For transfeminine people, the process of medical transition also involved hormones and surgery. Hormonal treatment involved an oral antiandrogen to block the effects of masculine hormones and an estrogen to replace those hormones with, which could be via an injection, a patch applied to the skin, or a pill. Then, someone could pursue surgery. Going in this direction when it came to surgery was far easier, as medical procedures going from male to female were given more attention in the medical field. Similarly, it is easier to surgically construct a vagina than it is to construct a penis.

[1] Delia Van Maris, “The Straight Dope on Hormones,” book, 1994, Digital Transgender Archive,  https://www.digitaltransgenderarchive.net/files/m613mx58n.