Trans Women’s Most Common Questions, Answered by Dr. Z

Dr. Z addresses three questions she gets asked repeatedly through emails, Instagram DMs, and consultations—questions that often keep trans adults stuck from moving forward.

The three questions:

Am I too old to transition? Many people believe they've missed their window due to age, health concerns, or believing passing is impossible. But gender transition encompasses far more than medical interventions.

Can I identify as a woman without hormones or surgery? This question stems from harmful medicalization spreading online—the narrative that you're "not really trans" unless you pursue medical and surgical interventions.

Can I start hormones without socially presenting as a woman? Many older adults wonder if they can access hormonal treatment for psychological well-being and internal alignment without stepping into full social transition.

These questions reveal common misconceptions about what defines trans identity, what transition requires, and who has access to gender-affirming care. Dr. Z provides clarity on each, drawing from 20 years of specializing exclusively in gender dysphoria and working with thousands of trans adults.