Transgender Teen Survival Guide

Lee says:

Hi there friend! It's 100% okay for you to use a packer.

Experimenting with your gender expression shouldn't be limited to people of a particular identity label.

It isn't "appropriation" (or inappropriate) for people to try binding or packing or anything else they may want to do, even if they don't identify as a binary trans man.

If someone thinks it might be fun to try something like packing, then I would encourage them to go for it, whether they identify as a cisgender woman and are just curious, whether they're butch, whether they're questioning if they're trans, whether they're confidently non-binary, or whatever the case may be.

And maybe they'll find that they like it because it makes them feel confident or sexy or reduces their dysphoria or they just like the look of it, even if they are not a binary transgender man-- and that's okay.

While I'm not 100% sure what you mean when you said that packing makes people look more genderless/smoothed over, that's sort of irrelevant anyway-- there's no "wrong" or "bad" reasons for wanting to pack, so it's a valid thing to do regardless of your motivation.

Your identity as an agender person who uses they/them pronouns doesn't make you any less deserving of a packer than a binary transgender man who uses he/him pronouns.

I'm a genderqueer non-binary transmasculine person, not a transgender man, and I used to bind and pack for several years before I got top surgery and bottom surgery.

I haven't maintained the list of packers in a while since I've had my own bottom surgery and now I personally don't need to pack anymore so I spend less time researching new packer models and new companies and stuff, but you can still see some useful resources on getting a packer here.

We also have a page on coping with dysphoria here since you're struggling with hating the genitals you currently have, and some info on getting bottom surgery here for things to think about in the future, but it seems like getting a soft packer is a great first step for you!

Lee says:

In terms of shaving, if you really do want to do it, I'd recommend trying to distract yourself while doing it (but while still being safe-- don't be distracted so much that you knick yourself!). Listen to music, turn on a YouTube video in the background, etc.

You can also reduce razor burn by:

But my advice is pretty simple-- just don't shave!

Are you really gaining any benefits from shaving? You mentioned a lot of negatives: you feel anxious shaving, you hate doing it, and it feels itchy when it starts re-growing. But you don't list your motivations in shaving.

If you made a "pros" and "cons" chart, would the "pros" column outweigh the "cons"? If the answer is no, and there are more cons than pros for you, or the cons are fewer but weighted more heavily then the pros, then shaving may not be worth it.

Getting a little personal here, but I trim most of my pubic hair with an electric razor but don't shave it entirely, but I do shave my balls which is a little hard to do. But that combo of trimming/shaving a happy medium for me in terms of comfort and aesthetics.

I plan on getting electrolysis or laser hair removal on my scrotum at some point but I haven't started yet. It was painful on my thigh & I have the feeling this will be worse, so I plan to get another numbing cream prescription before the first appointment.

But if you really do like the hairless aesthetic and you're committed to it in the long term, permanent hair removal or hair reduction might be worth the discomfort and awkwardness/dysphoria from having an intimate area treated and the struggle to find a trans-friendly electrolysis technician.

In the meantime, I'd recommend buying an electric razor with different attachments like this one ($20) so you can experiment with trimming to different lengths to find one that you find comfortable if you don't want to just fully grow it out.

Trimming with an electric razor is a good option because it’s quicker than shaving with a normal razor which minimizes the amount of time you spend doing it which helps if it makes you dysphoric, and it avoids the itchiness problem you can get with shaving.

But yeah, I'd experiment with just letting it grow for a while first-- take a break from shaving and see how you feel. You may find that you don't want to or need to shave or trim.

Followers, any advice for anon?

Lee says:

Discussing your feelings with a therapist can sometimes help you untangle the anxiety from everything else. It’s reasonable to have some apprehension about a major surgery that can have a big impact on your life because it is a big change- and like any other surgery, it also has medical risk and can result in complications. 

And reading about other people’s feelings about their surgeries can be helpful! I do recommend reading things from people who were happy with the outcome and reading things from people who weren't to get a better perspective on the range of experiences that can exist. Only reading the negative or the positive doesn’t provide a balanced view!

