What does female to male gender reassignment involve?

For a biological woman wanting to affirm his male gender, it is necessary to first start a regimen of testosterone (hormone replacement therapy or HRT). This will move the affirmed male into something akin to puberty, whereby he will experience beard growth and muscle development, along with a deeper voice, changes in his body odor, skin (it's common to get acne), and even personality. Affirmed men often feel more aggressive on testosterone, than prior to taking it.

On the whole, these changes can't be reversed later. It is also common for affirmed men to have a double mastectomy (breast removal) with chest reconstruction. This makes it much easier for the person to appear as a man in public.

After at least a year of hormone treatment, the ovaries and uterus are removed (although menstrual cycles tend to cease within the first couple of months on testosterone. For many female to male transsexuals, this is as far as they will go with surgery. Going further is more complex, very costly ... more.

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