For the classic, 'true' transsexual, such as your author, the future is very clean cut and straightforward. If you are less defined, if you are unsure or unclear, if your issues are not beyond question, then the multitude of choices become worth examination. Let us take this step by step.

THE CLASSIC TRANSSEXUAL

A classic, or 'true' transsexual follows a fairly predictable pattern, with a rather predictable and common life story. The basic cookie cutter version is easily summarized.

The classic transsexual is aware of gender conflict at a very early stage in life, usually somewhere around the age of five. The gender issue causes problems throughout life, because the transsexual  cannot entirely suppress or deny the truth of their identity altogether, despite social pressure to do so. As time goes on, the agony of gender dysphoria, and a life of misery and self-denial, becomes unendurable and something must be done about it, either to correct it, or to permanently stop the suffering. For the latter group, the answer is too commonly suicide, but for the former, the answer is very standardized: hormones, followed usually by surgery.
 

The age of desperation and action commonly begins in early adulthood, when the transsexual is finally confronted with the inevitability of their misery being permanent, or as soon as a degree of independence from family is achieved that would permit transition to the proper sex. This expression of transsexuality is sometimes called 'Early Onset Transsexualism'.

Sometimes the suffering transsexual is totally hopeless, without enough information or understanding, or trapped by choices and is also unable to  face suicide. The result is a massive purge and redoubled effort to conform, and the transsexual enters a stage of denial and repression that can last years...even decades. At some point, generally as the transsexual approaches middle life and the spectre of eventual mortality becomes real, as balding sets in and youth is lost, the repression abruptly ends and a mad scramble to make up for lost time and life ensues. Families are disrupted and all the carefully built up facade of normality is commonly thrown into chaos, as the aging transsexual rallies against cruel time and the misery of decades of lost years. The solutions are essentially the same as for the 'Early Onset' transsexual, only later in life, and with consequently far more complications. This expression of transsexuality is sometimes referred to as 'Late Onset Transsexualism'.

THE BEST POSSIBLE OUTCOMES

The very best situation is to know clearly what you want as early in life as possible, and to take definite, strong action as soon as feasible, possible, and safe.  The sooner that transition is begun, the better the result overall. This is because it takes time for the body to completely masculinize or feminize, and the younger a person is, the closer to androgyny, and the more changeable is the flesh. By approximately age 18, the effect of applied hormones to alter sex begins to diminish, by around age 25 the effect become half of what it was at 18, by age 30, the ability of the body to respond to hormones, as well as the acceptability of the result can drop to one fourth. After age 30, there is little effective difference over time, as the body has become fully mature, and there is no longer any special 'youth benefit' to assist transition.

This does not mean that the older transsexual cannot succeed in becoming a socially acceptable and ultimately comfortable member of the sex they were meant to be, but it does mean that the chances of being truly passable, attractive, and content are significantly less. This must be qualified by the direction of transformation, as Male-To-Female transsexuals suffer more at the hands of time than do Female-To-Male transsexuals.

DIRECTION OF TRANSITION AND SUCCESS

Put simply, the Female-To-Male transsexual tends to succeed cosmetically far better overall than the Male-To-Female transsexual at almost any age after 18. For the Male-to-Female, surgery is far better and the genital results more satisfactory, and for the Female-To-Male, the surgical results are generally quite poor. The reason for this is intrinsic to our fetal development.

All human fetuses start out as a quasi-female creature. The base human state is essentially a stock female form with incompletely differentiated ovaries. Both genetically male and female babies start this way, with proto-ovaries and a proto-vagina and labia.

Within short order, an influx of sex hormones switches on genes that begin to alter the stock female human form. For the genetic female, the stock form is further refined, as the proto-ovaries complete their formation, and the other sexual organs develop further as they already are. Thus is a girl constructed.

For the genetic male baby, male sex hormones begin an astounding and dramatic mutation of the base human form. The proto-ovaries drop down through the body cavity and become enclosed by the labia, which seal around them. This sealing together of the labia causes the distinctive ridge of skin that runs down the center of the testicle sac, that seam is the sealed labia. The internal body cavity also seals shut behind the proto-ovaries separating them (shy of a hernia!) forever from the body proper. Hormonal changes alter the proto-ovaries, and cause them to change their function to that of testes.

The clitoris grows and lengthens, deforming itself to massive proportion, even as the urethra is enclosed within it, becoming the penis. The tiny hymen is lost forever, sealed away inside the male body, in a eighth inch liquid filled pocket tucked just under the bladder, the last remaining part of the now absent proto-vagina.

Along with these changes are also changes made to the construction of the brain and nervous system, which occur in short, rapid spurts, influenced by hormones. If something should interfere with which hormones flood the developing child at these critical moments, the result is in mild form homosexuality, and in extreme form, transsexuality.

