Best surgeons for SRS w/o WPATH

[Heather]

There is so sound reasoning behind transitioning first and not last, its partially to "test you" and partially to get you and your body ready for the landslide of emotions you will get from the hormonal shift. sidestepping the requirements IMO would be a bad choice.

I completely agree with this I don't think anyone you start with the surgery first then transition. Transitioning is all about finding out who you are as a woman the surgery is just the final step on this journey. And also what happens to someone who say has the surgery first and then realizes that being woman isn't for them. At least with hormones you can stop if you don't like the emotional shift and go at least someway back to normal. But when you have the surgery there is no going back. The system may not be perfect but its there to minimize the chances of someone ruining their life for good.

[noeleena]

Hi,

Because im a bit different & live in N Z i did not do any of the details or jump through any hoops by passed the WPATH  & the other detail that came from the APA . i never did liveing as a woman for a time . = two years or what ever, never dressed as a woman ether,. i did take two years of   learning what would suit  myself as in clothes makeup , & that was it & only in the evenings with Jos, You see clothes dont make or change who i am,

I told Jos i am a woman. then told our G P who knew both Jos & i for a few years, i then went to our Psych talked with him for 3 / 4 of an hour & told him im a woman & I will live as one he signed me off & said i dont   need to see you again , then went to our Endo  was  on hormones with in 3 months at my request    had surgery with in 3 years again at my request .

In Phuket Thailand by Dr Sanguan , you can check my comment at,    Phuket Plastic Surgery ,    in the Testimonials

I still did not dress in my womens clothes & why should i ,  does wearing womens clothes make you a woman no you grow as one.

I was born intersexed, so did not need to do as most trans people do,   though i did not tell or say i was intersexed, as there was no need & it would have created more issues i did not need to have to contend with certinly not then.

I dont agree with most of the details that trans go through because most of it is out of date passed its use by date, & does not help a person who is very different from being a male as in trans , the reason being it may apply to some & yes will help them ,This is  where i wont agree is some of us are infact female & dont need to go through a systm thats based on money & that is what drives what the APA & other WPATH say , ,

I paid for my detail & surgerys, & im not a kid who needs to be told what i am i dont need to pass a test & what for, at a cost of some $ 1,000 or talking about what i need . sorry im the one telling my story ill be the one to decide whats best for myself .

& the other reason being is we are not all the same we dont all need to follow a one size fits all it did not work before or will it work now, or latter, no matter whats said & done,

Now those who need help ill say go for it im not opposed to those  who do. its about what works for some of us may not work for others,

Now i do know some who went through all the detail hormones surgerys talking sorting out who they were / are, & because they never were female or women have gone back to liveing as they  were,  why there are a few reasons though the one i hear is it was a fantisy ......ether your born female  like i am or you wont to be like a woman.

Now had i not been female would i have paid at   my expence for surgerys i dought very much that i would have wonted to.

The cost is more than just surgerys its marrage  family & a lot more involved , so no it was done to keep myself alive & have a life,    that would not have happened had i been a male. i never wonted to be female it was how i was born yet there are a few details that are similar to trans people, just not in all details,

So some of us are different & we all dont fully understand others in thier life, & what they need to do. & because we are different cant we have a say in whats best for us, with out others telling us whats best for us, or interfering . its our life when all said & done not thiers  its  the one who needs the help when they ask for it.

...noeleena...

[Sammy]

EU nations use their standards of care, usually requiring up to 2 years before getting hormone therapy.

The WPATH SoC is popular for a reason (even if aspects of it are outdated still) because people like to blame others for their bad judgment. There are surgeons who are informed consent but most of them aren't worth the risk. Thailand is probably the best country for access/quality of care.

There are no such thing as EU standards of care, because EU basically has no competence in this area. Each country decides for itself - for example in my country there are absolutely no standards/information as such. Although we (surprisingly) have two facilities, which perform SRS and several FFS manipulations, the rest - such as therapy and HRT is everybody's own responsibility. You wanna therapist? OK, fine, go find someone who is willing to work with You, but keep in mind that Your therapist will probably have no idea about gender issues, so please be ready for hours and hours of reflections into Your past/childhood/family etc.  - did I say that You are going to pay for this and Your insurance wont cover it? Oh, almost forgot, the therapist is not going to prescribe You any hormones, because he cant . Wanna endo? Go find Yourself one, then try to persuade Your GP to refer You to endo officially so You can try to get some state funding for Your HRT, providing that both - the GP and endo are smart enough not to diagnose You as TS... Wanna SRS? Go see three psychs and get their letters or another option - we can lock You up in closed-type mental hospital for one week so we can examine You and then decide whether You are truly TS or just another schizo... Yeah, and You will have to pay for the SRS and the state is not going to refund You anything, unless the whole matter escalates and we go to the Strasbourg court with this .
So my point is - WPATH or not, be happy that at least You have them and You dont have to pay for everything Yourselves

[Cindy]

After talking to a number of experts in the field of gender medicine there is a sizeable group who prefer the informed consent model rather than WPATH rules. However there are also a large group that prefer the WPATH guidelines.

