had the h before it. This usually calls for much practice, preferably alone to begin with.

It is of great help to record one’s voice on tape, listening closely to the playback. In this way you hear the difference in the sounds as you progress. Above all, train yourself to listen to how other people speak. This is easier said than done: you really have to learn to hush up and listen. After a while, you will find you start to use turns of phrase and inflections in the voice any other woman uses.

Another useful exercise is to sing along with records by female(!) singers. This helps to slow the voice down, giving better breath control. Try holding your hands, palms up, facing towards you, a few inches from your mouth, bouncing your voice back at you so you can hear it as others do.

Listen to other women of your age group. If you are young, your potential pitch range (also called modulation or compass) will vary far more than the typical male’s. Womens sentences often (but not always) end on an up-note, presenting a question mark to the listener.
 

Male sentences begin on quite a low tone, continue with very little pitch variation ("modulation"), frequently ending with a downward note, giving finality to the sentence, not inviting a reply. It is a statement.
 

Due to hormonal changes, post menopausal women often have deeper voices than younger women. The voices of some very old women sound like their male counterparts; their voice pitch range also often being smaller than the younger woman‘s.

An important vocal gender tag concerns the overall musicality of the voice. Not only do men tend to use a monotonous voice with little variation in pitch (and not using high notes very much), they are also more likely to speak in a minor key than are women. For the non musically minded this means they are more likely to sound sombre or fed up. A give-away for the ts>f is to speak in a minor key, the end of every sentence drooping in pitch, sounding like someone who is utterly fed up, each sentence sounding rather like a moped passing by.

Female voices do not use such deeply plunging downward pitch intonations, but use more upward intonations than male voices. Women use smaller downward shifts more often, but don‘t shift down so far. Women’s voices also have a smaller volume range than do men’s. These comments assume typical conversation.

RECORDING SPEECH EXERCISES
Normally one‘s own voice is heard mostly via bone conduction, which can give a false impression, whether good or bad. When recording practice sessions it is a great help to monitor your voice at the time by way of headphones plugged in to the headphones or speaker socket. Most portable cassette recorders allow this facility in the record mode. When heard live through headphones the voice sounds more as others hear it. Headphones are far better than ear-pieces for this purpose. Bouncing the voice off the palms (as above) has the same effect. Using headphones whilst speaking is also helpful because listening to the playback of a recording can leave you wondering how you made your voice sound so good when recording it ten minutes ago.

All this takes time but eventually, as confidence is gained, it becomes easier to speak in the new voice. The throat should not be strained; it should feel relaxed, not tight, and the voice should sound natural rather than affected. Altering it calls for gentle tactics and patience. Don‘t force your larynx to do too much at once.

A most difficult task for the ts>f is to grant oneself permission to change the voice, in a big way if necessary, all the time, including when chatting with people one knew before. If you slip into old habits for their benefit, or because you feel awkward, you will slip into old habits with other people too, and listeners may then have difficulty perceiving you in the right gender. If you are serious about your identity, that permission has to be granted.

The importance of qualified training is emphasised. Some people say they don‘t work on their voice as they wish to sound natural. With a little practice, the new voice becomes natural: a woman with a baritone voice sounds unnatural.

‘If I‘ve been alone, say, waiting for a bus, then suddenly have to speak after a period of silence, it‘s difficult to find the right pitch. Sometimes I struggle in several keys before doing so.‘
Try this. As you board the bus or whatever, sigh gently. Make the sigh soft, light and airy, sounding like a long haahhh rather than a brutal ug. This gives you the opportunity to find your vocal pitch and can become a useful habit.

"My voice is no problem until I need to shout."
Men raise their voices by filling their lungs, forcing their voices out with a thrust of the diaphragm; they open their mouths and relax their throats. Women raise their voices by constricting their throats and raising their pitch. You might remember female PE teachers doing this at school. It is fairly difficult for the ts>female to do, and is not recommended because it strains the vocal chords. Avoid having to shout: get closer instead. In the event of having to scream, doing so on an intake of breath will raise the pitch.

It is a mistake to let shyness affect one‘s speech exercises during voice training. Although these really need to be done in private, one might be shy of oneself. Another mistake is to only practice speaking quietly. It's no good having a convincing voice which the shop assistant in a busy department store cannot hear and which, when you speak more loudly, plummets down an octave. The key is to work at getting the voice right at a normal (not whisper) level from the outset, and once you can honestly hear progress, to spend more time practising that voice whilst increasing its volume. Sooner or later you will have to speak loudly in public. Be ready for this.

"I‘m pretty sure about make up and have my voice reasonably under control, but either people look at me in mixed company or they won‘t listen to me."
Your make-up and voice are probably better than you think! A Punch cartoon showed a boardroom meeting with the chairman saying: An excellent suggestion, Miss Bloggs. Would one of the gentlemen like to make it?

Whether or not we like society‘s conventions we have to live with them. A few thousand people cannot easily overturn rules etched into society over thousands of years. In mixed groups, women are not ‘supposed’ to have original ideas; women ‘do not’ interrupt nor talk over other speakers. There is no need to go along with this old theory but it helps to keep it in mind.

