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I'm still assuming, for the record, that transition is your intended direction. Ideally, you shouldn't go into therapy with this decision already made but we'll continue on those lines anyway. In any case, ETHICAL therapy - which is becoming more rare all the time - requires that you spend at least one year living in your chosen, non-birth gender. This is the Real Life Test. You may have to spend the first six months without any chemical "help" (i.e., no hormones) but you shouldn't feel too bad about this: Female hormones cause breast growth over a period of several years and soften skin (again, over several years), but they offer almost no other benefits. Specifically, hormones will NOT reduce facial or body hair growth, they will NOT change your voice (Male to female) and they will NOT make you look more like a woman (other than the eventual breast growth).
"Passing" really depends on how closely your body falls within the normal size and proportion range for the opposite sex, plus how closely your natural mannerisms conform to what is typical for your chosen gender. For elements like voice and personal conduct, practice is needed - and that is why this time period exists. Any therapist who fails to require an honest full year of RLT (Real Life Test) is unethical. "Honest" in this case means that you must live and work as your chosen gender. If you have to appear in public as your birth gender part of the time, then you are not doing RLT. We feel compelled to mention this because a small group of unscrupulous therapists have allowed some people to continue to work as their birth gender while they dress as the opposite gender at home. The obvious problem with this approach is that it takes "real life" out of the Real Life Test. When you finally make the "change," you will be doing something you never actually experienced before - and everyone will know... everyone. If you can't stand that thought during the period of adjustment known as the Real Life Test, then you are certainly NOT ready for transition, hormones and surgery!
This time period is your opportunity to find out if you can really succeed in your chosen gender. It is called the Real Life Test (RLT) or Real Life Experience (RLE) because - if done right - you learn everything there is to know about life as a transsexual without taking the final irrevocable step of surgery. Real transsexuals welcome the opportunity to live full-time as their chosen gender. They know they will be rejected by many people, but living as their chosen gender is more important than avoiding rejection. Persons who seek to avoid RLT are almost certainly not transsexuals. You see, the goal of transsexuals is always to be accepted and to live as their chosen gender. This is exactly what RLT helps accomplish. If one wishes to avoid living initially in their "chosen" gender but wants surgery or hormones, the person is most likely suffering from something OTHER than Gender Identity Disorder, such as OCD or negative gender stereotyping.
I feel this issue of gender stereotypes is important because I see a horrible epidemic of this in the gender community... Although widespread, the beliefs that "men are pigs" and "only women are truly sensitive and compassionate" have no basis in reality - any more than their opposite stereotypes which claim "Only men are logical and rational" and "women are conniving, scheming gold-diggers." False stereotyping, however, may be a contributing factor to gender dysphoria. I've seen this is some personal acquaintances in the gender community. If you are a victim of such rigid, false stereotyping, then you need to work through that. We'll discuss more about this in the alternative therapy section.
In addition to the above requirements, you should start facial hair removal as soon as you have a reasonable degree of certainty that you will transition. Facial hair is hard to cover with make-up, even with good make-up, and probably gets more people "read" than anything else with the possible exception of voice. The process of hair removal can take years and includes bother laser and electrolysis, so the sooner you start, the better. Even crossdressers can benefit from this process, but - like surgery - it is not reversible, so one should be very sure of what one is doing.