‘Coming out’ as a transsexual person connotes a cycle or pattern of acknowledgement that one’s gender identity does not match one’s birth assigned sex. That cycle may begin, for example, with acknowledgement to one’s self and move toward public acknowledgement. However, for many people, this process is not linear. It does not start with denial and end with acknowledgement. It may be a non-linear process where the individual struggles with denial and acknowledgement over a period of time until coming to terms with the true gender self. Many writers, as well as individuals who participated in the consultation, noted that there may be a childhood awareness of being different. This awareness may lead them into the ‘closet’, seeking to ‘pass’ through modelling behaviours that are consistent with their birth-assigned sex.
‘Coming out’ may involve behaviours ranging from occasional ‘presenting’ in one’s felt gender identity to full transition to daily life in that gender. The latter may occur with or without sex reassignment surgery. For those who do not undergo sex reassignment surgery, but who nonetheless identify as the other gender, the transition may still be complete with respect to the manner in which the individual conducts his or her daily life.
‘Coming out’ involves a lengthy process of self-discovery and requires patience and focus. This contrary to the notion of opponents of transgendered people, one often reflected in the media, that being transgendered is a whim, that it arises out of mental imbalance or that it is simply a matter of choice or preference. Although the process of self-realisation and acknowledgement as a transgendered person can be difficult, acceptance of one’s identity and then disclosure to others allows greater congruence with one’s self and with society. ‘Coming out’ breaks not only internalised silence about the true nature one’s self, but also the societal silence about the diversity of gender identity.
‘Coming out’ can also trigger discrimination and mistreatment, factors that point to the need to educate, for example, those who provide housing, service providers, those in the helping professions, members of the public service, employers and co-workers. For these reasons, public education about gender identity is crucial to both transgendered and non-transgendered people.
At different stages of ‘coming out’, there are risks such as increased harassment and negative treatment upon disclosure. For a transsexual who proceeds with surgery, it is inevitable that, at some point, they publicly come out and seek access to public services and facilities. Family, friends, employers and co-workers, caregivers, doctors, as well as members of one's spiritual community may witness and respond to this transition. At this stage, invisibility or non-disclosure is not usually a viable option.
 See J. Evelyn, Mom, I need to be a girl, (California: Walter Trook Publishing, 1998) which outlines the true story of a young male to female transsexual. See also L. Masters (Blake), Transgender Identity, A TransEqual Document: The application of new information about the origins of human gender identity, to transsexuals and transgenderists, (Ontario: TransEqual, 1993); G. Ramsey, Transsexuals: Candid Answers to Private Questions (California: The Crossing Press, Freedom 1996); Brown, M.L. and Rounsley, C. A., True Selves Understanding Transsexualism: For Families, Friends, Co workers, and Helping Professionals, (San Francisco: Jossey Bass, 1996); J.J. Allen, Inside the world of Cross dressing: The Man in the Red Velvet Dress (New York: Birch Lane Press Book, 1996).
 See P. Califia, Sex Changes: The Politics of Transgenderism (San Francisco: Cleis Press, 1997); see also K. Bornstein, Gender Outlaw, On Men, Women and The Rest of Us (New York: Routledge, 1994); see also M. Rothblatt, The Apartheid of Sex: A Manifesto on the Freedom of Gender. (New York: Crown Publishers, 1995).