Your wellbeing

Questions that repeatedly come up at meetings and online support groups are often on the subject of how things look, eg: ‘Does my chest look OK?’, ‘Are my nipples too low?’, ‘Are my hips too wide?’ There are also questions about other men, such as: ‘How does a penis hang normally?’ or: ‘How do foreskins work?’ Here we try to answer some of these questions, or help you to answer for yourselves.

Realistic male bodies

The men we see in films and magazines usually have square jaws, amazing bodies with huge muscles and body hair in all the right places. These are not the people to compare yourself to! Their job is to look good and so they have personal trainers and spend hours in the gym to keep looking like that, not to mention make-up artists, plastic surgeons and Photoshop wizards shaving off an inch or two and smoothing out wrinkles. To quote super model Cindy Crawford: ‘Even I don't wake up looking like Cindy Crawford.’ For most of us (trans and cis alike) this isn't a realistic expectation.

So how do you find more realistic male bodies? ‘Look around you,’ is the simple answer. Walk down the street, go to the beach or swimming pool and you'll see men with wide hips, men with boobs, no noticeable facial hair, no Adam's apple, men in all shapes and sizes.

As for genitals, professional porn is not the place to look! Porn actors will often be chosen because they have an unusually large penis, and pornography production studios tend never to show them soft either. There are plenty of men out there with a penis the size of a metoidioplasty, they just don't tend to be working as porn stars or underwear models.

Some transmen check amateur pornography websites for videos of a range of men’s genitals. There are a few transmen on there too if you want to see if your bits measure up before surgery.

Realistic FTM bodies

Testosterone and surgery are wonderful things but they do have limits. Testosterone won't make you taller or take away every single female attribute your body has, but it will change a lot. Surgery is pretty clever but not perfect - you will have scars and there are always risks with any operation.

Having said that, for most of us what we get is vastly better than what we had before, and for some the scars we carry are something to be proud of, a mark of everything we've fought to achieve.

There are many online groups with photo sections that you may find helpful. Try Transbucket or the Yahoo surgery group.

There are also hundreds of video blogs on YouTube covering everything from first going to the GP, to surgery and everyday life as a transman.

None of this compares with getting to see things for real though, and talking to other transmen about their experiences. Support groups are amazingly helpful, and more local groups are popping up all the time.

Diet and exercise

Aside from surgery and hormones you can change the way your body looks a huge amount with diet and exercise. If you can't afford a dietician, diet group or personal trainer, there are many apps available to help keep track of how you are doing or give you exercise routines to bulk up, tone up or thin down.

The human body is an amazing machine and if you look after it well it will reward you. So take pride in it and come to love the skin you are in.

There are times when we all need someone to talk to - and if you’re a transman, you might find it helpful to talk to someone else who knows what you’re going through.

Whether you’re a young transman, someone who is going through their transition or someone who transitioned a long time ago, you may benefit from having some counselling or group support. Counselling can help you to make sense of your feelings, especially if you’re feeling unhappy or unsure of what to do. A group can help with these things too, but can also just give you the feeling that there are other people who will understand your situation. Some people go to support groups even if they are happy with their lives and don’t have any problems to address – it’s sometimes just nice to be around other trans people.

If you decide you want to see a counsellor it might be important to ask them some questions on their awareness of trans people. Not all counsellors are aware, this doesn’t mean they will not be able to support you or explore your feelings and concerns. However, it can also be useful to have a therapeutic relationship with a counsellor who ‘gets it’ and who you are not having to ‘educate’ in the sessions.

Whatever stage of your transition, if you feel like you need some support and counselling, the following organisations can help. We have also included organisations that provide information.

a:gender is the support network for staff in government departments and agencies who have changed or need to change permanently their perceived gender, or who identify as intersex. 

The Beaumont Society is a national self help body run by and for those who cross-dress or are trans.

The Beaumont Trust operates a helpline and has resources to support people with gender identity problems or problems arising from cross dressing. They also support professionals working in the field of gender dysphoria.

cliniQ Dean Street Soho is a sexual health and wellbeing clinic for all trans people, partners, family and friends.

Depend offer free, confidential and non-judgemental advice, information and
support to all family members, spouses, partners and friends of trans people in the UK.

Gender Identity Research and Education Society (Gires) provide a range of medical and social information for trans people, including guides to lower surgery and hormone treatment. 

Gender Trust provides information and a membership scheme for trans people.

Gendys Network is for anyone who has encountered gender identity problems.

Gendered Intelligence work with young trans people.

Mermaids provide family and individual support for teenagers and children with gender identity issues.

Press For Change provides legal advice, training, and research to trans people, their representatives, and public and private bodies. 

The Scottish Transgender Alliance aims to improve the lives and experiences of all trans people living in Scotland. 

The Sibyls is a UK-based confidential Christian spirituality group for trans people, and their supporters, offering companionship along the journey, and information and advocacy to churches.

TransEquality can advise you on human rights law relating to trans issues. 

Trans Youth Network run by and for young trans people aged 11-26, Trans Youth Network is a new UK-wide project providing advocacy, support, social, empowerment, signposting and training opportunities to young trans people and young people unsure of, questioning, and generally exploring their biological sex, gender or gender identity in any way at all.  

