First you have to accept who you are which takes a long time as you're probably in denial and terrified of might be. Then you have to talk to a psychiatrist and get a referral to a unit that deals with people with gender identity disorders. The hard part about this is that some flat out tells you they don't want to write a referral as they don't believe a word you say because you don't fit into their own little idea of how a transgendered person is. Some takes a long time to write the referral as they either forget about it, waits because they think you'll reconsider, etc. If you get a referral though you still have to wait til there's a spot open for you at the clinic. After THAT you have to talk to psychiatrists, therapists, social workers, do physical examinations, live as the gender you feel you are fulltime (which can be very hard if you're not completely open about it to friends, family and co-workers and you might not want to be as you've been subjected to disapprovement, dismay and flat out abuse if you're unlucky) and if they deem that you are indeed transgendered you'll get hormone therapy after about 1-2 years of full investigation + discussions about different methods of surgery.

So, long story short... it takes time and it's not easy on the one dealing with these issues. The suicide rate among TS persons under the age of 30 is very high because of the attitude one is met with by the rest of society. :(