How long does it usually take to get a therapy letter for surgery?

[KamTheMan]

I should have begun this process so much sooner. I will no longer be covered by my parents insurance when I turn 26 this December so I only have until then to get any sort of coverage for top surgery. I want to go to Dr. Medalie and he requires a letter from a therapist. Basically I have five months to find a therapist, get a letter, submit everything to the insurance company, and get scheduled for surgery. I'm just trying to figure out if I'll seem like I'm rushing when I approach a therapist and if I even have enough time for everything.

[SX0877]

I started by telling my therapist i did not need therapy, just the letter for surgery and got it soon. When my second therapist met me when my primary therapist was on vacation, she just said "son you need to get the surgery today" after talked to me for 30 min.
i went to medalie too.

[Alexthecat]

$280 and a month you can have a letter. http://gendertherapist.com/

[JayDawg]

Kam, my therapist said she'd write my T letter on either the first or second visit, I forget which. My first visit was a "getting to know you" and history stuff, 2nd visit was more focused on my gender dysphoria. Anyway, they should know pretty quickly and be willing to write your letter.

Edit: You were talking about surgery and I had T on the brain, sorry. But she said she would write both letters if needed by my 2nd hour with her. You have time

[aross1015]

Pretty sure it varies by therapist.

[Kreuzfidel]

Yes, it varies by therapist and where in the world you live.  Some are hard asses and want you to wait for months and some will give it to you the second or third visit.

[KamTheMan]

Thanks for the replies! Hmm, so should I call or email and just ask flat out? Let them know I'm on T and looking to get verification from a therapist for surgery and am on a deadline?

[Asher123]

I should have begun this process so much sooner. I will no longer be covered by my parents insurance when I turn 26 this December so I only have until then to get any sort of coverage for top surgery. I want to go to Dr. Medalie and he requires a letter from a therapist. Basically I have five months to find a therapist, get a letter, submit everything to the insurance company, and get scheduled for surgery. I'm just trying to figure out if I'll seem like I'm rushing when I approach a therapist and if I even have enough time for everything.

You'll really have to hurry to get that letter. I'm going to Medalie and it took about 6 or 7 weeks to get an approval from my insurance after I had all my stuff together (therapist letter, consultation fee, etc.). Now he's booked up until at least October.

[KamTheMan]

You'll really have to hurry to get that letter. I'm going to Medalie and it took about 6 or 7 weeks to get an approval from my insurance after I had all my stuff together (therapist letter, consultation fee, etc.). Now he's booked up until at least October.

Did you just book an appointment? I'm wondering if I can get the letter by the end of August and get insurance approval by the end of October then will I be able to book the surgery before 2015 hits.

[Bimmer Guy]

$280 and a month you can have a letter. http://gendertherapist.com/

Kam, if it were me, I would just do what Alex did.  You aren't say you want therapy, just a letter.  Also, Medalie may not need to see a letter before he is willing to schedule.  Garramone didn't, he just expected it to be sent in prior to surgery.  The question though is if Medalie wants proof that insurance will pay before he will schedule.  I would just say to the office in a CONFIDENT manner that you will pay if insurance doesn't.  Maybe then they would be more confident in scheduling you prior to proof from insurance.  Good luck.

[Alexthecat]

Kam, if it were me, I would just do what Alex did.  You aren't say you want therapy, just a letter.  Also, Medalie may not need to see a letter before he is willing to schedule.  Garramone didn't, he just expected it to be sent in prior to surgery.  The question though is if Medalie wants proof that insurance will pay before he will schedule.  I would just say to the office in a CONFIDENT manner that you will pay if insurance doesn't.  Maybe then they would be more confident in scheduling you prior to proof from insurance.  Good luck.

Medalie wants the letter before he even looks at your chest. You have to send him pictures. You can schedule before insurance gets back to the surgeon if you plan to go ahead with the surgery no matter what insurance says. That's how it went for me.

[KamTheMan]

$280 and a month you can have a letter. http://gendertherapist.com/

Did you go through this site?

[Alexthecat]

Did you go through this site?

Yes I did. It is a very well written letter too. Medalie was the one that actually gave me his info.

[KamTheMan]

Yes I did. It is a very well written letter too. Medalie was the one that actually gave me his info.

Okay awesome I'm going to check it out. Thank you!!

[Alexthecat]

Okay awesome I'm going to check it out. Thank you!!

Here's what he originally sent me when I inquired him.

Dear Alex

I thank you for your recent enquiry and interest in my long established counseling and gender service. I would be pleased to assist and provide assistance of your gender issues.  As an on-going part of that process, I would also be happy if required by endocrinologist or surgeon to provide a letter to confirm gender status and if required affirm that you meet the criteria top surgery in no more than 6/8 weekly sessions,  the sessions are normally carried out weekly.

