Coming to terms with crossdressing is, on the whole, a bit easier psychologically than working through transgender issues. Dressing up allows you to acknowledge and celebrate your feminine side, but the realization that this is more than just a sometimes need is life-changing. While acknowledging that you may be transgender is amazingly difficult, it also poses a number of questions and choices about how you will handle this, from lifestyle changes to physical transitions. Hopefully, you'll have both good friends and a supportive counselor to guide you through this process.
First, you can choose to continue living as you do now, dressing up in your free time. You may opt not to transition for personal, financial or professional reasons. If you do make this choice, try to do so in as honest a way as you are able, acknowledging who you are in situations that feel safe and appropriate. Come out of the closet to close friends, your partner and your family if possible. Create a support system to keep the stress of living a life that isn't totally comfortable under control.
You may also opt to begin living full-time as a woman. This can be a step on the way to physical transition or may be a long-term solution for you. Opting to live as a woman enables you to feel true to yourself, but poses many challenges. Even if your partner accepted crossdressing with ease, transitioning to full time life as a woman may challenge your relationship. You may still feel quite uncomfortable with your male body, making relationships and sexuality difficult. Discrimination in your personal and professional life will become a reality. Often, living full-time as a woman, at work and at home, is required before you can begin any sort of medical or surgical transition.
The first step is, for many transwomen, hormone therapy. Hormone therapy can be over-the-counter supplements, but more often typically consists of anti-androgens to block the action of testosterone in the body, as well as female hormones. Hormone therapy typically results in a higher voice, reduced facial and body hair, the growth of breast tissue and softening of the skin. Substantial side effects do pose risks to your health and personal life, including a higher risk of heart disease and strokes, a risk of blood clots and sexual dysfunction. Depending upon your age and general health, hormone therapy may or may not be an option for you. You can reduce the health risks associated with hormone therapy by eating a healthy diet, stopping smoking and exercising regularly.
There are a number of surgical options if you are transitioning from a male body to a female one. With all surgeries, choose your doctor carefully and research all of your options. Many transwomen opt to go abroad for surgery. Depending upon the surgery and hospital regulations, you may be required to undergo a period of counseling or live as female for a number of months prior to surgery. Breast implants can provide the curves nature forgot, particularly if hormone therapy is not an option for health reasons. Sex reassignment surgery, sometimes called "bottom surgery", creates labia, a clitoris and a vagina. This procedure is both highly invasive and quite painful, but does provide full sexual function, with a little practice. Facial feminization surgery can reduce the appearance of a strong jawline, brow or nose, creating more feminine contours to your face.
Transitioning or even recognizing a desire to transition can impact more than just your day-to-day appearance. Opting to live full-time as a woman can come with high financial costs, especially if you work for a less-than-understanding employer. Hormone therapy is a costly ongoing expense and is often not covered by insurance. Sex reassignment surgery is very expensive and requires time off work to recover. You may find that your sexual interests and orientation shift and change as your gender does, causing problems and difficulties within your relationship. Transitioning also puts you at risk of not only discrimination, but gender-related violence.
Regardless of the choice you make, embrace your decision with confidence. Recognizing your needs and desires, whether you choose to take the plunge and transition or opt to maintain your life as it stands today, will give you the freedom you need to be happy and live a life filled with joy. This doesn't have to be an all-or-nothing choice. You can present as male at work while living female the rest of the time or take advantage of an inclusive employer while still pulling out the khakis and polo shirts for dinner with your parents. Find the support and resources you need online and in your community to determine the path that works best for you. Being true to yourself provides the strength to meet any challenge, no matter how large.