Why surgery is only part of the journey to transition

The Government recently made the bold decision to remove the cap on publicly funded gender reassignment surgery.

But for those who go through such a change, surgery is just one small part of their transition.

"I used to wish and dream that I would wake up a boy," writer Lee Jacobsz told Three's The Project. "Then I stopped dreaming and wishing."

Gender affirmation surgery is not a term we hear every day. It's all about aligning what you look like on the outside with how you feel on the inside.

Mr Jacobsz has fought that battle for most of his life.

"Up until pretty recently, I felt I was in the wrong body."

Born in 1986, Lee started life as Liezle. All along, something didn't feel quite right.

"I didn't fit that mould even though it seemed like it, I looked like it, I didn't feel like it."

His struggle between his mind and his body is known as gender dysphoria, and seven years ago he decided to do something about it.

"I'm comfortable with my body now. But I don't know if I would have gotten to this point if I didn't have the opportunity to transition medically."

Navigating adolescence and making it to adulthood as a trans person was tough, even hostile - and Mr Jacobsz is not alone in that journey.

"When I was young, I knew that I was different," says artist Jaycee Tanuvasa.

"But for so many years I was told 'no, you behave this way, because boys behave this way, women or girls behave this way'."

"There is a lot of trauma that we've experienced growing up because we had to fit into a space that wasn't welcoming to our people," adds social worker Torranice Campel.

That need to fit in can sometimes involve taking a radical step, like Mr Jacobsz did.

"Society is shaped to have these certain ideas and labels and beliefs of what things have to look like, so we try and conform to that," he says. "Sometimes that involves changing your body."

The big problem is that doesn't come cheap. The average cost of male-to-female surgery is between $25,000 and $82,000.  For female-to-male surgery, you'd be forking out much more: up to $500,000, if things were to get complicated.

For years, people have resorted to desperate measures because of the huge costs involved.

"Sometimes trans women or trans men put themselves in unsafe working situations, work in the sex industry (to) obtain the money that they need," says Ms Tanuvasa.

The help the Government announced in October will ease the financial pressure. But for some, that's not the only pressure weighing them down. Even after surgery, solving that conflict between body and mind can still be elusive.

"When I did finally transition medically, I became really macho," says Mr Jacobsz.

"I was trying so hard to be seen by society the way that I had always felt, I was trying to fit a mould. I only expanded my thinking around all of it much later on. After I had already had top surgery, had been on hormones for a long time. Until recently, when I realised I didn't need to have bottom surgery anymore."

"We are so secure of ourselves and so assured, but for a lot of young girls, I can totally understand why the first thing they want to do is to get surgery," says Ms Tanuvasa.

"It comes from the want to fit in, conform or find love."

"I don't think that what makes you a man is what's between your legs," says Mr Jacobsz. "That doesn't make me a man."  

Ms Tanuvasa's advice to young trans women is to try not to feel pressured into surgery.

"They need to take their time and figure out themselves first. But for those that want to feel complete, they now have the opportunity."

Mr Jacobsz is optimistic about the future for the trans community.

"I do think humanity is shifting to be more inclusive in a way, to be more inclusive of all, no matter what - and I think that being generically male and generically female might soon become a thing of the past.

"Maybe not in my lifetime, but I think that it could. Why not?"