Your behaviour and body language can be as much a give away as your voice. If you are an ardent feminist, you can be one in a feminine, not masculine way. If a woman wants to make an effective point, she does so during a space in the conversation. In conversation in all-female groups, women tend to leave each other spaces, or indicate with a look when others are expected to join in or comment. Learn to listen and look. If you have nothing to say, there is no harm in being silent but looking attentive, people expect that. To dominate conversation is masculine. Ts>males might reverse the above advice, taking care not to over compensate.

"I am uncertain of how to deal with hair that is fine but dark and appears at the base of my back, buttocks, and the tops of my legs. As there is so much, and as it is so fine, electrolysis may not be the answer."
The only safe ways to eradicate hair growth permanently are by electrolysis or perhaps the (less readily available) laser treatment. (It is much too early to say whether laser hair removal is permanent.)

The quantity of hair present may not be a reliable indication of how much electrolysis will be necessary to get rid of it. Finer hair can be easier to eliminate than the coarser variety, and therefore cheaper to remove with electrolysis. Some women have considerable hair growth in the body areas mentioned, more profuse than might be imagined, and some leave it as it is. The usual methods of getting rid of it are either waxing, shaving, depilatory creams or, funds and motivation permitting, electrolysis. Almost all women who have hairless legs have recently used one of those methods.

The easiest way to dispose of unwanted hair is by shaving, which can be quite successful (but obviously not permanent), using a twin-bladed razor immediately after a bath, with the body still damp and, preferably, while still standing or sitting in the bath. This allows easy re-wetting of any parts which have dried in the meantime, without making puddles all over the floor. The off-cuts can then easily be rinsed away.

When shaving parts which you can‘t see easily it is helpful to use both hands, one to do the shaving, the other to lightly follow each stroke of the razor in the search for stubble. With practice this makes the procedure much faster than struggling with mirrors at awkward angles and is also very helpful in areas which can be seen. And it teaches the hand (that is holding the razor) the contours to follow. A hand-over-hand movement is best, as if stroking the cat with both hands. On the torso and limbs a closer shave can be achieved by shaving against the grain, or nap, a light touch with the razor being best.

When prescribed, "female" HRT can have a quite good effect on body hair, but this entirely depends on the individual‘s metabolism and whether the compounds prescribed are the best combination for that person. Some patients find Androcur to be good at reducing body hair, others do not. In rare cases Androcur has made body hair more profuse, whilst being taken, as have oestrogens (the latter temporarily). Hormones have no effect on some people‘s body hair. Some lose all their body hair through taking oestrogens alone, others find oestrogens combined with progestogens (usually Duphaston or Provera) help to reduce it. The only way to ascertain which prescription is ideal for any person is trial and error. The length of time one has been taking hormones can often make a difference, as can whether one is pre- or postoperative.

Trying to increase the effects of hormones by increasing their dosages above the usually prescribed levels VERY RARELY WORKS but invites serious medical problems involving deep vein thrombosis which can be fatal. Read on to understand why this is a pointless exercise.

The body can only respond to a finite degree to hormonal compounds, after which further increases in dosage are countered by feedback loops within the body‘s endocrine (hormonal) systems. Beyond a certain level, increasing the dosage has no further effect on the secondary sexual characteristics (bust, thighs, skin tone, hair, ... ). The hormone surplus then starts to have adverse effects elsewhere, which may become life threatening. The serious conditions which arise as a result of HRT overdose DO NOT ALWAYS HAVE ANY PRIOR WARNING SYMPTOMS. The warning is on the label, where it says how many pills to take per day.

Consider this analogy: on the back of a television might be the message: 240 Volts. One would not consider plugging the set into a 1000 Volt supply; doing so would cause serious damage. On the pill bottle or pack is a label with the message of how many tablets to take in a day. One can buy another television but not another body. The dosages generally prescribed have been found (by trial, error, and world-wide study by your peers over many years) to be optimum.

If medication is not proving effective, it is sensible to discuss the matter with the prescribing consultant who cannot know whether a particular treatment is working for a particular patient unless the patient feeds back such information.

"Hormone therapy is working well for me but has made my finger nails brittle. I cannot grow them very long as they keep breaking. How can I strengthen them? I‘ve tried taking fish oil, vitamin tablets, and raw jelly to no avail."
Women’s nails are more brittle than men’s and, assuming one‘s physical health is otherwise good, brittle nails show the oestrogens are working well. The only products that can strengthen finger nails are those which do so mechanically, such as nail varnish with added nylon fibres, but these may irritate the cuticle. Like hair, every visible millimetre of nail is dead tissue.

There is no known product which can be taken internally to have the effect referred to because the visible parts of the nail (and hair) are no longer directly plumbed into the blood supply. Unless there is a vitamin deficiency or illness, for fish oil, vitamin pills or raw jelly to begin to have the desired effect would require such large intake of those products that poisoning would be threatened. It would then only marginally affect new growth of nail. Scalp hair also becomes finer and more brittle on HRT; all these comments apply to it too.

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