The Standards of Care advocated by the Harry Benjamin International Gender Dysphoria Association, Inc., include the recommendation that candidates for reassignment surgery dress and live in their chosen gender for a period of time prior to surgical intervention. This recommendation causes some people to feel pressured to begin transitioning right away.

It is our experience that results are better if this step is taken only after careful planning. If you are planning on joining the program and if you are not already presenting in the nonbirth gender on a regular basis, please wait until you have joined and discussed your plans.

Planning is particularly important when it comes to transitioning in the workplace. In addition to helping you plan your transition, the GDPCO can help smooth the way by contacting or meeting representatives of your company (but only if you feel this would be appropriate). Approaching your supervisor appropriately, with respect for his or her position, can win you indispensable support. Leaving your employers out of the loop or putting them on the spot, on the other hand, may lose you a job you needed to keep.

While living in the nonbirth gender consistently is a requirement for those seeking SRS, it is important not to wreck your life in the process. Maturity in coping with the often difficult situations SRS candidates encounter is necessary for a successful transition.

Invariably, those who deal with their gender concerns without completely disrupting other aspects of their lives make the best adjustment, while those who proceed through the transition in an abrupt and radical manner -- breaking sharply with the past -- almost always adjust less well. Individuals who fail to keep goal and process in perspective often find themselves with a recommendation for SRS but without the financial or emotional resources to complete the process.

It is not uncommon for candidates to take time and reexamine their options. We welcome this and encourage people to take time out and reconsider their goals. However, participants who wish to rejoin the program after an absence of one year or more may be asked to fill out the intake questionnaire again and to schedule a meeting to ensure that they have dealt with the issues that caused them to leave the program.

The costs of the initial psychological evaluation, psychological testing, individual therapy, and group therapy are minor compared to the cost of hormone replacement therapy, electrolysis (when needed), and surgery (tens of thousands of dollars). For that reason we strongly urge SRS candidates not to put life on hold until the resolution of their gender issues. It is vital that people complete their education and pursue long-term career plans before or simultaneous with their examination of gender issues.