GENDER TRANSITION
SOCIAL AND LEGAL TRANSITION
Social gender transition is often the first step in publicly acknowledging one's gender identity. It includes practices such as packing (using penile prostheses to present a male appearance underneath the cloths in the genital area), tucking (using tight undergarments to tuck away penis and scrotum to present a female appearance underneath the cloths in the genital area), makeup, changing hair style and/or clothing. Another important component of social transition can be supportive mental health care and voice or speech training (to help communicate a more male or female impression). Legal gender transition includes the change of both official name and gender identity on legal documents. It usually comes after social transition, and in some cases after medical treatment with hormone therapy and/or gender-affirming surgery. Different states and federal agencies have differing requirements that need to be fulfilled in order to request a legal name and gender change. Usually, a variance of court order, psychologist's or doctor's attestation (letter), and in some cases proof of gender-affirming surgery are required.
Social Transition
A first step in social gender transition is often coming out to and discussing gender identity with family, friends, and loved ones. This can also include joining social support groups and specific social networks. It is important to build a strong social support system to rely on when facing adversity from other societal groups. In addition to social outreach, there are several other practices that can help transitioning socially. For instance, packing describes the use of penile prostheses to present a masculine genital contour underneath the clothing, while tucking represents the use tight undergarments (a gaff) to tuck away penis and scrotum to present a feminine genital contour. Similarly, binding (wearing a tight top of strong stretch fabric or tightly winding a piece of cloth around one's chest) increases masculine appearance of the upper body (trunk), while removable breast, hip or buttock implants may highlight a feminine shape . Makeup, hair style and clothing can further accentuate gender identity. Voice and speech coaching can help adapt phonological presentation towards the identified gender. Moreover, it may be desirable to start supportive mental heath care, which can improve coping mechanisms in dealing with societal pushback and animosity. This might also be helpful in initiating legal name and gender change procedures, as well as requesting health insurance coverage for medical or surgical treatments, which sometimes require prior psychological counseling.
Legal Transition
Legal gender transition is heavily dependent on the regulations governing legal name and gender change in different states. Some states only require a letter from a doctor or psychologist diagnosing gender dysphoria and supporting legal name and gender change on official documents such as birth certificate and state IDs. Other states require a court order approving legal name and gender change, while yet others request proof of gender-affirming surgery, or both (i.e., "a court order indicating that the sex of an individual born in this state has been changed by surgical procedure"). The Transgender Law Center provides a good overview of the various requirements in all states, together with further resources on the regulations in each state and how to start the process (https://transgenderlawcenter.org/resources/id/state-by-state-overview-changing-gender-markers-on-birth-certificates).
Once name and gender have successfully been changed by the state issuing the birth certificate (where a person was born), these documents (changed birth certificate or court order approving name change) can be used to apply for updated IDs with Federal Agencies (such as USCIS or SSA). The US government provides information about name change (https://travel.state.gov/content/travel/en/passports/have-passport/change-correct.html, court order or supportive evidence required) and gender change (https://travel.state.gov/content/travel/en/passports/need-passport/selecting-your-gender-marker.html, self-identification process, does not require updated birth certificate, current options female (F), male (M), non-binary (X)) on its website. The Social Security Administration also requires a court order granting name change or other documentation of both the old and new names (such as original birth certificate with old name and updates birth certificate with new name).