Women of the Beaumont Society operate a Helpline from their personal experiences and knowledge of being in a relationship with a gender dysphoric person.

As trans people we can often have a sense of isolation and social exclusion. The lack of understanding within families, the workplace and society as a whole can contribute to low self-esteem and a lack of self-care. Ongoing therapeutic support which doesn’t pathologise trans people can be important for wellbeing and can help reduce the risk of self-harm and depression.

If you have thoughts of self-harming or discomfort and difficulties around your gender identity, try to get help. Helplines such as Samaritans offer confidential, non-judgemental emotional support. Their number is 08457 90 90 90 and you can contact them 24 hours a day. You can also email them: jo@samaritans.org

The Gender Trust also has a directory of counsellors and support groups. You can also find them on The Gender trust in Facebook. 

If you want to talk to a counsellor about being trans, it might be important to you to ask them how ‘aware’ and experienced they are of trans issues and identities. Counsellors often have very little, if any, training on trans awareness so some trans people feel as if they are the ones educating their therapist.

You might want to see a counsellor for issues unrelated to your identity and it might be important to let the counsellor know this too - that is, if you want to disclose to them that you are trans (or someone with a trans history).

Discrimination can be one of the main issues that can impact on mental health for trans people. A report entitled ‘Engendered Penalties: Transgender and Transsexual People’s Experiences of Inequality and Discrimination’ by Stephen Whittle, Lewis Turner and Maryam Al-Alami surveyed 870 trans people. It found:

• 73 per cent experienced some form of harassment in public, ranging from comments and verbal abuse to physical violence.
• 21per cent stated that they avoided going out because of fear of harassment.
• 46 per cent stated that they had experienced harassment in their neighbourhoods.
• 64 per cent of young trans men and 44 per cent of young trans women experienced harassment or bullying at school by pupils, staff and teachers.
• 28 per cent stated that they had moved to a different neighborhood because of their transition.

Developing your self-esteem and wellbeing can really help you feel good about who you are and help you to value yourself more. Having social contact with others who have been on a similar journey can provide valuable support – put simply, other trans people are more likely to ‘get’ who you are. However, making friends and social contacts outside the trans communities can be just as important.

For a counsellor near you 
NHS Transhealth Page 

As trans people we will have potentially the same age- related health issues as cis gendered people. However some issues will be more relevant to transmen.

Hormones

If you transitioned early on in life and you are now over 60 you may have been on androgens (testosterone) for well over 40 years. There are possible issues with the longer term use of testosterone and it is useful to have your hormone levels checked regularly, to make sure you are on the correct doses of testosterone for you. As testosterone affects cholesterol levels and liver function you should also have those levels checked regularly too.

Many people believe that after a hysterectomy you can reduce or even stop taking testosterone. However, too low a dose of hormones might not offer you protection against osteoporosis, which causes thinning of the bones.

Hormone level checks

If your GP offers you hormone level testing, along with a yearly general health check, it is important that they understand the correct hormone levels for you as a transman.

Endocrinologists (endos), specialise in understanding hormones, your GP can refer you to an NHS endo, however they don’t all understand or specialise in trans peoples’ hormonal issues, so it is important your GP refers you to the appropriate specialist. If your GP doesn’t know who to refer you to, ask him or her to contact the local gender identity clinic (GIC) for information.

Sex life – libido

Libido refers to a person's sex drive or desire for sexual activity. The desire for sex does not have to decrease as we get older and some people’s libido will remain the same throughout their life. Some older people find their sex drive seems to be decrease - some people are happy with this but others may find this distressing. If it is a problem for you, discuss it with your GP or endocrinologist to ensure your hormone levels are still correct.

General health

Because we are trans, it doesn’t mean that we aren’t also concerned with issues that face all older people: living a healthy independent life, thinking about who will take care of us if we need it, having enough money to live on when working life ends. We are as entitled to advice, support and care as other older people.

Age UK is a good place to start to get information.

While the percentage of the UK population who are transgendered or transsexual is not known, it can safely be said that trans people are in a minority. Because of this, many of us don’t know anyone else who is trans. Some aspects of ourselves will be shared by someone we know but being trans is often unique to us, which can make it feel wrong or make us feel isolated.

For that reason, meeting other trans people can have a very positive effect on your self-esteem and wellbeing. Other trans people will be able to empathise with your situation, they will know how to articulate feelings that may be harder to convey as a cis person, and they may have experiences and advice that can assist you in your life.

Many trans communities exist online, giving you an opportunity to talk and potentially arrange to meet in person. Different sites will have their own cultures and audiences, so you might want to look around to find one that suits you.

Larger cities are more likely to have a trans support group. These groups may advertise in lesbian, gay, bisexual and trans (LGBT) spaces or you will be able to find them by searching for ‘trans support group [your city]’ on the internet. LGBT spaces in general can be good places to meet fellow trans people, even if they aren’t exclusively trans spaces.

Groups exist for trans people of all ages:

• Mermaids supports young children and teenagers with gender identity issues.
• Gendered Intelligence supports trans teenagers and young adults.
• Opening Doors supports older LGBT people in London.