But even if you read other people’s stories, and talk to them about why they feel the way they do about their choices and bodies, nobody else can tell you what you should do for yourself. Even a therapist can’t know for sure if you will regret surgery (or anything else that you choose to do) because nobody can see into the future, see into your heart, and see into mind simultaneously to and determine for certain what it is that you need. 

As soon as I came out as non-binary when I was 15, I started saving money for top surgery. I was someone who ran towards top surgery at full tilt and I didn’t give myself any space for doubt about whether it was the right choice for me because I felt it was the only choice I had-- forwards or nothing. I was pretty severely depressed at the time and had a brief hospitalization the month before I turned 18, and I was sort of pinning all my hopes on top surgery reducing my dysphoria and booting out my depression. So I scheduled my consultation as soon as I turned 18 and was legally an adult and could do so without parental permission. I immediately scheduled my surgery for the soonest available date, and had inverted-T incision top surgery about 3 months after I turned 18.

Now I’m 21 years old, and I’m 3 years and 5 months post-op from my top surgery. 

In retrospect, top surgery was 110% the right choice for me. If I could do it all over again, I’d do it in a heartbeat. Top surgery really did reduce my dysphoria by a significant amount, and that made it easier for me to cope with my depression and other mental health issues. I was proudly parading around the house shirtless as soon as I was able to stop using post-op compression, before my incisions had even healed into scars.

I don’t have any dysphoria about my chest anymore, especially now that I’ve gotten tattoos to cover my scars. I finally feel like I look like how I always knew I was meant to look.

I don’t post pictures of my chest anymore because I have distinguishing tattoos but I’ve posted a few before/after pictures when I was 3 years post-op and I think things have only gotten better now.

I was lucky to not have any complications; I don’t have any nerve pain, and hypertrophic or keloid scarring, and I didn’t need any revisions. But there are some things that are non-ideal compared to if I had just been born with a typical cis-guy flat chest. My nips are a little wonky in color and shape, and I plan on getting medical tattoos at some point to even the edges out. I also have slightly muted sensation in my chest now, so everything is like slightly number than it was before.

When I was pre-op, I did enjoy having nipple sensation that was pleasurable; even though I had inverted t-incision top surgery which preserved the nipple stalk, I still only have tactile, temperature, and pain sensations in my chest. If you put an ice cube on my nipple and my eyes were closed, I’d know it was cold. If you poked me while I was looking away, I’d still feel it. And if you squeezed me, it would hurt. But somehow it doesn’t feel good anymore like it used to. 

I don’t know how much of that loss in erotic sensation is a mental thing and how much is a physical change caused by scar tissue build up around the nerve. But regardless, it is a real loss. 

For me, that loss is well worth it. While I might have been physically capable of experiencing erotic nipple/chest sensation before, I rarely actually did have that experience because it made me too dysphoric and I didn’t like to take my shirt off during sex. Now I feel more fully present and comfortable in my own body and it makes me more engaged so I can focus on my partner and on the other feelings I’m having and how I look isn’t something that is detracting from the experience. 

In general, top surgery has made my life better in a million ways. I love running shirtless with my college cross country team, I like going swimming at the beach with no shirt, and I like the way I look now when I see myself in a mirror after stepping out of the shower. 

When I get dressed in the morning, my day starts off on a neutral note because it’s just me putting on clothes. Sometimes I pause to think about how I can just put on a shirt and feel good about it and move on. Before, I used to be upset every morning because the first thing I’d be reminded of when I woke up was that my chest was there and I didn’t want it to be. I’m Autistic, and binding was Not comfortable for me sensory-wise, so not having to bind was also nice.

I would choose to get top surgery again, but that doesn’t mean that it’s the right choice for each and every person. I am sure it was the right choice for me, and I have no regrets at all, I never want to have breasts again. But someone else might think that not having erotic nipple sensation is a dealbreaker, or they might not be comfortable with scars if they tend to heal with more visible raised scars that are harder to cover with a tattoo like I did mine.

