Bruce Jenner, the former US Olympic athlete turned reality TV star, has confirmed that she has transitioned into a woman, making the announcement in an interview with American TV host Diane Sawyer and appearing on the cover of Vanity Fair magazine.
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The pronouncement came after months of speculation in the press that Jenner had already begun the transformation (some reports say as early as in the 1980s) which will be the subject of an eight-part documentary series to begin airing in July 2015.
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The transition from a man to a woman is a complex one, with many diverse parts of the body being affected. Here’s what Bruce likely went through:
Hormone Replacement Therapy
The female sex hormones, the most well-known of which are estrogen and progesterone, affect a wide range of bodily functions and are often the first port-of-call for those undergoing gender reassignment. Individuals usually start with a low dose and gradually increase it in order to minimise the risk of side-effects.
These hormones are responsible for the development of secondary sex characteristics in females; this includes the development of breasts and the widening of the hips. If Jenner opts to undergo sex reassignment surgery to replace her penis with a vagina, hormones will be essential in ensuring the adequate functioning of the female genitals.
In the interview, Jenner revealed that she took hormones for five years in the 1980’s, before deciding not to fully transition.
Certain photographs taken of Jenner taken over the past few months show what appear to be small breasts, suggesting she recommenced hormone therapy some time ago.
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Image: In this June 1, 2015 photo, a journalist looks at Vanity Fair's Twitter site with the Tweet about Caitlyn Jenner, who will be featured on the July cover of the magazine. Caitlyn Jenner, the transgender Olympic champion formerly known as Bruce.
While hormone therapy can promote the formation of breasts, it’s unlikely that Jenner will develop a large or well-defined pair of breasts by this method alone. If this is one of her objectives, then breast augmentation surgery is a very common, relatively straightforward procedure which can give her a pair of breasts of the size and shape she desires.
There have also been reports that Jenner had breast augmentation and that it was filmed for the upcoming documentary series on her transition.
People undergoing gender reassigning often seek a higher, more feminine voice, as opposed to the deeper, more masculine one they already have. This can be achieved by surgery, such as through shortening the vocal cords, however, this approach is often deemed unnecessarily costly and dangerous.
Instead, transgender people often undergo voice therapy to train their voices to naturally be at a higher pitch, according to a paper published in Musicology. Male conversational voices are around 125hz, whereas for women it’s closer to 200hz, highlighting the distance Jenner has to cover for an authentic-sounding female voice.
Voice therapy focuses on all aspects of speech, starting from the basics, such as changing breathing patterns, up to prosody, which is the melodic characteristic of speech. Often when people attempt to adopt a voice other than their natural one they can under or overexaggerate the way they speak, voice therapy seeks to ensure that the changes actually alter the original voice, rather than artificially manipulating it.
A tracheal shave can drastically reduce the size of the Adam’s apple, a prominent male characteristic. This is a straightforward procedure and can even be done using just local anaesthesia.
Pictures of Jenner with a bandaged throat were published by the Daily Mail in January last year, showing that she had already undergone this procedure.
Alongside a tracheal shave, there are a number of common cosmetic procedures that can soften the masculine features of the face, making it seem more feminine. Which procedures Jenner opts for will depend on his particular features and desired look. Jenner has quite a pronounced jaw, so she may choose surgery which will reduce the profile of the jaw and taper the face, this can also include increasing the length and definition of the chin.
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Jenner confirmed to Vanity Fair that she had undergone facial feminisation surgery that involves corrections to the hairline, forehead, jaw and chin. She has also undergone two surgeries to slim down her nose.
Lip augmentation procedures are also used to plump up the lips, giving them a fuller appearance. Collagen injections are relatively simple, but must be readministered at least once a year, which can become costly.
A more effective option is to have a thin layer of synthetic material inserted into the lip. This is a permanent solution, and produces a consistent result, but some who have had it done find the feeling uncomfortable.
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Gender reassignment surgery
In the interview, Bruce Jenner intimated to Sawyer that she still had male genitals, and it remains unclear whether she will seek to turn these into female genitals during the course of her transformation.
These waters are muddied somewhat by the unclear status of Jenner’s sexuality. In the interview she stated “I am, as far as I know, heterosexual. … I’ve never been with a guy” before later saying she’s “asexual…for now.”
Image: Bruce Jenner after winning the men's decathlon in a World Record of 8618 points during the Summer Olympic Games in Montreal, circa July 1976.
The surgery itself is complex, with several different routes available to Jenner. Firstly, her testicles would need to be removed, along with most of the shaft of the penis. The skin of the penis is then inverted into the pelvis, creating a vagina. Other parts of the penis, such as the glans and scrotum are used to create the clitoris and labia.
It’s also important to note that Bruce Jenner, who will now be known as Caitlyn Jenner, is 65 years old, and the dangers of surgery increase exponentially as one reaches old age. Her doctors may advise her that the surgery is too risky.
Options for male to female surgery procedures
Respecting a transgendered person
Transgender hormone therapy generally safe
What is gender identity?
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