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Home»Sexual Health»Your Transgender Journey – Sexual Therapy Carolina
Sexual Health

Your Transgender Journey – Sexual Therapy Carolina

healthtostBy healthtostDecember 9, 2023No Comments6 Mins Read
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Good news: we live in a world where people of the LGBTQI community are finding a voice and are becoming more and more accepted in our society. We live in an age where resources and information on LGBTQI issues are abundant and at our fingertips. But, that doesn’t mean it isn’t difficult, confusing and scary. I want to acknowledge that I’m a cisgender man, so I haven’t struggled with my own gender identity, but through my training in transgender issues and my work with transgender clients, especially teenagers, I’ve found that there are some early concepts that are useful for discussion. and exploration. In this post, I’ll give you some background to get you started on this gender identity journey and give you some good first steps to take as well as some important things to consider.

First, let’s talk about the differences between gender identity, gender expression, and sexual orientation.

Gender identity is your inner sense of being male, female, neither, or both. When thinking about your gender identity, remember that our society really likes categories. we like to put people into nice, neat buckets. But, you don’t have to identify as just male or female. Maybe you’re more comfortable with a non-binary gender identity, where you feel like you don’t fully identify with either male or female. Perhaps gender fluid is a better term to describe your gender identity where your gender is not consistent. Perhaps one of these terms best fits your gender identity: gender ambiguous, pangender, neutrois, gender expansive, masculine-centric, feminine-centric, androgynous. The point is that your gender identity is a part of you, and getting to a place where you understand your own inner sense of gender identity is a good first step in your gender journey.

Gender expression refers to the outward ways in which people show their gender. This can be your behavior, your voice, your dress, your haircut, etc. What ways of expressing your gender feel good? Do you feel more comfortable in certain clothes? Do you wish your hair were longer or shorter? Are there parts of your body that you want to emphasize or not emphasize? Is your gender expression changing? Maybe one day you want to wear a dress and fishnet tights and the next you want to wear ripped jeans and a baseball cap. Take some time to think about the ways in which you express yourself externally and what that message means to you and how you want the rest of the world to see you.

Sexual orientation is related to romantic and sexual attraction and is not related to gender identity and expression. This is about who you find attractive. that attracts you. This is another category that our society has historically thought should follow strict rules: boys like girls, girls like boys. But, you don’t have to fit into these buckets. Are you attracted to people of the same gender identity as you? People with opposite gender identity? Both? Or maybe you’re pansexual and potentially attracted to anyone, regardless of their gender identity.

Therefore, considering these three concepts is important work in creating a world in which you will be happy, open and free. You might consider finding books to help you explore these things within yourself (see the references at the end of this post). But, once you feel confident about your gender identity, gender expression and sexual orientation, what next?

Going out

Telling others about your gender identity can be one of the scariest parts of your journey. Before reaching out to others, you may want to talk to a neutral person, such as a therapist or school counselor. You may also want to find books to help you prepare to come out (see references). When you are thinking about coming out, make a list of all the people who are most important to you, it could be parents, friends, siblings, teachers. Then start thinking about how those people are likely to react. Start by telling the people you think are most likely to accept you and be with you on this journey. Always consider your safety. Find a safe environment and safe people as you start dating. It’s a good idea to plan these discussions in advance. Practice what you want to say and be prepared to answer some of the typical questions you might get. You want to be too mentally prepared in case you get a more negative reaction than you expect. Remember, you don’t have to contact everyone, but it’s a good idea to contact some people close to you so you have a support group on this journey.

Transition

One possible step in the transgender journey is transitioning. When we hear transition, we often think of medical transition, but it’s also important to think of social transition. Social transition is about your gender expression, your name, your gender pronouns and other aspects that are reversible. Before you consider medical transition, consider your perception of gender and gender expression in our world. We’ve all been shaped by how our society thinks men and women traditionally act and look: men are into sports, women are creative. men have short hair, women have long hair. What suits you? Don’t let yourself get caught up in thinking that because you’re transitioning into a certain gender identity, you have to fit society’s rules around how that gender acts and expresses itself. And what name do you want to use? What pronouns? Part of social transition is implementing these changes. asking others to start calling you by a new name and using new pronouns.

Medical transition is a broad topic with many considerations, so I’ll keep it short. Find a good doctor. If you’re young, find a pediatric endocrinologist who can help you figure out what to do about puberty blockers and hormone replacement therapy. If you’re an adult, an endocrinologist can help you get started, especially with hormones, but do your research first. Search for a “trans-friendly doctor” near you or use directories of LGBTQI providers. (See references for a list of provider directories). Sometimes it is helpful to find someone, such as a therapist, who specializes in working with transitioning clients and can help you navigate the transition medical system.

This post just begins to talk about this complicated gender journey you are on. Check out the references below for books and other resources to help make this journey as smooth as possible.

bibliographical references

Discussing Terminology and Pronouns at UCSF Transgender Care.

GLMA Provider Directory.

Hoffman-Fox, D. (2017). You and your gender identity. A guide to discovery. Skyhorse.

Lev, AI (2004). Show transgender. Routledge.

Directory of OutCare Providers.

Rainess, SJ (2015). Real talk for teenagers. Getting Started Guide to Gender Transition and Beyond. Type Harbor View

Search the World Professional Association for Transgender Health (WPATH) provider directory.

-Matt Todd MA, LCMHCA


Matt Todd, MA, LCMHCA is a licensed clinical mental health counselor in North Carolina and a former employee of the Carolina Sexual Wellness Center. To schedule an appointment with any of the therapists at CSWC, call 919-297-8322.

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October 8, 2025

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