There are a number of common medical and surgical procedures that trannies will occasionally go through. Not all trannies go through all of these, by any means, or in any particular order. They are just the services that are available. I'll list them off, anyway:

• Counselling. OK, most of us are confused at one stage or another, most of us feel bad about ourselves occasionally. Rather than getting down in the dumps about it, why not go and drop it all on someone else's shoulder. GPs, counsellors, and psychiatrists are typically great listeners.
• Diagnosis. In order to be prescribed hormone therapy or be considered for surgical procedures, you must satisfy a doctor, or usually more than one doctor, that you are genuinely 'gender dysphoric', and aren't suffering from any other psychiatric complaints. This is the bit that makes some people start to hate some doctors. It's a pity that diagnosis is a part of the whole thing, because I'm sure that I'd get a lot more out of counselling with my doctors if I didn't feel I had to satisfy their criteria all the time.
• Hormones. Most people are prescribed sex hormones by either a GP or an endocrinologist. This is a whole topic in itself. Not everyone goes for hormones, and there's a lot of debate and experimentation to go through in figuring out just what dose of what is right for you.
• Cosmetic Surgery. All sorts of things are possible, including breast augmentation, breast reduction, rhinoplasty, cheek implants, lip implants, tracheal shaves, you name it, and it's been done, all in the name of a more feminine (or masculine, if you're of that persuasion) appearance.
• Gender Reassignment Surgery. This one is not cheap, nor easy to get recommended for, nor even vaguely pain free. However, it's reasonably popular, despite all the well publicised drawbacks. There are a number of different procedures, and a number of different opinions as to which is best.

Anyway, I'll go through a bit of a review of what to do, and expect, where.

The first contact:

You've been going over all this in your head for years now, and you've finally plucked up the courage to talk to someone about it. I'll relate my experiences here, as they seem to be reasonably typical of the norm.

In the beginning, I was confused. I knew I didn't want to be a boy, but it was painfully obvious that everyone else wanted me to be a boy. In order to please, I made myself as boyish as possible. My teenage years were spent in dirty t-shirt and jeans, with a crewcut, and a somewhat suicidal outlook on life. As soon as I was able, I grew a beard. I figured that it gave me a bit of a buffer. I got married, rather early, to a girl I'd made pregnant while trying to prove I was more boyish than everyone else. Needless to say, it didn't work. I've got my ex-wife to thank for a lot, including allowing me to come out of myself. I lost the beard pretty quickly, then the hair on my legs, etc, etc. In any case, I found myself becoming more and more depressed about this boyish body of mine.

Eventually, I looked up all the obvious bits in the local phone book, and found, you guessed it, absolutely nothing. I started looking everywhere I could, and found the original revision of this guide, from Jane. It listed both the Seahorse society in Sydney, and the Gender Centre. After a couple of weeks of working up the courage, I called them both. Both organisations were really nice, and I poured my heart out to a lovely girl from the Gender Centre for a good hour or so one day. In any case, I ended up joining the Seahorse society, but found I had little in common with the majority of their members. I was still depressed, and after a while, my wife got fed up and rang the Gender Center to ask them if they knew of any doctors or counsellors here.

I didn't go straight away, of course. It took another couple of months before I worked up the courage to make an appointment to see the doctor, and even then I nearly didn't turn up. When I got there, it was very tempting to just say I had a sore throat, or something equally inane, in order to get out of it. But I didn't. When he asked what the problem was, I paused, cleared my throat, and blurted out 'I want to be a girl.' That said, I'd like to say that it's been easy ever since, but it hasn't. We talked for ages (I'm sure I wasn't popular with his other patients that day), and I told him candidly just how I felt at the time. I left with an appointment (a long one this time) to see him again a week later, and a reference for a book on dealing with depression. I read that the same night, and found it of little value. I knew what the cause was. In any case, I went back and started asking for hormones. This took a while, during which time I was referred to a psychiatrist for a second opinion, had an EEG done (it was fun, but useless), and started to get really frustrated.

One thing led to another, and here I am. I'm glad to say I'm not nearly as depressed as I used to be, because I'm taking some huge positive steps. So, what you do, and who you see, depends on where you want to end up. Counsellors are cool, if you want to talk things through, and they are really approachable. In fact, everyone in this section is.

Your local GP, if you can find one, will usually be your main point of contact. It will be he (or she) that refers you to other specialists, such as psychiatrists, endocrinologists, surgeons, etc., and it will be he (or she) that usually prescribes hormones (often on the recommendation of your endo) etc. If you can't find a GP that's close to you, like in the same city, then ring one of the counselling or support services up, and start asking questions. Doctors are also pretty good at knowing what each other is up to, so try the closest GP you find, and ask him or her if they know of anyone closer. Failing that, doctors that advertise as dealing with HIV patients and other 'minority' cases are usually really cool, and at least will listen to you. Each of the doctors listed here was broken in at some stage. Once you've done that, of course, you will be a doll and tell us, won't you?

It's important that you and your GP develop a good relationship, as you'll get nowhere if you don't like each other. If you don't get on, then try someone else.

Finally, all I can say is that if you feel you need some sort of help, please ring someone. The people in this guide are really cool and understanding, and trust me, they've seen it all before.