So I can tell you that top surgery has made my life better and I’m glad I got it and I don’t think that there would have been any way for me to be as happy as I am now if I had not gotten it. Top surgery is life saving and life-changing for some people, and I am one of those people. I might be more inclined to tell people that if you think you need surgery you should get it because my surgery went so well and because I’m still identifying as genderqueer, transmasculine, and non-binary, just like I was when I was 15, so my identity is pretty static there.

Some other post-op people may tell you that they regret their surgery, that they wish they hadn’t done it, and they would make a different decision if they could go back in time. They might want to help warn other people to not make the same mistake that they did.  Detransitioned folks often (but not always) have a different perspective than folks who persisted in being transgender and that’s okay- it isn’t a better perspective or a worse one, just a different one. But both trans and reidentified people can feel this way, even though it’s usually more common for de-trans folks to regret surgical procedures that it is for trans folks.

I semi-rushed into surgery for both emotional and logistical reasons but I knew it was right for me. But that isn’t the best choice for everyone and if you aren’t 100% sure that it is what you want and need then there’s nothing wrong with having the consultation with the surgeon to learn more and then thinking things over before you schedule a surgery date (or don’t), you don’t need to immediately schedule a surgery date after the consult. Think of it as an interview and as an information gathering session.

Neither of us can tell you what you should do because neither of us are “right” or “wrong” about top surgery. It’s just a different experience and a different perspective. We all have biases based on our own way of seeing things, and that can inform our advice.

If you know what the risks are, and you’ve given it careful thought and can provide an informed consent, then whether you should get surgery is your decision. I won’t tell you “go get it!” or “don’t go get it!” and I don’t think that any blogger should be telling anons what medical procedures to get or not get. 

Worrying that you’re faking it, that you don’t know who you are, and worrying about regret is something that can be pretty scary and frustrating, but you don’t need to figure it out on your own, and it’s okay to take a little longer to come to a decision and talk it over with a therapist if you think it’s necessary to help you cope with that anxiety.

But yeah, I believe that ultimately you have to trust your gut feelings on what you know to be right for you.

Lee says:

Anyone can wear any underwear they like! If you like wearing underwear sold in the women’s section, go for it! If you like wearing underwear sold in the men’s section, go for it!

You don’t need to have X body part or Y gender identity to buy the clothes that you like, it’s all just fabric and you can put it on your body if you want to. Trans women can wear women’s underwear without tucking, trans men can wear men’s underwear even if they don’t have the parts to fill out the pouch and don’t want to pack.

And yes, trans men can still wear women’s underwear, and trans women can still wear men’s underwear because gender identity isn’t the same thing as gender expression, and it’s ok to wear the clothes associated with your assigned gender at birth if you want to, and it doesn’t make you any less trans or any less valid.

You can often see the sizing on the package of underwear if you’re looking at it in the store, but when you’re shopping online check the product page for their sizing chart and then measure yourself with a measuring tape to find the right size for you. If you don’t have a measuring tape, see this post!

If you’re looking for some specific brands, I do have a few links below, but yeah, you can also just wear Hanes like anyone else too- being trans doesn’t mean you have to buy special “trans underwear” or something. But sometimes, we do have specific wants/needs/body considerations that can make buying a pair of specific-use underwear useful.

Flat-front masculine underwear (doesn’t have penis-room for folks who aren’t big down there/don’t have a penis):

Period underwear:

STP packer-compatible underwear (typically also compatible with non-STP packers, but it depends on the packer model):

Soft packer-compatible underwear (underwear you can wear with packer without also having to wear a harness underneath):

Packer harnesses (wear underneath your own underwear):

Packing pouches (attach to your own underwear):

Pouch underwear is sometimes recommended for the well-endowed folks who need extra support (#BigDickProblems are sometimes like a real™ thing after ALT phallo) and sometimes is also helpful for packing:

For those looking to do the opposite and minimize their bulge, gaffs might be helpful:

Wearing semi-tight spandex or cotton boyshorts is usually enough for most folks who want to have a flatter looking crotch area. But for people who like wearing tighter and more revealing clothes or are having bad dysphoria days, wearing Spanx-like shapewear, or cutting the legs off tights so they’re just the length of underwear and using those is a more effective option. If you don’t find those options comfortable, you can try buying a gaff like the ones listed above which can help gently flatten things without the risks involved with tucking with tape or pushing the testes into the inguinal canals.

