delete

[chipper]

delete this bs

[aleon515]

You don't necessarily always need a letter from a mental health worker of some kind. Some doctors who require a letter, they don't really know you. THey want someone to vouch for you. The case with Dr G. I could have had my PA write it. I thought my counselor is more used to those sorts of letters.

--Jay

[Sebryn]

I've been lurking for a while now on this site but I figured I'd make an account to let you know that the surgeon I'm getting top surgery with next week does not require any letters and performs top surgery on an informed consent basis. Dr. Gary Lawton in San Antonio, TX. Good luck in your search.

[Bimmer Guy]

I received this in my consultation packet from Bartlett's office. It's clear that he requires 2+ letters.


Jay, are you positive Dr.G just requires a letter that isn't specifically from a mental health professional? Thanks for the lead, I'll call his office to clarify... if a letter from my PCP is suffice at Dr. G's office, that would be awesome! I don't mind traveling... I just seriously don't want to go through the whole mental health clearance route again, I've already wasted enough money on the therapist that wrote my T letter.

I believe that Jay is incorrect here (sorry Jay).  I am pretty confident he requires one letter from a mental health professional.  He used to require a very long winded letter one from a therapist.  Now it is a simple check off box.

[aleon515]

I believe that Jay is incorrect here (sorry Jay).  I am pretty confident he requires one letter from a mental health professional.  He used to require a very long winded letter one from a therapist.  Now it is a simple check off box.

This is Re: Dr Garramone. Sometimes clones disagree. Brett, I'm always right, unless I am wrong. YOu should know better than that. LOL

In this case this is what the webpage says:
We will need a signed copy of the Letter of Recommendation for Transgender Surgery from your therapist, psychologist, psychiatrist, or Primary Care Physician. The letter must state "Transgender Surgery is the next step in the transition process."
I understand he is sticky only about it saying the line "Transgender Surgery is the next step in the transition process." There is a form and various questions he wants asked. I think the questions are of the CYA nature, so make sure you CHA. He does have a check off box.  LOL.
OTOH, never heard of anyone turned down by a bad letter or something.

--Jay

[Alexthecat]

Dr. Steinwald in Illinois doesn't need a letter. Though I got my letter from Dr. Graham http://www.gendercounselor.com/ for $280 for top surgery. He basically guarantees a letter after a few sessions. Big shots like Medalie accept his letters.

[Bimmer Guy]

This is Re: Dr Garramone. Sometimes clones disagree. Brett, I'm always right, unless I am wrong. YOu should know better than that. LOL

In this case this is what the webpage says:
We will need a signed copy of the Letter of Recommendation for Transgender Surgery from your therapist, psychologist, psychiatrist, or Primary Care Physician. The letter must state "Transgender Surgery is the next step in the transition process."
I understand he is sticky only about it saying the line "Transgender Surgery is the next step in the transition process." There is a form and various questions he wants asked. I think the questions are of the CYA nature, so make sure you CHA. He does have a check off box.  LOL.
OTOH, never heard of anyone turned down by a bad letter or something.

--Jay

Ooops, you're right my friend!  Yes, the statement of "transgender surgery is the next step in the transition process", is what really opens doors for genderqueer/non-male identifying folks to get top surgery (which I believe is the reason Garramone worded it this way).  For some, the "transition process" means nothing more than top surgery (no hormones, no gender marker change, etc).  I think it is great that a respected surgeon (Garramone), is providing this service to the non binary queer community.

[aleon515]

Brett, I love to hear "You're right", so carry on. LOL.
Btw, GID in the one surgeons' letter is kind of outmoded, but I'm sure they'd be okay with the new term which is "gender dysphoria". There are quite a number of surgeons who will do surgery on people (cis or otherwise) with chest dysphoria as well.
I believe most of the docs wanting letters are doing it for CYA.

--Jay

[blink]

I knew this list would still come in handy even after I finally picked a surgeon.

Dr. Steinwald
Chicago, IL

Dr. Gary Lawton
San Antonio, TX

Dr. Mangubat
Bellevue, WA

These are just the ones I found who definitely do informed consent for top surgery. Supposedly if you ask, explain your circumstances, etc. some surgeons will make exceptions to letter requirements. The worst they'll say is "no".

[Arch]

Bartlett really needs to do something about those typos. They don't inspire confidence. He wants TWO letters, but he can't even hire someone to proofread his guidelines?

I have heard that Meltzer does not require letters for top surgery if you have M on your identification documents. Don't know how true or which documents, but I think it's just a driving license. (SS usually requires surgery for a change from F to M.)

[Darrin Scott]

SS usually requires surgery for a change from F to M.)

Not anymore. I think they just changed the law that you don't need surgery to change your gender marker with SS.

[Arch]

Not anymore. I think they just changed the law that you don't need surgery to change your gender marker with SS.

True, they changed it sometime last year. I ought to have said surgery or documentation--you can't just change your gender marker on your say-so. But my point was that I heard about Meltzer's ID requirement a few years ago, back when SS required surgery; therefore, I don't think he would have required his surgical candidates to have changed their sex with the feds, just the state.

[neutrois]

I second Dr Steinwald, he uses straight up Informed Consent, plus has a very good technique.

Dr Crane seems to require one mental health letter, but makes exceptions: "some exceptions are made for patients that transitioned years beforehand and have had legal documents changed reflecting their true gender."
At one point I had emailed Dr Beverly Fischer in Maryland and it seemed they were willing to make an exception as well. Worth emailing and pushing to find out.

I am always an advocate of pressuring surgeons to opt out of this letter requirement, especially if you have evidence of transitioning or intent to transition. In your case, taking T and having a PCP letter is a good case.

[neutrois]

I should've added that Steinwald does not require any letter, or specific gender identification, or mental health clearance whatsoever. On top of that, he will issue you a letter to change your legal documentation to male, for free, with all the necessary legal jargon for your state. (This is sometimes an issue with other surgeons.)

Since it's been a while since I did more research on this, and it's a popular question, I posted it on my tumblr. It should get a few more replies to add to the list.

[FlightyBrood]

Don't know if this guy's been mentioned, but I just got my surgery done with Dr.Horowitz in Huntington Beach, California, and he didn't ask for a letter. He was also way awesome, I can't see my results yet because I'm tightly bandaged, but I have really high hopes.