After birth, the body of either sex continues to form into full adult sexual differentiation, reaching completion of the process around age 30.

With the understanding that masculinity is a mutation of the basic proto-female human form, it becomes easy to comprehend why the Female-To-Male transsexual generally has a more cosmetically acceptable transition at any given age. It is easier to mutate a base form, than to reverse the mutation once it has already occurred.

Clearly, the younger -and thus the less solidified the mutation- the better the intervention and correction will be.

The Female-To-Male transsexual can look forward to a voice that will drop in pitch as the throat responds to male hormones, but the Male-To-Female transsexual cannot hope for a rise in pitch: the mutation can never be undone once it has occurred. Likewise, facial and body hair are permanent and can only be removed by physical effort, such as electrolysis. Breasts are permanent, and must be removed by surgery once grown.

Even so, there is much that hormones can do, more dramatically the younger they are applied.

Hormones alter the distribution of fat in the body, of muscle tissue, and alter the basic chemistry of the brain, affecting perception and function. Hormones change the texture and composition of the skin, activate the growth of structures such as breasts, hair and vocal changes (for the Female-To-Male), and affect the overall chemistry of the body in total.

But for large scale fundamental structures, only surgery will suffice. Bones are permanent once formed, as are sex organs. To have proper genitals, the transsexual must undergo sex reassignment surgery. Again, while rather unsatisfactory for the Female-To-Male transsexual, surgery is often undetectable in the Male-To-Female transsexual, even by trained medical professionals.

THE 'TRANSGENDERED' INDIVIDUAL

There are those who are not driven to complete a full sex reassignment to fit an easily defined,  polarized gender. It should be understood that gender is NOT a simple Male and Female polarity. In actuality, gender is a continuum, a spectrum between the poles of male and female, with an infinite number of possible states of being in between. Even the most polarized individual still contains elements of the 'opposite' gender within their construction and expression. No human is ever completely male or completely female.

Some individuals are compelled by transsexual motivations, by a need for a different or even expanded gender expression, and this drive may need to be manifested physically as well. Such persons commonly identify as 'Transgendered', a new term which is questionable in definition, but useful in practice.

A transgendered individual may choose to partially undergo transition only, enjoying a 'half-way' or 'alternative' gender expression. Here too, the use of hormones, or even limited surgery, can bring happiness and contentment.
 

As always, though, the best course of action is to determine clearly exactly what you want, as soon as possible, and take definite and immediate action. Biology waits for no soul, and doing nothing is as much a choice as taking matters into one's own hands. The body will do what it is programmed to do, unless a person takes control.
 

WHY YOU NEED TO BE ABSOLUTELY SURE

While there is no question that early intervention is of supreme benefit to the transsexual -and the earlier the better- it is often tantamount to suicide to make an error of judgment in the matter of sex reassignment, whatever the degree of alteration. For this reason, careful filters have been created, such as the Benjamin Standards Of Care, to help prevent the occurrence of hideous mistakes. Even so, there are always a few souls, and the suggestion is that the number is large, who use their special gifts to get around the system. Rarely, this results in the partial or total destruction of a life. The blame for such a mistake is squarely on the head of the person seeking reassignment, though some, in their pathos and degradation, attempt to sue or harass the very individuals that gave them what they themselves demanded. There is no bottom to which some humans cannot sink, in their attempt to avoid responsibility for themselves.

It is self responsibility that is the key issue here! There is currently no sure test, no absolute method of determining the gender orientation of any person. While gender issues are deadly serious, they are also exceedingly subjective, and the physicians that have the courage to care for the transsexual or the transgendered must act from a position of acceptance of the claims of the patient. The full burden of responsibility MUST fall only upon the transsexual or transgendered person, for there is no realistic way for any other person to truly know what is best to do for them.

For this reason, it is mandatory that the person with gender issues take total responsibility for their own life. It is required that YOU KNOW WHAT YOU ARE. You must define YOURSELF, and you must do so honestly.

The penalty that nature, that reality itself inflicts on the casual, the unwary, the unconcerned  and the foolish is ABSOLUTE. Sex reassignment is absolutely ONE WAY ONLY, and attempts to reverse the procedure after completion are sad at best. The bottom line is very simple.
 

If you make a mistake, if you screw up, if you are wrong, you HAVE to live with the consequences, and no matter what you may feel about it, it could ONLY have been your own choice, it is utterly your OWN RESPONSIBILITY. There is no one else to rationally blame.

This means, of course, that the person who is not entirely sure of what they are is in a special, terrible hell. Time is quickly ticking away their easily mutable youth, and changing them in one direction or another whether they like it or not, and if they act wrongly to solve their misery, they could end up FAR worse off.

