What does the term female-to-male (a.k.a. FTM and/or F2M) mean?
Female-to-male simply refers to the direction that a transgendered person is going in. Whether they are changing their sex or simply cross-dressing, all female-to-males were either born in female bodies or were born intersexed and raised female. Until relatively recently (partly due to the fact that F2M crossdressers could pass unnoticed by society and that sex reassignment surgery for F2M was less successful), almost all gender community and media attention was focused on male-to-female transsexuals and crossdressers, to the extent that many people did not even know that female-to-males existed.
Why do some people born female identify as F2M?
That's a big question with as many answers as there are individual F2Ms. But, generally speaking, a person born female identifies as F2M because throughout all or part of their lives they have experienced what is known as gender dysphoria (the feeling that the sex which you were assigned at birth does not match the gender that you feel you are internally). Some F2Ms are conscious that they are really boys/men inside throughout their lives and transition to male as soon as they are able to do so. Others feel male inside from an early age but then spend part of their lives in denial before finally coming to terms with their feelings and transitioning to become their true selves.
As to why F2Ms experience gender dysphoria in the first place, no one knows for sure, but modern studies lean strongly towards the theory that something happens in the womb which causes us to be born with male gender identities. Regardless of where gender dysphoria comes from, one thing is for sure: it is a lifelong condition and the only way to "cure" it to change one's body to match how one feels inside.
Are all F2Ms transsexual?
No. There are F2M crossdressers and transgenderists, both lesbian and straight-identified, although little is know about them and their numbers appear far fewer than those of M2Fs CDs and transgenderists.
How many F2Ms are there?
If were accept the common estimation that 1 in 50,000 [more modern estimates place this figure significantly higher at 1 in 10,000 and even 1 in 1000. - ed.] people are transsexual and that nearly half of all transsexuals are F2Ms, my best guess would be that out of 300 million Americans around 3500 would be F2Ms. This is only a very rough estimate however, and new F2Ms seem to be turning up every day.
Is it really possible for a F2M transsexual to transition to successfully living and passing as a man?
Yes! There are many happy, well-adjusted F2Ms out there with jobs, lovers, and families. In fact, it is very likely that you have met an F2M at some point in your life and not even realized it. Thanks to the magic of the masculinizing hormone therapy they receive, transitioned F2Ms pass so well no one can tell that they were not born male.
What are the physical effects of taking male hormones?
When a genetic female takes testosterone, for the first couple of years the experience is very much like going through male puberty: your voice cracks and drops significantly, your facial features coarsen and masculinize, your skin gets rougher, facial and body hair sprouts, your sex drive increases, and you often break out in teenage acne on your face, chest, and back (this goes away after a while, though). Other effects more specific to the genetic female include the menstrual cycle stopping after a few months and the clitoris growing large enough to resemble an extremely small penis.
How do hormones affect emotions and personality?
During your first year on hormones you will probably experience some "teenage" mood swings, but your moods will level out as your body adjusts to its new hormonal environment. Mood swings aside, most of us usually feel much happier upon starting hormones, and, contrary to the stereotype that testosterone causes aggression, many guys report feeling a greater sense of calm once they have begun taking hormones. Many of us also report feeling more assertive and being quicker to stick up for ourselves, but the important thing to remember is this: testosterone will help bring out your real self, but it will not turn you into someone you're not. If you are a nice person you will stay a nice person, and there is no need to worry about becoming the Incredible Hulk.
How effective is chest reduction, and how realistic are the results?
When performed by the right plastic surgeon, F2M chest reconstruction surgery yields very effective and convincing results. They are good enough to take your shirt off in public or hang out at the pool or beach without any self-consciousness.
How effective is genital reconstruction, and how realistic are the results?
First the good news! Many F2Ms, in fact probably the majority, lead happy fulfilling lives (including sex and love lives) without having any genital reconstruction at all. Now for the bad news: the reason so many F2Ms don't have genital reconstruction is that, compared to M2F genital surgery, ours is far from perfect and often very expensive.
