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Indeed, the physical results of FTM HRT are visible but may differ depending on an individual. It is possible also to identify some physical changes such as a deepening voice, facial and body hair growths, and redistribution of the fatty mass. It is best to consult with a gender-affirming healthcare provider who specializes in trans healthcare

It's wonderful to hear you're considering surgery to align your physical body with your identity. At 52, many individuals successfully undergo this life-affirming procedure. Costs can vary significantly based on the surgeon, facility, and specific needs, typically ranging from $20,000 to $30,000 in the U.S. I strongly recommend consulting a qualified plastic surgeon who specializes in gender-affirming surgeries. They can help you understand the entire process, including potential risks and recovery. 

Transgender women who have had hormonal treatment and/or surgery may notice a drop in sperm count and fertility as a side effect of the process. But this scenario, when became the case, is an exception. Effective relationships between transgender women who wish to have a baby and a reproductive endocrinologist or fertility specialist are of utmost importance as they will provide them with advice and the needed support.

Yes, transgender women can have sex. Transgender women have the same sexual organs as cisgender women and can engage in sexual activities just like them. It's important for transgender women to practice safe sex and protect themselves from sexually transmitted infections.