The calculus of transition

One of the advantages of avoiding the trap of identifying with your dysphoria is that it becomes only one factor in the decision to transition. I believe that transitioning should be considered in a holistic perspective, and the positive and negative effects that it might have upon your life should be considered. The feelings of dysphoria are not a choice, but actions are a choice. If one is caught in the thought trap: I have dysphoria -> I am trans -> I must transition, then that freedom of choice is lost.

Some of these factors include:

Severity of dysphoria

Dysphoria is on a spectrum and comes and goes. Most people report that it has a variable quality to it. Sometimes it happens in response to stress and triggers. Is it possible to manage by reducing these triggers or bring more good things into your life? Obviously, if the distress is so severe that it is causing potential suicide or self-harm that is a call to action.

Age and body type

The ability to “pass” will strongly effect quality of life as a trans person. For MTF-spectrum, a younger person will almost certainly do better with this than an older person. Likewise someone with a small frame will do better than one with a large frame. This is an important consideration and one to be realistic about. In order to get out of the fantasy and into reality, meet people of a similar age and body type to yours who have transitioned and see how that has worked out for them. This is what it is likely to be like for you as well. This is not fair, but it is the reality.


Quality and depth of relationships is one of the most important factors for happiness. This is borne out by numerous studies. One’s ability to form romantic relationships may be impaired by transition. Again, age and body type are factors. The younger generation is also more open to dating trans folk, and whether you are in a liberal or conservative community will effect this. You can of course choose to move to a different community. Lots of trans people find relationships, but it is harder.

Also existing relationships matter! If you have a partner, their feelings should be considered as well. Children even more so. Losing these relationships is a profound loss. Parents have duties to their children, these should be considered!

Not passing might lead to social discrimination, being stealth creates a situation where you aren’t free to talk about your life. Both of these reduce intimacy and connection.

Coping tools

What tool does one have for dealing with dysphoria? What additional tools can be learned. If someone is at mid-life and hasn’t transitioned, they must have some mechanisms to cope, how did one cope in the past.

Confounding factors

Confounding factors can include trauma and porn addiction. If dysphoria or AGP is being exacerbated by porn, taking a break from that is advised. Likewise working through trauma is a wise step for anyone, dysphoric or not.

Partial Solutions

A lot of people with MTF gender-dysphoria report feeling better without testosterone and with estrogen. It is possible to alter hormone mix without transitioning but that gets complicated. Again this might depend a lot on age, relationship status, and body type. Eliminating testosterone will certainly relieve any erotic compulsions. The short-term effects of changing hormones is not always the same as the long-term, there can be a kind of hormonal euphoria with both estrogen and testosterone, so to truly determine if hormones are improving depression or dysphoria the long-term effects are important to see.


Most studies show that people are satisfied with transitioning, it is a valid choice if well-considered. There is also no question treatment is more effective when young, creating a situation where young people who are considering this may want to stop the testosterone effects. On the other hand if you are 25 or so, a year difference won’t matter much so there is time to consider.

I found that transitioning didn’t actually relieve dysphoria I was still uncomfortable with the unchangeable masculine characteristics of my body. It is only possible to partially change your sex, this is something that one must come to terms with.