In talking to these groups it is getting difficult for me not to think that those who want to follow the WPATH guidelines have a vested interest in protecting their careers and a lucrative source of patients.

Interestingly the people who I understand as the leading experts seem to prefer informed consent.

That said I agree with those who argue that surgery prior to HT reassignment may be a recipe for disaster.

Having genital reassignment does not cure problems beyond what is between your legs. Life problems in identification as a trans* person are in my experience far more complex.

Indeed I think many post op woman suffer depression and yet many have successfully transitioned as woman for long periods prior to surgery.

Surgery does not solve the problems of gender identification but it is more the final piece of the puzzle for many of us.

I did read that there are surgeons in Mexico who will put a hole between your legs for a few thousand and no letters needed. I'm not sure if that is a good price or a good solution.

I would be extremely cautious of any surgeon who will do, or advertise that they will do, an SRS without the letters.

You have one life and one body and to be crippled and maimed by a person with a scalpel will not solve many problems.

This is purely my opinion and I do not mean in anyway to insult or be insensitive to anyone at all.

Cindy

[misschievous]

Www.icath.org

Informed consent transgender care organization in the US.

Hmmm I might have to check this out. I still want to go through therapy, for other reasons, but this will help get the ball rolling.

[DrBobbi]

Here's an IMPORTANT point with respect to post-op depression, it could be simply the need for an adjustment in HRT. Any post-op that's not on HRT, with the correct level of testosterone is asking for severe complications, including depression, or worse. Life-long HRT is mandatory for all post-op trans women. Period. Any doctor that doesn't push for their patient's HRT following SRS is committing malpractice, IMHO.

[misschievous]

DrBobbi and Cindy

    I agree with you both. What I am interested in is starting HRT, since it is such a long process. After I started HRT I could go to the therapist this way I could get other issues taken care of and get working on the SRS letter.

[DrBobbi]

There's nothing wrong with that. In fact, It's a great Idea. Your feminized brain on HRT is amazing, and a good therapist will help you work out what to expect. Like taking a test drive before signing the papers. Otherwise it;s like sitting in the car lot with the engine off. HRT changes everything, and if it's not for you, you can stop. I love my brain on HRT. I feel, for the first time in my life, normal thinking like a woman. Just make sure you don't self medicate. I recommend going to an endo. Good luck!

[muuu]

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[misschievous]

Just make sure you don't self medicate. I recommend going to an endo. Good luck!

Accually I did try to self medicate for about a month. Saw Palmetto, Soy Isoflavon, Phytoestrogen pills, and Wild Yam. I followed doses recommended on the bottles. After I got onto this site and did some more research I realised the damage it could do, so I stopped.  Now I will definately see an Endo and get put onto the proper medications.

[Cindy]

 

I have just removed two posts that are provocative.
Please think before you post and read the rules.

I will impose penalties if there is any continuation.

Cindy

[DrBobbi]

Accually I did try to self medicate for about a month. Saw Palmetto, Soy Isoflavon, Phytoestrogen pills, and Wild Yam. I followed doses recommended on the bottles. After I got onto this site and did some more research I realised the damage it could do, so I stopped.  Now I will definately see an Endo and get put onto the proper medications.

Happy that you decided against the self-medicating. If you can, find someone that uses the estradiol pellet implant. Easy, painless, and with the constant rate flow approximates a more natural delivery of circulating estrogens. Good luck.

BTW, I know the estradiol is working. Since I've had a cell phone I've never gone over 50% of my alloted minutes. On estradiol I'm 3x over and it's only the 18th day :-) lol.

[victoria n]

 There is some concern Wpath Soc promotes gender treatment that is not based on real research.Their guidelines are probably better than nothing though.
You need hrt if you get SRS otherwise you will get post menopause symptoms.  Even post menopausal women have some estrogen produced naturally.
Or take HRT without SRS. 

Why would anyone want to get SRS in the first place. We are born genetic males with a peculiar problem. the feminized brain is just 1 unproven theory.
I don't think SRS  is the best treatment for transgenders. 

SRS can cause post op depression, a long adjustment period that may never end, and the dreaded Post op Regret. also it is much easier to orgasm as a male.   
Or you may do just fine especially if you are outgoing and generally happy.

The problem is all the people encouraging SRS saying how great it is. how it cures everyone's GID, how they are so happy post op,and all the brainwashing 
And if transgenders are unhappy after SRS, suicide is the answer ?That's cold .

IMO the only reason for gender surgery  is for intersexed people who consent to having surgery. Do you think for one minute if they had  normal genitalia they would get MTF SRS?
Thailand needs a therapist Dr's letter, you need blood tests and have to be over 18.they all have to abide by Wpath.

[Sarah Louise]

You are certainly entitled to your own opinion Victoria, but it is exactly that, your opinion.

I know many who are extremely happy they had SRS.  I also know a "few" who had problems afterwards.  It happens.

This does not mean it isn't right for others.

[muuu]

.