I use both chat (typing) and the occasional video sessions; I now take pleasure in enclosing details of what I offer. If following reading you feel you could benefit from this service, would like me to answer questions, or simply make an appointment - please do not hesitate in contacting me through-etherapy@gmail.com. I am also attaching a BIO form which I would ask you to fill in and return preferably before the initial session.

The Bio form helps me identify the best way to assist you and provides some basic information which can be used in the letter I write for you. I do appreciate that filling in a form for some can be a daunting task. If this is the case just fill in the basics or as much as you can and return it online. I will ask questions in relation to any further information I will need during out sessions. Try not to leave relevant sections blank.

I am currently located in the UK, To commence sessions - at the time of returning the enclosed BIO, form kindly suggest a day and time which you can be available for our weekly sessions.  Following that kindly send appropriate fee, block or agreed discounted package fee through PayPal (drglpeveller@gmail.com) Western Union or HSBC Bank transfer. We shall then decide and agree a mutually agreeable appointment so we can commence our weekly gender sessions asap - it is that  simple.

My professional fees are no more than ($50 US for a single session) which can be discounted to 35 US. for Students and low wage earners). For discounted sessions, letter fees and complete packages - see below.

The objective of my service is as well as accepting all clients, irrespective of whether they are male or female, is to provide a respectful, supportive and beneficial online experience for all. One that provides relevant and correct information which enables clients to reinforce and further develop their sense of self worth and an inner strength to develop a tolerance of their dysphoria which has normally been felt over many years.

Further to provide a letter of recommendation to alleviate the dysphoria over time by way of hormones and surgery. I will do all I can to enable and guide clients throughout their journey with advice and support.   My service is tailored to meet the needs of each client and to provide flexibility in such a way that fits their unique personal situation, social circumstance and gender needs.

I personally have never viewed Tran's persons as suffering mental illness. Current research clearly shows it to be a birth defect caused by a hormone imbalance occurring at the cell differentiation stage of brain development.  Not unlike inter sexuality, which is caused by a hormone imbalance at the cell differentiation stage of internal/external sex organ development.

To commence this service as soon quickly simply fill in the enclosed BIO form and return. Send a suggested day and time for our weekly sessions (in-line with time zone differences I am located in the UK), pay the fee through PayPal (drglpeveller@gmail.comthen commence your sessions - it is as really as simple as that –

Use the following chat link: http://messenger.providesupport.com/messenger/gender.html

My sessions for all transgender clients are tailored and respectful, I work with both trans-men or trans-women clients and all who identify as diverse, transsexual intersex or ->-bleeped-<- 'cross dressers'.

Following appointment and receipt of your completed BIO form (see attached) I commence our absolute maximum 12 regular weekly sessions or less by gaining background history together with 'your personal story' and account of your feelings and experiences to date.

Following the above I  then write the letter of recommendation for that long awaited visit to an endocrinologist, competent surgeon or other gender health professional.

I also write letters for court in regards to legal matters (Note: name and gender prefix change procedures vary between States). Together with letters of recommendation for those who require a brief and appropriate assessment or other surgeries such as breast augmentation, top surgery, penectomy or orchiectomy(castration).

My letters of recommendation are acceptable in the USA, Canada S. America, UK Europe, Thailand and other countries worldwide by gender surgeons, endocrinologist, urologists and other medical professionals.

ONLINE SESSION

It is my opinion that online counseling is very much the future, a progressive and relatively new approach, that has gained acceptance and recognition by the medical profession and organizations such as WPATH and the American Counseling Association and other professional organizations. It is easily accessible from home, office or a local library. Online counseling provides confidentiality and convenience it is particularly useful for those who suffer a disability, live in isolated areas, for those whose work requires irregular hours and frequent travel, or clients who are shy, embarrassed, or concerned about the stigma that can, at times, be associated with direct face to face gender counseling/therapy.

QUALIFICATIONS

I have been specializing in gender related issues over the past fifteen years, both in a SRS clinical setting and online. I am English and am fully qualified having over 45 years experience of working with people from all walks of life. I have now over many years specialized and studied the complexities of Transsexuality. I hold a doctorate degree PhD in Human Development with a special interest of Gender related issues, in particular, transsexuality and its related problems. A Masters degree in Humanities, also a Social Sciences qualification, linked with a UK social work qualification Certificate of Qualification in Social Work (CQSW) Diploma in Social Work (Diploma in Social Work covering generic Social work issues, Social Sciences, Mental Health, Law, Sociology, Psychology, Psychotherapy and counseling.

I have in the past undertaken further training in mental health, child care and have child protection experience, together with psychotherapy and counseling training and relevant qualifications with further and relevant social work career interests. My qualifications have been gained over a 45 year period as a Child care worker, Head of both an Assessment and Children's Remand Center, Counselor, psychotherapist a fully qualified UK Generic Social Worker, Child Protection Team Manager a trained and qualified Mental Health approved Social Worker appointed and acting under the UK Mental Health Act. A mental health specialist charged with the responsibility of carrying out community mental health assessments.

