Transitioning in USA as an immigrant

Statue of liberty
Statue of liberty

It has been almost 2 years since I moved to USA for higher studies. But that wasn’t the only reason why i had moved here. You see, I am a pre-op trans*woman who had not yet begun transitioning when entering this country. I had barely accepted myself and was still pretty much in the closet even as far as community support and reach went.

Grass is always greener on the other side.

Like most other Indians who move to the United States in hopes of better lives, I arrived here with my own perception of how life would be. In fact just a few months prior the NALSA judgement was passed by the Supreme Court of India that has made life for trans*people, at least constitutionally, better. Within the first few months I realized that maybe it is not as advertised.

For starters, if you do not have insurance, it’s going to be expensive (at least 20-30 times more than it is in India) and because of this, many people refrain from going to surgery or are stuck in a situation they would rather not be in. Secondly, USA has lost lots of trans*women to hate crimes. And then there are the conservatives pushing hard for discrimination against transgenders by inculcating fear in the cis-populace.

Added to all this was my status as a student. An international one at that. What with having taken a loan that was larger than my head’s worth, it all but seemed to be a daunting prospect at first. But hey, the good news is, I have been transitioning for over 9 months now and it has been doing wonders for me.

Wondering How?

Well let me list out everything that I did and would suggest every trans*person coming to the USA to do.

Firstly, almost all reputed colleges would have a Gender and Sexuality Center. My reason for choosing the university I went to was because it had consistently ranked among the top 25 colleges in the country for LGBT acceptance and inclusivity. The GSC here is an amazing support system. Weekly meetings, frequent events, potluck dinners, night outs, party nights, activism, parade participation, parade conduction, etc are all taken care off by each university’s GSC. If you are an LGBT person hoping to come to USA for education and acceptance, ensure that you research well and find colleges that have an active GSC. Even getting your degree certificates changed post transitioning is not at all an issue unlike in India.

If the college you choose does not have a GSC then worry not. Most of the cities here have areas where the LGBT community is present in abundance. For instance in Chicago, North Halsted and surrounding neighborhood are considered to be part of the boystown. The parade goes through that route and they have so many gay bars and hangout places and thousands of LGBT peeps living in that area. Most major towns have similar such areas. And if you are worried about your safety, did you know that the said area is among Chicago’s poshest?

Okay, you have a local support system in your college. Now what?

Next step would be to approach a counselor through the GSC and then have them recommend a professional therapist. Every college has its own clinic/medical center where doctors from various fields work with patients affiliated to the university. The majority of the costs would be covered by insurance. You would be assigned a primary care physician who would take care of your medicinal needs while the therapist works with you for resolving your issues, whatever they may be.

In my case, my PCP started my medication within a week of my first visit once i gave my informed consent for HRT. I needed to start the journey and I did not particularly enjoy being stuck. However, there would be those who are willing to wait for a few years but would like to at least get their psychological analysis and therapy done with.

Whether you’ve decided on HRT or not, you need a therapist. I was in her waiting list for almost 5 months before i was called by my doctor’s assistant to set up an appointment. It took me 12 sessions and i guess that would be the minimum for most people. 12 sessions spread over the same number of weeks, we began by talking through my childhood and adolescence and my life until that point. The subsequent sessions dealt with various issues i may or may not have and then eventually around the 9th session we started working on my transition letter. this letter is not exactly necessary however, it is proof that you have actually been analysed over a few months and the therapist has indeed diagnosed you with gender dysphoria. There are people to whom that would be a huge help in coming out to their parents.

The next step is of course working on your transition and adapting to living full time and maneuvering through all the obstacles society throws at you. All for at least a year. Once you have lived as your preferred gender for over a year, you can go to a therapist once again and work with them for your surgery letter. This would again take at least 12 sessions if you have not bothered to take the transition letter from your first therapist. After this a second opinion would be highly recommended. And then starts the research on finding surgeons and suitable surgeries to go through.


Financing your transition and surgery

I have left discussing this part for the very end because it is as mundane as it is necessary. tens of thousands of trans*people in this country are unable to go for transitioning and surgery because they do either do not have insurance or do not have eligibility for availing insurance for SRS. In spite of various companies coming forward and making SRS and HRT an integral part of their insurance schemes, there are so many smaller companies that are backward as far as trans*lives are concerned. So it is an absolute must that you research on different insurance companies and their various schemes and policies to choose the best option for transitioning. Many colleges cover SRS and even FFS under their Campus Care insurances. So opting for surgery even while studying is not an issue as long as your mind is set on it.

Whatever I have written in this article is based on my observations and experience over the past couple of years. If you do end up in USA there are of course various other factors to consider but the above written steps would be the most essential ones that would be enough for a happy transition.




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