There are two basic options available to us, phalloplasty and metaoidioplasty. In phalloplasty, the neophallus is fashioned from skin taken from the forearm and butt, stomach, or thigh. The urethra is routed through it, sensation is enabled via nerve hook-ups to the clitoris, and erection is enabled via the use of removable stiffeners. This one allows you to be hung like the proverbial horse, but it is very expensive (up to $100,000 and beyond), requires multiple surgeries, and is often prone to complications.
The metaoidioplasty involves releasing the testosterone-enlarged clitoris to form the neophallus (with the clitoral hood now serving as a foreskin), and implanting silicone balls in the labia to serve as testicles. This is a much simpler, less-expensive (around $10,000) surgery which makes use of the genitalia that you already have in order to allow full sensation, spontaneous erection, and even shallow penetration in some cases. The result, however, is small (usually around a couple of inches).
That explained, let me reiterate: While both of the above options have turned out to be the right choice for many guys (and only you can decide what's best for you), it is very possible to live a full, happy life as a man without any genital reconstruction, and you will not be any less of a man if you chose not to undergo it.
Do all F2M transsexuals identify as heterosexual men?
No. Many F2M transsexuals are attracted to men and identify as gay or bisexual men. Lou Sullivan, one of the most famous and influential F2M transsexuals, identified as a gay man.
Is it possible for an F2M who identifies as a gay or bisexual man to date non-transsexual gay and bisexual men?
Yes. Many gay and bi- F2Ms have had good luck in finding genetic gay man who were willing to date them.
"Are there any books or magazines about the F2M phenomenon?"
Yes. A small sampling of F2M-oriented books from the IFGE bookstore catalogue and other sources includes:
Information for the Female to Male Crossdresser & Transsexual by Louis Sullivan - a virtual bible of useful information on everything from passing tips to surgical descriptions.
Sacred Country by Rose Tremain - a novel about an F2M growing up and then transitioning in 60s and 70s England.
From Female to Male: The Life of Jack B. Garland by Lou Sullivan - fascinating story about an early 20th century F2M who lived as a man in the days before hormones and surgery.
Masculinizing Hormone Therapy for the Transgendered by Sheila Kirk, M.D. - a very helpful and descriptive guide to testosterone and its effects.
One periodical which every F2M should keep up with is the quarterly newsletter of FTM International.
To subscribe, go to the FTMI website.
Another magazine is Transgender Tapestry.
Subscribe online now or write to Subscriptions, P.O. Box 540229, Waltham, MA 02454-0229. Or call 781-899-2212 or email: FTM@ifge.org.
Are there any organizations or support groups for F2Ms?
Yes. FTM International. Write to the above address for information on support groups near you.
Also, call or write to IFGE, P.O. Box 540229, Waltham, MA 02454-0229. 781-899-2212 or E-mail: FTM@ifge.org
There is an all-F2M internet mailing list that your can subscribe to by writing to: MtMinfo@home.com
How can a F2M individual find knowledgable, understanding psychotherapists and physicians?
The best way to find a good therapist or doctor is to inquire within the local gender community and ask a lot of specific questions: Who has had experience working with F2Ms? How understanding are they? Are they someone who you would feel comfortable working with? Do they seem genuinely interested in helped clients transition within a reasonable amount of time, or are they behaving obstructively so as to make as much money off them as possible? In the case of surgeons, always ask to see photos of their work first.
Also, write to FTM International at the above address and ask about the price and availability of their Medical and Legal Resource Guide.
Are there resources for spouses and significant others of F2Ms?
Yes. FTM International and IFGE have information on local and national support groups.
This information is provided by:
The International Foundation for Gender Education
a 501(c)3 non-profit organization serving the transgender community
P.O.Box 540229, Waltham, MA 02454-0229