Is bottom surgery harder without a letter? (ftm)

[Bosch]

I hear about top surgeons that'll take us with no therapist letter but I don't see much from bottom surgeons?

Also, it seems like there is not as much inovation in this as there should be? I mean, there isn't in top surgery either but our top surgery options work. Whereas both options for bottom surgery are rather lacking atm. I know doing what they do at all takes a ridiculous amount of talent but still... like I'm hearing no news of any possibilities as technology advances. No kind of "we're looking into if this is possible..." or something.

I guess it's lack of demand (vs. the total populous).

I dunno, I"M FRUSTRATED.

[bojangles]

WPATH standards of care are stricter for bottom surgery.
Would imagine surgeons are following those standards. It usually requires 2 letters & a specific period of real life experience and testosterone.

From my perspective, bottom surgeries are nowhere close to as limiting as the original equipment.
There is also a difference between looking at pictures (many of which are too early to give a good assessment of final results) and seeing boy parts on yourself or in the mirror. Of course, that is not important to everyone. It is important enough to me to learn to adjust to imperfect results.

[Jayr]

I mean, there isn't in top surgery either but our top surgery options work. Whereas both options for bottom surgery are rather lacking atm.

They are lacking and wouldn't work for YOU.
Some guys find them just just fine.

Careful with these threads, they have a tendency to end up being a ''lets insult bottom surgery'' fest.
I've seen AMAZING bottom surgeries. Surgeons are becoming better and better, and more surgeons are getting into it.
I want bottom surgery, and I personally think the results are WAAY better than what I have now. 

[Bosch]

Sucks. I hate therapists and have no interesting in going near one ever again in my life.

As for bottom surgery. Dude. I am asking about getting it without a letter. And bemoaning lack of inovation in the field. I'd think it's safe to assume I'm not all that happy with the equipment I've got either?
Unless you're telling me you'd reject a (let's say cost-free) surgery that'd give you genitals that look and function like cis penis or you think we don't need to improve 'cause we're perfect where we're at with our surery options then my point still stands. We could use some improvments and it'd be nice to see some innovation in the field.

Like I remember hearing something about "advancing the crura" and now... nothing. I don't know if that means "it'd never work" or "surgeons see no reason to try it". Also, if one spent the years to stretch the labia (some can get 7 inches in length) why couldn't that skin be used and thus avoid a secondary scar (since they'd be cutting all that out anyhow)? Or why can't a penis be stretched when people can apparently stretch ears, labia, lips, necks etc. (not really surgery related but I would like to know)?

I just find it irritating and I'd like to have an honest conversation about where we're at and where we could be going. Actually, I'd really like to have the conversation with someone knowleagable enough to answer some questions but I have no idea who to direct the questions to and atm I'm just venting some frustrations at how stagnant everything appears (love to be proven wrong there though). I would think that's fair. Or should I not be frustrated?