In the state of Missouri where I began my transition to “Mitch,” you have to undergo gender therapy in order to receive a letter of authorization from a therapist stating that you are of sound mind and that you are, in fact, transgender and experiencing gender dysphoria – a disorder that calls for appropriate medical intervention – before you can start hormones. During my time in gender therapy, we discussed some of what to expect once I began transitioning. Most of this was centered around the physical changes — more body hair, a deepening of the voice, changes in fat…