Notes:
Here is a time line to give you an idea of the process a Male to Female transsexual goes through.
It begins with Mental Health Therapy*, including a Diagnosis of GID. After a few months, a letter is written for hormones.
The patient makes quarterly doctor's office visits* to prescribe and monitor hormones.
The patient fills the hormone prescription* and take the medications.
Usually the patient will also undergo electrolysis* to remove facial hair.
After careful planning, the next step taken will be to 'transition' - that is, to begin living full time in the new gender.
The Real Life Experience must last at least one year.
Shortly after the transition, there is usually a legal name change.
After completion of RLE, 2 letters are written supporting eligibility for surgery.
There is a waiting list for the good surgeons, so a surgery date is scheduled months in advance.
On the scheduled day, a group of 4 surgeries, often collectively called Sex Reassignment Surgery* is performed.
The surgeon writes a letter, verifying completion of SRS.
The transsexual can use this letter to update documentation, such as birth certificate and Social Security records.
For the rest of her life, the transsexual will need maintenance-level hormones (a much smaller dose) and semi-annual doctor's office visits to monitor them.
Thus, HRT (Hormone Replacement Therapy) can be divided into two parts: Transitional (the first 2 years, higher doses to change the body) and Maintenance (lower doses, but for a longer period of time.)
* Medical expenses are marked with an asterisk.