Gender Transition Age: Understanding When and How to Start the Transition Process

The decision to undergo transition is one of the most important decisions, involving various stages and aspects. This decision requires psychiatric and medical evaluations, and the individual must be prepared for it in every respect. The feeling of inconsistency between gender identity and the body causes stress, anxiety, and depression in individuals of all ages; therefore, many trans individuals prefer to improve their lives through gender confirmation. This procedure involves many risks and psychological and social pressures. Therefore, the individual usually needs to be past a certain age to undergo it. Stay with us to fully familiarize yourself with the age for gender confirmation and its limitations.

What is the Minimum or Suggested Age for Starting Transition?

There is no specific and fixed age to start the transition, for two reasons: firstly, the law of transition differs in various countries, and secondly, transition includes different stages, some of which have age restrictions and some are without age restrictions. To undergo any type of transition, the individual must receive complete psychological counseling and be psychologically and physically prepared. Furthermore, the individual must have full family support. Because transition involves many psychological and social pressures, the person needs psychological and emotional support. Some transition changes can be started in childhood, and for others, a minimum age of 18 years is required.

Medical Aspects of Transition Based on Age

Medical transition is usually performed in three main parts: puberty blockers, hormone therapy, and surgery. At each stage, one of the types of transition can be performed depending on the individual's age and circumstances. In the younger years (childhood and adolescence), puberty blockers are used to prevent the changes of puberty. At older ages, hormone therapy or surgery can be used. The important point is that necessary tests must be conducted before any action to check hormonal health and the general condition of the body.

At What Age Can Puberty Blockers Be Started?

Puberty blockers are usually prescribed before the onset of puberty signs, at the age of 10 to 12 years. The important point is that these medications are completely reversible and give the adolescent an opportunity to make a more informed decision about their gender identity path without hormonal changes or surgery. This stage, like other transition stages, requires approval from a psychologist, an endocrinologist, and parental consent. The use of puberty blockers can reduce the psychological pressure on the adolescent during this important and high-pressure period, allowing the adolescent to experience a safer and more secure phase.

At What Age Can Hormone Replacement Therapy (HRT) Be Started?

Hormone therapy (HRT) is another stage of transition that is usually performed starting at the age of 16 years. The main condition for performing this method is the approval of a psychiatrist and a specialist endocrinologist. In this stage, trans men are injected with testosterone hormone, and trans women are injected with estrogen hormone. The hormone causes changes such as voice change, breast growth, change in body shape, and reduction of fat tissue. Adults can also use hormone therapy at any age. HRT not only creates physical changes but also positive psychological effects, helping the individual to find greater alignment with their gender identity.

Surgical Transition and Age Requirements

Medical surgery is an important and complex stage in transition. Surgical procedures are permanent and completely align the individual with their true gender identity. These surgeries are divided into two categories, and there are specific age restrictions for both:

Non-Genital Surgery or Top Surgery

This procedure relates to the upper body. In FTM trans individuals, it involves removing the breasts and flattening the chest to give the upper body a masculine appearance. This surgery is generally feasible from the age of 16 and 17 years. The goal of this surgery is to reduce dysphoria and increase self-confidence, helping the individual to have an easier life.

Genital Surgery or Bottom Surgery

In this surgery, the male genitalia is converted to female genitalia, and vice versa. These surgeries are also permanent, and the legal age for performing them is approximately 18 years in all countries. Before surgery, the individual must undergo a complete psychological evaluation and have experience with hormone therapy.

How Old Must One Be to Undergo Gender Affirmation Surgery?

As mentioned above, there is no specific age or law for this matter, but generally, for Top Surgery, the age must be at least 16 to 17 years, and for genital surgery, the person must be at least 18 years old.

Age and Consent for Surgery

Similar to age, the law regarding parental or court consent for surgery is specific to each country. In most countries, including Iran, if the person is under 18 years old, parental consent is mandatory. For ages over 18, the person can decide on their own to undergo top and bottom surgery. In any case, court approval is necessary and psychiatrist approval is mandatory for surgical procedures at any age.

Conclusion

The age for transition is flexible in every country, and there is no fixed and specific age. The transition path starts in childhood and can be initiated in the teenage years with puberty blockers and hormone therapy, and if needed, surgery can be performed from the age of 18 onwards. Psychiatrist approval is mandatory for performing any of the transition stages at any age. Children and adolescents under 18 require formal parental permission. Surgical procedures in Iran must be performed with a court order.

FAQ

Is it possible to start transition at age 16?

Yes, puberty blockers can be used from this age.

What is the best age to start hormone therapy?

Hormone therapy can usually be started from age 16 onwards, and there is no age restriction for adults.

Is parental permission required for transition?

Individuals under 18 years old need parental permission for any type of transition.

Can individuals under 18 receive puberty blockers?

Yes, puberty blockers can be used from about 10 to 12 years old.

What is the minimum age for gender confirmation surgery?

In most countries, the individual must be 18 years old for genital surgery.

Can the legal gender be changed before age 18?

In some countries, yes, but in Iran, legal gender confirmation is only possible with surgery and from age 18 onwards.

What is the minimum age for gender confirmation?

Supportive and psychological stages can be started in childhood or adolescence, but for important medical interventions, the person must be over 18 years old.