[Ltl89]

There is some concern Wpath Soc promotes gender treatment that is not based on real research.Their guidelines are probably better than nothing though.
You need hrt if you get SRS otherwise you will get post menopause symptoms.  Even post menopausal women have some estrogen produced naturally.
Or take HRT without SRS. 

Why would anyone want to get SRS in the first place. We are born genetic males with a peculiar problem. the feminized brain is just 1 unproven theory.
I don't think SRS  is the best treatment for transgenders. 

SRS can cause post op depression, a long adjustment period that may never end, and the dreaded Post op Regret. also it is much easier to orgasm as a male.   
Or you may do just fine especially if you are outgoing and generally happy.

The problem is all the people encouraging SRS saying how great it is. how it cures everyone's GID, how they are so happy post op,and all the brainwashing 
And if transgenders are unhappy after SRS, suicide is the answer ?That's cold .

IMO the only reason for gender surgery  is for intersexed people who consent to having surgery. Do you think for one minute if they had  normal genitalia they would get MTF SRS?
Thailand needs a therapist Dr's letter, you need blood tests and have to be over 18.they all have to abide by Wpath.

I understand that surgery is not for everyone.  It should be avoided for those who don't feel it would benefit them.  Also, if one was to feel uncertain, they should wait and consider whether this would be right for them.  There are plenty of trans individuals who are on the fence or against getting srs for themselves personally.  I respect their feelings.  They shouldn't be prompted to get it done and made to feel like killing themselves.  That's evil in my opinion.

Having said that, there are plenty of people that do desire this procedure.  I don't think it's fair to say that this isn't the proper course for someone else.  I don't like when people tell non-ops that they are going about it the wrong way and vice versa.  It's not right for us to determine what would make another person happy.  I'm in the beginning of my transition, but I can tell you I would be happy with SRS.  I've never liked that area of my body and I long for a sense of normalcy (normalcy for me).  I've gone through surgery in that area before and had to consider the loss of function and/or part of that area.  I can say I have thought deeply about this before and know to a degree how I'd feel.  Other pre-ops can tell you the same.  Just as well as the many happy post-ops

No one should feel pressured to go one way or another.  Non-op and Post-op are both viable paths.  Do what you want and what will make you happy.

[Jamie D]

I would ask the membership to remember that this is a support site, for all of us in the transgender and transsexual community.

The question of whether to have a gender confirming surgery is highly personal, and even if desired, may be out of reach of some of our members.

There is no doubt that SRS/GRS/GCA is an arduous process, fraught with the potential for complications.  That is why therapy and counseling is highly recommended, prior to making decisions of this magnitude.

[misschievous]

I understand that surgery is not for everyone.  It should be avoided for those who don't feel it would benefit them.  Also, if one was to feel uncertain, they should wait and consider whether this would be right for them.  There are plenty of trans individuals who are on the fence or against getting srs for themselves personally.  I respect their feelings.  They shouldn't be prompted to get it done and made to feel like killing themselves.  That's evil in my opinion.

Having said that, there are plenty of people that do desire this procedure.  I don't think it's fair to say that this isn't the proper course for someone else.  I don't like when people tell non-ops that they are going about it the wrong way and vice versa.  It's not right for us to determine what would make another person happy.  I'm in the beginning of my transition, but I can tell you I would be happy with SRS.  I've never liked that area of my body and I long for a sense of normalcy (normalcy for me).  I've gone through surgery in that area before and had to consider the loss of function and/or part of that area.  I can say I have thought deeply about this before and know to a degree how I'd feel.  Other pre-ops can tell you the same.  Just as well as the many happy post-ops

No one should feel pressured to go one way or another.  Non-op and Post-op are both viable paths.  Do what you want and what will make you happy.

You go girl, tell it how it is.

[RosieD]

WPATH is based on 60 year old guidelines. Many believe the "real-life" experience requirement was an exercise in sadism. THat what was really being tested was a trans person's capacity for humiliation. Therapy is there to help those of us deal with the truth, family, friends, and what to expert through the transition process. Therapist should not be the HRT gatekeepers. In the EU it;s the right of every trans person to transition.

And I was one of the many who thought exactly that until about 6 weeks in to the 3 months RLE that Cymru requires. For me, truth be told, I can see the advantages of the way that it has forced me to both face up to a number of problems that may not go away and to understand some of the issues I will have to deal with if they do. The former major one for me has been coping with being mis-gendered with grace and not letting it spoil the rest of my day. For the latter it is the opposite side of the passing coin where you feel threatened because you have passed as female.

I am not sure that I can say that this is a superior care plan to any other, but I have begun to realise that there is some sense to doing things this way.

Rosie.

[misschievous]

Happy that you decided against the self-medicating. If you can, find someone that uses the estradiol pellet implant. Easy, painless, and with the constant rate flow approximates a more natural delivery of circulating estrogens. Good luck.

BTW, I know the estradiol is working. Since I've had a cell phone I've never gone over 50% of my alloted minutes. On estradiol I'm 3x over and it's only the 18th day :-) lol.

Ok so what is a pellet implant? Is it an injection?