I have further gained both clinical and online experience of gender issues all as a result of being involved with the setting up development and overall management of a Gender Clinic in Asia, I have 5 years experience within a clinical setting and 10 years of online assisting a worldwide client base.

I am registered in the UK and a full professional member of The World Professional Association for Transgender Health (WPATH)), formerly The Harry Benjamin International Gender Dysphoria Association (HBIGDA). The Psychological Association of the Philippines (PAP), The American Counseling Association (ACA) , The association for Lesbian Gay Bisexual and Transgender Issues in Counseling (ALGBTIC), 'The Online Therapy Institute' and am further registered under various other counseling and transgender organizations in the UK and Worldwide.

FEES

My professional fees are no more than $50 US per single counseling session. The counseling sessions are discounted to $45  if purchased in blocks of two/four sessions, plus there is a $100 US charge for a letter of recommendation, name change, confirmation of gender status or letter for any other purpose. I also consider further discounts to $40US or $35US for students or clients with financial difficulties. My sessions are carried out over 8/10 weekly sessions. 

You may also be interested in my discounted packages below. Further discounts can be discussed and agreed for students and low wage earners.

NOTE:

Specially discounted all inclusive packages are available for Hormones $420 US.  Vaginoplasty/Phalloplasty $420 US and Top surgery $280 US.   All discounted offers are inclusive of sessions and letter.

NOTE: Your chosen session fees are paid in advance through PayPal (drglpeveller@gmail.com) or Western Union details - Graham Peveller Erith Kent England. After sending please provide Western Union - MTCN (10 digit number) - Full name of sender - Where sent from and Amount sent. For all matters relating to my professional fee please contact me further at - etherapy@gmail.com

LETTERS OF RECOMMENDATION

Although in producing the letter of affirmation of gender status and counseling requirement it is my intention to follow the new WPATH Standards of Care guidelines, due the recent changes of opinion arising out of recent and past research, therefore all counseling programs and requirements are tailored to meet individual needs. Note: I personally work from an opinion and understanding of transsexuality developed and gained over many years, which does not consider a 'gender identity condition to be a mental illness, or, wholly sexual in nature although I do concur mental health issues such as anxiety and depression can out of the gender dysphoria arising to varying degrees throughout the life of a transsexual.

I reiterate, as mentioned all of my letters have been accepted by surgeons in the Thailand and the US over the past 12 years and where normally two are required and (Thailand only requires my letter, plus a psychiatric interview following arrival). For the purpose of the US second letter I have a fully qualified and registered colleague in the US (N. Carolina who also works online and would be more than happy to endorse my letters by providing the second one. This would normally follow three minimal brief and inexpensive sessions. In Thailand where only one letter is at times required my letters are accepted by all surgeons including Dr. Preecha, Dr. Saran, Dr.Chettawut, Yahnee Hospital, Dr. Suporn and others. Finally my letter is accepted by 99% of endocrinologists in the US. The second SRS letter required can also be used in Canada and others. This excludes female to male top surgery for which hormones are not required to have been taken prior to top surgery.

TIME-ZONE DIFFERENCES (WORLD TIME ZONES)

Note: In the UK we are currently 5 hours ahead of EST USA; sessions may be arranged by appointment. When replying - please mention when you are available during UK day light hours.

ARRANGING APPOINTMENTS

For an appointment email me at etherapy@gmail.com or come online through my chat box on http://www.gendertherapist.com-when doing so please be patient whilst waiting for an answer.

For our online sessions - 'cut and paste' the following to your browser - Go to: http://messenger.providesupport.com/messenger/gender.html

CONFIDENTIALITY

As with any other form of Counseling/Therapy as a professional counselor and online therapist, I am committed and duly bound by a strictly enforced and adhered to Professional code of ethics'. Finally, I thank you for your valuable enquiry and hope that the above is of interest and what you require. I look forward to hearing from you and hopefully working together soon. If you would like to proceed with this service do not forget to complete the attached BIO form and return before the initial session, it will help me decide how best to assist you.

Dr Graham L Peveller PhD
Counseling Psychologist
Gender Specialist

http://www.gendertherapist.com

Phone:+44 (0) 1322 44 6968

email: etherapy@gmail.com

LINKS FOR OUR SESSIONS: http://messenger.providesupport.com/messenger/gender.html(direct link to chat box

https://chat3.mioot.com/miootdev/webclient/CheckNickNameC.aspx?visitorID=41264&sessionID=48936&skillID=1&Called=V&pCode=895&Who=A4629&prechat=yes&preview=no&t=1339568799327&rurl=&url=http://www.gendertherapist.com/