People may realize that they are transgender at any point in their life. A person can transition and present as more feminine at any point in their life.

A transgender woman who may have transitioned later in life.Share on Pinterest
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A person who is transitioning later in life has access to the same medical and nonmedical gender affirming procedures as people who begin transitioning earlier.

But due to a person’s age, there are several considerations that may influence which course of action a doctor may recommend.

In this article, we will discuss what gender dysphoria is, how to transition medically and nonmedically, what to expect when transitioning, and how to prepare for a doctor’s appointment.

There is currently no age limit on receiving medical help. Healthcare professionals may offer psychotherapy and hormonal and surgical treatments to adults who want to transition.

There are some extra considerations when receiving medical help to transition as an adult.

These include:

  • having access to a care team, including an endocrinologist and mental health services
  • managing expectations of external appearances after transitioning
  • discussing risks and benefits of hormonal and surgical treatments
  • discussing fertility, as hormonal and surgical treatments can cause infertility

There is no age limit on when a person can experience gender dysphoria.

Gender dysphoria is a condition where a person identifies with a different gender than the one a doctor assigned them at birth.

While it is possible for a person to experience gender dysphoria at any stage of their life, a healthcare professional will look at different diagnostic criteria depending on a person’s age.

For a doctor to clinically diagnose an adolescent or adult individual with gender dysphoria, a person must have experienced at least two of the following conditions, for a minimum of 6 months:

  1. A significant difference between a person’s experience or expression of gender and their primary or secondary sex characteristics.
  2. A strong desire to not have those primary or secondary sex characteristics.
  3. A strong desire for primary or secondary sex characteristics of another gender.
  4. A strong desire to be another gender.
  5. A strong desire for others to treat the individual as another gender.
  6. A belief that the individual has the same feelings and reactions as another gender.

As well as experiencing at least two of these conditions, a person must also experience distress or difficulty in social, occupational, or other areas of life as a result of their gender dysphoria.

Nonmedical transitioning, or social transitioning, may involve changing a person’s name or appearance.

It can also involve legally changing their gender.

Changing name socially

A person does not have to change their name legally.

People have the right to ask others to refer to them as their preferred name in education and work settings.

A person can also ask people to refer to them with their self-identified pronouns.

Learn more about gender pronouns here.

Changing name and gender legally

Some people may decide to legally change their name and gender.

Once a person legally changes their name and gender, their IDs and other paperwork will reflect their gender identity.

Some states have different rules and procedures for changing a person’s name and gender on legal documents.

The National Center for Transgender Equality has a free tool on their website that allows a person to find out what rules they must follow to change their state and federal legal documents.

Changing appearance

A person can also nonmedically change their appearance.

This may involve:

  • altering their wardrobe choices
  • wearing makeup
  • altering their hairstyle
  • altering their body shape using prosthetics, such as hip pads or prosthetic breasts

Learn more tips on how to present more feminine without hormones here.

Some people may decide to transition medically.

This involves using medical treatment, such as hormones or gender affirming surgery, to help a person’s body match their gender identity.

Hormone therapy

A person will experience different changes depending on whether they are transitioning using hormones or surgical treatment.

A person can expect the following changes while using estrogen hormone therapy:

  • the skin may become drier and thinner
  • the skin may be more sensitive to pain and temperature
  • development of breast tissue
  • fat distribution around the hips and thighs
  • body and facial hair may decrease
  • experiencing different emotions or feeling
  • a decrease in erections
  • testicles shrink in size

Learn more about how estrogen hormone therapy changes the body here.

Surgical options

According to Planned Parenthood, a person who undergoes surgery may have the following procedures:

  • breast implants
  • orchiectomy, which is the removal of the testicles
  • laser hair removal
  • tracheal shave, a process where the Adam’s apple is made smaller
  • facial feminization surgery
  • penile inversion vaginoplasty, which is the creation of a vagina from the skin of the penis


According to the University of California, people over the age of 50 may have a higher chance of developing blood clots, heart attack, diabetes, and cancer after starting hormone therapy.

Taking estrogen through the skin, such as using a patch, might be safer than other forms of hormone therapy.

A doctor may recommend that transgender women over the age of 50 who still have testicles only use testosterone blockers or use lower doses of estrogen.

If a person has undergone an orchiectomy or vaginoplasty, they can stop taking testosterone blockers. But to reduce the chance of osteoporosis, they should continue taking minimal doses until they reach 50 years of age.

Additionally, surgery carries several risks, such as infections and complications, which surgeons will talk through before a person has any surgery.

It is important to find a doctor who understands and who is empathetic.

Transcaresite has a directory of transgender-friendly medical professionals and medical centers.

It is important to check whether any medical professionals are in a person’s insurance network.


The cost of gender affirming procedures can vary depending on whether a person has health insurance, and whether their health insurance covers these procedures.

While some health insurance companies in America cover the costs of gender affirming surgery, many do not.

The cost of surgery and hormones will depend on which surgery and type of hormones a person opts for.

How to prepare for the doctor’s appointment

It is important to know what questions to ask a doctor when making an appointment to discuss transitioning.

Some questions that people may want to ask include:

  • What medical and nonmedical options are available?
  • How much do procedures cost?
  • What are the waiting times for procedures?
  • Which hospital or medical center performs these procedures?
  • What are the risks and side effects of each procedure?

How to prepare before taking the hormones

While some people may opt to take hormones they source from online without a prescription, healthcare professionals do not recommend this course of action.

Buying and taking hormones without a prescription can carry many risks, including poor quality, improper doses, and possible harm.

It is important that a person and their doctor discuss when it is the right time to take hormones.

Before starting hormone therapy, a doctor will discuss any risks and determine which treatment is suitable after looking at any health conditions.

There are several organizations that can offer advocacy and support throughout all stages of transitioning, including:

In the United Kingdom, Consortium provides a directory of LGBTQIA+ services for those over the age of 50.

A person should contact a doctor if they are experiencing gender dysphoria and would like more information regarding medical and nonmedical options to treat this, such as using hormones to transition.

A doctor can give a person who is transgender further advice on which healthcare professionals and facilities can best help people transition.

Transitioning is possible no matter a person’s age. While there are certain considerations that a doctor may take into account before recommending certain transitioning procedures, there is currently no age limit on when a person can socially and medically transition.

It is important to consider the risks and benefits of certain transitioning procedures, such as hormone therapy and surgical procedures, to make sure that undergoing medical transitioning is the correct course of action for an individual.