Therefore one must act more quickly to come to a better understanding of one's true identity, to come to self understanding, than almost any human being. It is a tall order. The question, is how to do this.

There are many resources for this process, from counselors and therapists to friends and even occasionally family. Nothing can replace the only real method, being willing to face one's own true feelings, which with or without guidance, is a solitary pursuit. You must make the effort to try to face yourself, and NEVER GIVE UP. Only you can ever really know you...though others can often act as mirrors if you are too close to your issues to see them directly. The key to success in self knowledge is to pursue it. Those enslaved to denial and avoidance, who put off and procrastinate, are the souls destined for doom. If you have gender issues that hurt badly enough that they need to be addressed, then you must confront them. Talk about them to those you trust, hang on, pursue, learn, study and focus until you finally can decide who you are and what you want. Putting it off will only make things vastly worse. It is hard work, it is not easy, and it hurts to do this. But remember, it hurts anyway, or you would not be driven by your gender issues. That pain will likely only get worse as the years progress. Regret is terrible, whether for lost time, or for making the wrong choice.
 

The bottom line here is that to figure out what you truly want, you have to stop repressing, denying and hiding, and come Out to yourself. You have to be emotionally willing to accept whatever you may turn out to be. If you do not know what you want, it is because you are disassociated from your own feelings, as a defense mechanism. The only solution is to overcome that which made you deny your feelings. That is done by examining your attitudes and beliefs, questioning them, and dropping the ones that cause you to feel like disassociation is a safe thing. Perhaps you may have internalized homophobia, or religious intolerance of your own condition, or a scolding parental program running in the back of your mind, or fear of rejection, or just plain do not want to face the inevitable pain of dealing with things. Whatever is the cause (or causes, more likely), you must find it and dispose of it. When that is done, then you must start to really feel what you are, want and need.

HALFWAY MEASURES: THINGS YOU CAN DO TO TEST YOURSELF

One excellent way to learn is not theoretical, it is by hands on experience. In the circumstance of discovering gender identity, a supreme tactic is to experiment.

The best experiments would ideally be nonfatal, non-permanent and very revealing. Perhaps the single most effective tool for self knowledge of gender identity, is to experiment with hormones.

To much of the medical establishment this is a bold, or at worst, a precipitous thing to suggest. It is not without some risk, but the risk is fairly small, short term.

Go on hormones for up to six months.

Beyond six months, the effects of hormone therapy start to become permanent, with eight months being the edge of going too far. Within six months, almost all effects, at least of estrogens, are reversible over time. It should be noted that for Female-To-Male transsexuals, testosterone changes are not reversible at all.

Hormone therapy is very revealing. The test procedure very simple. If after several months, you love and prefer how you feel, think and are, then you are probably on the right track, indications are suggestive that this is right for you. If you really don't like how you feel, think and are, if it makes you uncomfortable, disturbed and uneasy, then this is a direct indication that changing your sex is not the best choice.

Hormones affect almost every aspect of your functioning, and simply by noting if the experience is good or bad, you should get some idea of what you really want. Remember though, that what you want could be anything, even some comfortable place Other than Male or Female, so keep an open mind.

Simply quit when you choose. Take responsibility for this.

A less biological test is to simply live in your chosen gender role for a given time. This is often hard to arrange, but a vacation or time off, or other retreat can provide the space to experiment. If you are brave enough, or passable enough to do so openly, then do so.

If it is awful, it is not right. If it is good, it is.

THE THINGS I DID

Things that helped me to know myself included the horrifying realization that I was gradually developing adult sex characteristics, the careful use of psychoactives to destroy my inner inhibitions and barriers, direct life-or-death confrontation with my problem, and on a more gentle side, the effects of movies and stories.

I paid attention to the things that made me cry and feel powerful emotions and used those to help me uncover my own repressed desires. By pursuing my own obsessions and fascinations, while at the same time making sure that I observed my own feelings while doing them, I gradually broke down my own internal barriers. I experimented with my issues and made note of what made me the happiest. I kept a diary and used it to total up my own actions to gain a perspective over time. I sought out the stories and ideas of others who had already done what I imagined I wanted to do.

But in the end, I dared to take total responsibility for my own life, made a choice, and resolved to accept the consequences with honor and courage. Ultimately, that is all you can ever do. 

Transsexual and Transgendered people can and do live happy, rewarding lives, all the better for having faced their own issues and winning through.

I know, because I have done so, and so have my many successful transsexual and transgendered friends.

Of course you can, too. You just have to be willing to be courageous, responsible, and intelligent. Gambatte !