If you want to shop online for underwear instead of browsing in a store but you don’t have a credit/debit card or don’t want your family to see what you’re buying, see this post about buying binders online! The same technique can be applied to buying anything online.

Lee says:

The most effective method of T really depends on the person. Maybe your lifestyle is different than mine and you want to do your T once and forget about it for a few months while you go camping; maybe you want to do it daily to minimize hormone fluctuations which can be an issue for some people with certain mental illnesses. 

In general, I’d recommend considering the likelihood that you’ll be able to actually be compliant with your HRT treatment with each method knowing yourself and your abilities and so on, consider the practicality, and consider the cost. 

1: What method are you able to use?

2: What method is best for your particular body?

3: What method is most affordable with your insurance?

I might say that the form of testosterone that was most effective for me personally is weekly subQ injections because I was depressed when I started T and didn’t shower often enough so the gel built up in a gross layer on my skin and didn’t absorb, but if you know that you’re someone who could never stab yourself with a needle on a weekly basis then daily gel is going to be better for you than missing two out of three or four injections every month. 

And you don’t necessarily need to stick with the form of T that you start with. Say you start with gel and find it isn’t effective for you. Then you can talk with your testosterone prescriber and raise the dose! If the higher dose works, then great! If it doesn’t work, talk with your testosterone prescriber and switch to shots, or patches, or whatever else you want to try! 

It can be a bit of a trial-and-error process to find the right for of medication for you, and it’s pretty typical to switch forms of T at some point on your T journey. So you aren’t necessarily permanently locked into using the form that you started on forever. 

There are different pros and cons for each type of T, so there’s no one “best” and most effective way to be on T. How effective it is depends on your body’s reaction and you can’t predict that in advance, you have to find it out as you go along and experiment. 

So all things aside, if every form were equally accessible in price and availability and practicality, there still wouldn’t be a universal “best” and most effective option because different people have different bodies.

That being said, most people tend to have good results with injections after finding the right dose so it’s a good place to start if you are comfortable with needles— but some folks are allergic to the carrier oil and need to switch from cypionate to enanthate for example, and there is more than one type of injectable testosterone and more than one way to inject it (intramuscular vs subcutaneous, and even if you choose one type of injection like SubQ there different sites like thigh vs stomach) so even saying “do shots!” leaves you with a lot of choices too, and none are clearly superior, just different.

The various options for testosterone are listed in our Testosterone FAQ, and as always, talk to your healthcare providers about what they recommend for you!

Lee says:

Our Binding FAQ has a post about that: How to buy a binder without parents knowing

Lee says:

There’s no real benefit in keeping your fallopian tubes, and no real downside to removing them, so most people just have them removed because it reduces the risk of cancer slightly.

There are both benefits and disadvantages in keeping your cervix so that’s sometimes a harder decision. Personally, I wanted mine gone, but some people choose to keep it which is valid too.

Removing the cervix reduces the risk of cervical cancer, so people who have a family history of cancer or are HPV-positive might want to remove their cervix. Even folks who aren’t HPV-positive and don’t have a family history of cancer might want to remove it just in case to minimize their risk.

If you keep your cervix you will have to have pap smear tests at the gynecologist every few years. For people who want to reduce their interactions with gynecologists and eliminate a potentially dysphoria-provoking swab from being part of their future, removing the cervix might be a good idea.

The cervix also produces cervical mucus, so some people who are dysphoric about discharge find that getting their cervix removed helps reduce discharge a tiny bit. Getting rid of the uterus and menstruation is the biggest factor, and the vaginal atrophy on T sometimes helps a little as well, but typically people will still experience some discharge from the lubrication the vagina produces unless they get a vaginectomy.

