Transgender healthcare is any and all healthcare that supports transgender people in their health and well-being. It can include primary care, as well as specialized medical care or gender-affirming care that supports their gender transition or gender affirmation goals. Transgender healthcare can include gender-affirming hormone therapy (GAHT, sometimes called HRT), gender-affirming surgery including facial feminization surgery (FFS), top surgery, breast augmentation and other surgeries, emotional support, mental health services, peer support, reproductive medicine, and other types of care.
This article will give you ideas and suggestions about some common terms, definitions, and issues you may have during your transition. While there is no one way to be trans, these experiences are very common for folks in our community. This guide may help you navigate some of your questions about non-surgical supports during your gender transition.
Binding is the practice of flattening or minimizing the appearance of your chest. Some people bind with sports bras, tape, or swimsuits, while others wear a special garment called a binder. Binding is safe and can help alleviate gender dysphoria, but there are some precautions to help prevent injury. Learn more about safe binding here.
For those of us who bind, tuck, pack, use a gaff, or pad, Transtape is a body-safe option. This gentle adhesive tape is gentle on skin and can be used daily (but give your skin a break overnight, please). It comes in multiple sizes and skin tones, too! The tape is backless and waterproof, so it can go with you from the gym to the pool.
Literally “the fear of transgender people,” transphobia is an irrational hatred or aversion to people from our community. Transphobia is expressed in different ways, usually through physical and verbal threats, shunning, excluding trans people, diminishing us, or taking away our rights. Transphobia is harmful to our mental health, so seek support if you need help coping.
Tucking is when you tuck back your penis and testicles using tape, tight underwear, pantyhose, or another method. This can help you get the smooth look you want in body-fitting clothes, a swimsuit, or just because it feels good! Not everybody wants or needs to tuck, but for those who do, make sure you practice doing it safely in a way that doesn’t stress your skin.
A gaff (or gaffe) is a special compression garment that works like underwear. When you wear a gaff, the fabric helps you tuck by making sure your body parts stay put! You can buy a gaff from a trans-affirming lingerie or underwear shop. Many people make their own gaffes from pantyhose, Spanx, swimsuits, or other DIY methods. Bear in mind that you may still need to tape or tie while using the gaff, depending on the look you want.
Stuffing and packing
Many transmasculine people, trans men, and FTM folks like to pack. Packing or stuffing means putting fabric, a specially designed packer, or another object in your underwear to give the look of fullness. Some people use a rolled up sock, while other people prefer to buy a packer, which is a piece of soft, skin-tone silicone shaped like a non-erect penis. You can tape, pin, or fasten your packer to your underwear.
A trip to the beach, pool, river, or swimming hole can be intimidating for trans folks. Affirming swimwear helps you feel your best. Some types have built-in chest binders and small pockets for your packer. Others have built-in gaffes for tucking at the beach. Many brands offer gender-neutral one-piece and two-piece suits too!
Affirming lingerie and underwear
If you want to create a more feminine look, there are many options. Breast forms are a soft gel or fabric pad that gives the shape of breasts or cleavage. Padding around the waist, hips, and bottom can create more of a traditionally feminine “hourglass shape.” And while many people make their own tucking and gaff garments, specialty lingerie can support you with built-in padding, breast forms, and tucking support.
When you transition in a way that can be noticed by others, you might begin wearing different clothes or a new style. One of the first things you may notice is that clothes are very gendered. Women’s sizing is very different from men’s sizing! It can be hard to find the right fit or figure out what to buy. Before you go shopping, make sure you have your measurements: waist, hips, inseam, shoulders, and chest. Then, compare them to the sizing chart most brands have on their website or in stores. If you sew your own clothes, use the pattern size on the back of the pattern. With these measurements, you can choose (or make!) clothing that fits without having to guess.
When you’re ready to start using your chosen name and updated pronouns socially, or if you’ve recently changed your legal name and gender marker, you might feel intimidated. Telling family and friends is a big step in your journey! Most folks simply tell their loved ones, “So you know, I’m trans and I’d like you to call me ____. My pronouns are ____.” Take your time and don’t be shy about sharing your authentic self with the people you trust!
How to tell your family that you’re trans
If you want to come out, or let your family know that you’re trans, nonbinary, or gender non-conforming, take some time to practice. Maybe you want to write a letter, or maybe you’d prefer to share your news face-to-face. You can also share this helpful guide. Only you know what is best for your journey! If you need some support making this big decision, check out our resources for telling your family about your gender identity.
Coming out at work (or not)
You may be out socially and to your family, but work is a different story. Some of us come out at work for reasons of necessity, because we are transitioning, or because we don’t want to stay closeted. Depending on your work situation, you may want to come out—or not. Trans people are protected from workplace discrimination, but you’re the best judge of your work culture!
Everyone’s gender transition is different. Gender and self-discovery are not linear. There is no “one-size-fits-all” path for trans, nonbinary, and gender non-conforming people. The word “detransitioning” generally means stopping hormones or changing your gender expression to align with your assigned gender. A very small percentage of people make these changes due to regret, stress, lack of access to adequate gender-affirming care, or not being ready to live out as a trans person. However, many more people who “detransition” are actually entering a new phase of their journey—not back-tracking, but simply undergoing another change and seeking a new understanding of themselves. It is very common for people to choose to discontinue hormones after a certain period of time. Many folks realize their gender is more fluid than they assumed, and it’s important to honor that.
Changing gender-affirming medications
Gender-affirming medications include gender-affirming hormone therapy (GAHT, sometimes also called HRT or hormone replacement therapy), as well as other support medications. If you want to change which medications you take, work with your Care Team to make a plan. You can also change how you take a certain medication, such as switching from T gel to injections, or switching from estrogen pills to patches. To learn more about your medication options, talk to your Care Team!
Our community is intergenerational—our sharing of knowledge, caring, and mutual support between generations makes us all healthier and stronger. The term “trans elder” refers to someone of an older generation. That can mean they are only a few years older, or decades older! Some people jokingly call any trans person over 30 a “trans elder,” but this is just to be funny. In reality, trans people have been around forever. There are trans people who are living, thriving, and enjoying life in their 70s, 80s, and 90s!
Transitioning as a younger person
Trans youth and healthcare are hot topics. At Plume, we think everyone should receive gender-affirming health care regardless of their age. Research shows that the majority of trans, nonbinary, and gender non-conforming people understand their gender identity by the time they start kindergarten. Some young people are able to start blockers prior to puberty, while others use hormone therapy to transition shortly after turning 18, leaving home, or going to college. Everyone’s path should be respected, and you’re never “too young” to know who you are.
Transitioning as an older person
You’re never “too old” to live authentically and enjoy your life. Trans people can come out, transition with surgery and hormones, start relationships, find community, and learn more about themselves at any age. There are trans people who are living, thriving, and enjoying life in their 70s, 80s, and 90s! There is no “wrong time” to accept your true self and give yourself the love you deserve.
“Stealth” is slang for “undetectable.” It can be very hard to tell if someone is trans or nonbinary just by looking at them. Some folks can “pass” as cisgender, or blend in without being visibly identifiable by changing their voices, body language, or other gender expression. Staying stealth can be a choice that someone makes to protect themselves, avoid scrutiny or discrimination, or for personal safety.