Guidelines are

1.Diagnosis by two Psychiatrists

2. Psychological assessments

This initial workup taken as starting point

3 months of counselling

Monthly visit to primary consultation and behavior assessment (recording ) by primary psychiatrist ..

3rd month : hormonal treatment can be started if patient is well

6 month ( from starting point) : counseling sessions

Behavior assessment and recording by psychiatrist .

repeat psychological assessments.

Minor surgeries can be done which include that of breast etc except sexual organ change

12 months from starting point

Minimum 6 counselling sessions for future adjustment, expectations of patients , behavioral assessment and recording

Psychological tests

Hormonal tests

Certificate to go for sex change surgery

All behavior assessment and counselling sessions record should be with certifying psychiatrist

Patient should continue counselling in follow up for 6 months idealy