Once someone had socially transitioned, it was time to explore medical intervention. This likely entailed hormonal treatment and/or surgery, which for transmasculine people involved an injection of testosterone about every two weeks and removal of breasts and reproductive organs. Genital surgery was very imperfect for FTM surgeries, and many opted to avoid the procedure because of the complications and unrealistic-looking final product.
[1] Louis G. Sullivan, “Information for the Female-to-Male (1980),” leaflet, 1980, Digital Transgender Archive, https://www.digitaltransgenderarchive.net/files/8623hx748.