If you plan on getting a vaginectomy in the future, which is often part of a phalloplasty or metoidioplasty that involves urethral lengthening, removing the cervix is good because typically surgeons will want that done before the vaginectomy.

The cervix is technically the end of the vagina, and removing it can therefore reduce some of the vaginal depth. If you want to preserve the depth of the vaginal canal, talk to your surgeon and they can replace the cervix with a stitches to make the vaginal cuff. 

You may still notice a slight change in the depth of your vagina, and a partner might notice that it is now a more clearly defined “dead end” so to speak, but most people don’t find it to be an issue. 

But if your partner has more length than you have depth and if you like being vaginally penetrated during sex and if that ends up hurting because of the length/depth issue, you could buy a product like the OhNut to help control the length that gets inserted.

Personally, I had both my cervix and my fallopian/uterine tubes removed during my hysterectomy without oophorectomy. 

I had my surgery about two and a half years ago and I have no regrets about getting my cervix and fallopian tubes removed, but only you know what you want and need for your own body!

For more general info, check out our Hysterectomy and oophorectomy 101 page! And, of course, talk with your surgeon and doctors!

Lee says:

A non-medical way to make your butt look flatter might be wearing compression shorts or shapewear.

Shapewear (often made by companies like Spanx or Underworks) can slim your thighs and squish down some of the fat on your hips:

You can also get sports-type compression shorts which are generally less tight and more comfortable but also a little less effective.

If you don’t find your clothing options effective, there are two medical interventions that can make your butt look flatter:

And of course, make sure you try on the pants you’re going to buy before you buy them (or return them after buying them) if they emphasize your butt in a way that makes you uncomfortable. 

Followers, any other suggestions for anon?

Lee says:

If you’ve looked at their shipping & delivery page and that hasn’t answered your question, and your tracking number doesn’t show the item in transit, then it doesn’t hurt to email them at [email protected] and ask what’s going on! 

Lee says:

It’s relatively easy to change your gender marker on your birth certificate in some states, and extremely difficult (as in it’s not even an option) in other states.

So it really depends on where you were born.

This website has info on how you can update your gender marker on your birth certificate, if it is an option in the state you were born:

https://transequality.org/documents

Re: this post

Lee says:

Lol I’m not sure what you mean by this?

The last picture with the paper template being held over the thigh is my real leg (and my real underwear too). I don’t have prosthetic legs, if that’s what you mean?

But that’s someone else’s leg in the NYU image/the first picture. I’ve got brown skin & the first image doesn’t because it’s someone else, maybe that’s the thing that’s confusing you?

Lee says:

You should use your legal name on any and all official legal documents, including your taxes.

It might be a different story if you hadn’t yet updated your name with social security because matching your name on your tax returns to the name on record with social security is key.

But since you’ve legally changed your name and you’ve updated the social security administration to get your new legal name on your social security card, you should also file your taxes using your new legal name.

https://www.irs.gov/newsroom/heres-how-a-name-change-affects-a-tax-return

Lee says:

I didn’t have to stop testosterone before any of my surgeries so far, I just had an injection of an anticoagulant before surgery because I have high hemoglobin and hematocrit as a result of being on T. 

So I haven’t had to stop T before my top surgery or my hysterectomy, and I’m not sure yet about my phallo in 4 months because I’ve heard mixed things from the patients I’ve talked to who saw the same surgeon, so I may or may not have to stop for phallo-- we’ll see.

In the past, it was pretty standard to stop HRT before surgery. But now that’s less common because the research has showed it’s not as high-risk as it was thought to be and isn’t as likely to cause complications as had been assumed; there’s a study about that here.

It really depends on your surgeon’s preferences and what your endocrinologist says about your particular health risks given your body and disabilities and so on. 

Since some people are told to stop HRT before surgery, you should always talk to your surgeon and HRT-prescriber about it and ask them if and when you need to stop T before surgery, and when you can start after surgery, and why they’ve recommended what they’ve recommended. 

More info on top surgery: Top surgery