The term transition can mean any number of things to a transgender person. For some, transitioning will mean changing the way they dress. For some, it will mean hormone treatments. For others, it will mean surgeries. Some people will do all of these, and some will do none.

What’s the reasoning for not having surgeries?
For some, the cost is prohibitive, as it can be expensive. But even if the surgeries or medical treatments are available, there are people who will choose on their own not to take those steps. Those are all personal choices, and each of those transgender people fit under the transgender umbrella.

You said that for those who do want to have surgeries or medical treatment, the costs can make it prohibitive. But I thought I read that some insurance companies cover it?
It depends on the insurance company and the place of employment. Starbucks announced in a press release that the company would expand its medical coverage for transgender employees:

Starbucks health insurance plans include not only gender reassignment surgery (which had been covered since 2012), but now also a host of procedures for transgender partners in the US that were previously considered cosmetic, and therefore not covered, such as breast reduction or augmentation surgery, facial feminization, hair transplants and more.

Got it. OK, so what else do I need to know?
Not everyone uses the same terminology. What Starbucks called “gender reassignment surgery” is sometimes referred to as “gender-affirming surgery” or, in the case of a 2017 Teen Vogue article, “gender affirmation surgery.”

What’s the difference between those surgeries?
The difference is more in how the terms are phrased and discussed. The difference here is not in the surgery, but in the focus of the term. Older terms framed the surgeries in terms of changing something about the person’s body parts, whereas more modern phrases put the surgeries in terms of how the person sees their own gender.

But you also said a person can transition even if they are not taking hormones or having surgeries?
Correct. Each person will transition in a different way, and the word will mean something different to everyone, because the process will not be the same for everyone. Because of that, a transgender person’s transition cannot and should not be framed in terms of surgeries and hormones, because for many, the transition will come without those things.

Right, so I guess it’s inappropriate to talk about a transition with someone who is not getting surgery or hormone treatment?
It is. And even for the people who do elect to have surgery and hormone treatment, that is considered a personal, private choice. It is part of transition for those people, but they will not think of those medical procedures as the central part of their transition.

In a 2014 interview with Katie Couric, actress Laverne Cox discussed what she thought was a preoccupation with transgender people’s body parts:

I do feel there is a preoccupation with that. The preoccupation with transition and surgery objectifies trans people. And then we don’t get to really deal with the real lived experiences. The reality of trans people’s lives is that so often we are targets of violence. We experience discrimination disproportionately to the rest of the community. Our unemployment rate is twice the national average; if you are a trans person of color, that rate is four times the national average. The homicide rate is highest among trans women. If we focus on transition, we don’t actually get to talk about those things.

OK, so it seems like it’s a topic to just not bring up, regardless of how anyone chooses to define the term.
You got it. And that should carry over to many social topics. Would you want someone to ask you how you and your partner conceived your child? Would you want to be asked about your body parts?

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