Patients with GID often require ancillary treatments to improve their quality of life and their likelihood of being accepted in the opposite-gender role. Although the latter goal is not universally sought after (Bolin 1998; Rothblatt 1995), the majority of patients desire to “pass” in the aspired-to opposite-gender role and can benefit from an honest appraisal by an objective mental health care provider. Most MTF patients will require electrolysis of the face, neck, and possibly other areas of the body. This has traditionally been one of the more expensive components of complete transition (

Table 70-11).

Some patients seek injections of silicone oils or gels into various parts of their bodies to attempt to mimic the opposite-gender habitus. This is a highly dangerous, if not lethal, approach, as this substance can migrate throughout the lymphatic and venous system and lead to significant deformities (Hage et al. 1999).