also, another thing to note:
One of the reasons why you need a letter for an orchi is because of the doctors' ethic system here and the fact that many people are sue happy.
A doctor will not remove testicles just because someone says so. It goes against the Doctors' creed of healing people. In a situation where a person walks into a hospital and say "I want my testicles removed" no doctor will be happy to oblige to your request. That would be like someone walking into a hospital and saying "I want you to remove my foot."
It requires documentation from a certified specialist to show the doctor that it is beneficial to have the testicles removed or the foot removed. For example, if the person has diabetes and their care provider writes the referral letter that the patient must have their foot removed this is an example of the situation being beneficial. Same goes for having your testicles removed. These referrals are written to prove there is a benefit to the surgery and it covers the doctor performing the surgery.
You mention the US has some pretty bad healthcare practices. I agree. However, this is one of those practices that I disagree 100% with you on.
My mother is a doctor and she pays out 250,000 a year. Yes, that's right. A quarter of a million dollars of her paycheck a year to cover her malpractice insurance. In 1984, when she started, she paid out 8,000. She's never lost a settlement....the 250,000 are normal for cardiologists with a clean record. Gynecologist/Obs pays out 750,000 a year. That's how many people and scum lawyers there are in this country who will sue for anything.
So when that doctor gets a letter she or he knows her arse is covered....for the most part. You can't come back and freak out stating this doctor cut your testicles off and now you can never have children again...because you gave him the letter from your therapist stating you know the consequences of your actions.
The Mexican doctors could care less about lawsuits. You can't sue them if you wanted too. I've seen some pretty craptacular work by Doctors who service transgender people because the transgender person was too impatient to take their time and do it right.
It's the second biggest reason why I get suicide calls. The first is being their families has disowned them. The second being, they rushed into their transition and now they are full of regret. And you are exhibiting every single carbon copy excuses those trans had before who now calls me freaking out. They too said they thought they were ready, the didn't need "the system", they knew what they wanted and they knew the consequences....now they wish to God they were more sensible.
