Social Transition Only: Valid Path for Trans Adults

You're 55, 60, 65, or older, and you've come out as trans. You're doing social transition—using your correct name and pronouns, changing your presentation, living full-time in your authentic gender. But you're not pursuing hormones or surgery. And the responses you're getting are dismissive: "So you're not really transitioning?" Even within trans communities, there's an unspoken hierarchy that treats medical transition as "real" and social transition only as incomplete.

After 20 years specializing in transgender and nonbinary adults and conducting over 7,200 comprehensive assessments, I need to push back on this narrative. Social transition without medical intervention is not "transition lite." For many trans adults transitioning at 50, 60, 70, or beyond, it's actually the most sensible path. Medical risks genuinely increase with age—estrogen carries elevated risks of blood clots and stroke after 50, testosterone can worsen existing health conditions, and surgery becomes more dangerous with harder recovery. The physical changes from HRT are also more limited when you start older: you're looking at minimal breast development or modest masculinization, often still needing extensive additional interventions like voice training and hair removal to achieve passing. Meanwhile, many trans adults transitioning later have different goals entirely—they want to stop performing their assigned gender and live authentically, not necessarily pass as cisgender.

In this video, I explain the specific medical realities that change the risk-benefit calculation as you age, when social transition makes more sense than medical intervention, what successful social transition looks like in practice with real examples from my practice, the genuine challenges you'll face, and how to think through whether this path is right for your specific circumstances, health, finances, and goals.

Watch this video to understand why social transition without medical intervention is a legitimate, complete path for trans adults over 50—and how to navigate this choice with clarity and confidence rather than shame.