Should someone be allowed SRS who is not planning to present as a female?

[androgynouspainter26]

While I totally think that people should have a commitment before heading into surgery, it'd utterly confounding to require anyone to act a certain way and dress a certain way before they can have a body that feels right. 

[Ltl89]

My thoughts have changed on this.  At first, I would have said srs should only be allowed by those who fit in the "Transexual" group and will live full time.  As I learned about more experiences than my own and saw what others had to deal with, I don't think I have any right to deny or allow treatment for another person.  The same way cis people that judge me want to reduce my access to treatment the same way they have to deal with judgement from their own community.  I don't think that's right.   On the otherhand, I don't think having some safeguards to ensure someone is very serious about the surgery is a bad thing.  Gate keeping doesn't have to always be bad, if it's done in the right way.  It's just not always done the right way as it caters to a narrative that doesn't fit everyone in our community.  That shouldn't be the sole factor for denying treatment if this is what a person truely wants.  Hell, who is to say I man can't have a vagina either?  I know plenty of men that do and they are definetly men.

[peky]

With increasing frequency, we've been seeing forum members speak of a need for gender surgery without socially transitioning. E.g. living post-op as a male with a vagina. They're looking for a way to do this.

The reasoning is usually something like this:
* They have body dysphoria but not social dysphoria.
* Lots of men live perfectly happy lives with vaginas. We have dozens of them posting on our FtM forum.
* Going through an RLE requires needless effort on their part and an uncomfortable year and is not helpful in decided how they want their body shaped.
* The WPATH requirement for RLE is a "guideline" and not a "rule".

Most of the time they are actively discouraged from doing this, often by the site staff. Their reasoning:
* RLE is a good idea because doctors require it.
* This is a huge step, and it's not unreasonable to require a patient to spend a year thinking about it.
* If you're not ready to live as a woman, you're probably not ready for SRS either.

What do you think? Should someone be allowed SRS who is not planning to present as a female?

If deemed mentally sane, then in my opinion yes, they should be allowed to have their vagina...

How about the hormones to be taken? One way of another he/she would have to take either T or E to ward off osteoporosis...

How about breast implants or breast growth if in E ?  Still present as male, maybe wear a binder?

[peky]

I do not think that any psychiatrist will give a letter of recommendation to anybody expressing this kind of wishes...

[Jessica Merriman]

I'm at a bit of a loss for words over this. I'm not sure how to put this, but you appear to be saying that others have to suffer just because you did? What about when people had to do RLE to get hormones - perhaps we should all keep doing that too?

That is not what I am saying!! I am saying if someone wants to do this they should not be given a letter until they complete whatever protocol is developed for this procedure. Just because you are identifying as non binary it should not be a free pass to surgery. I have to prove as everyone else here that I can handle it psychologically and socially. Non binaries should have some form of psychological and social RLE as well to help cut down on incidences of post op regret, that's all!

[androgynouspainter26]

See, this whole argument against letting whomever wants SRS to have it after a period of commitment is based on the asumption that the catigories of male and female are anything more than sexual features.  Having to wear dresses, date men, grow your hair out, and talk in a lilting voice just because you should have been born with a vagina is demeaning to us.  Sure, if that feels right do it-but saying you have to act a certain way to be a woman is mysoganistic.

[Jessica Merriman]

See, this whole argument against letting whomever wants SRS to have it after a period of commitment is based on the asumption that the catigories of male and female are anything more than sexual features.

Not sexual identity categories for crying out loud. Are you people listening at all? What I am saying is OK, but make sure the mental and social skills are there for BOTH identity groups. Post op regret is the only thing I think is important to address before it happens. Jeesh, for the thousandth time I am not against non binaries.

[Jessica Merriman]

 I am for the mental health and social skills of BOTH groups. I do not care if a person wants a carrot for a nose, just examine this person adequately to see if they can handle having a carrot for a nose. I am getting a little sick of this "Jessica is intolerant stuff". I have supported each and every person here from introduction post's to post op post's.

[mrs izzy]

To answer the question.

NO.

My personal opinion.

People are not ready for normal paths to GCS. Not alone fast tracking.

Been holding way to many hands from some who went through the system who are struggling post op.

It's not a game. It's real lives being effected.

No magic wand to make it all better.

Being it seems to be issues of late, just so not to confuse anyone. That is Izzy the forum member talking.

[Heather]

While normally I am all for personal freedoms but in this case I am not for this personal freedom. And I have several reasons why I guess the first would be if you can't commit to living as a woman for just a year. How in the world do you commit yourself to dilation and all the other hassles that come along with SRS?
Second the surgery was meant for people in the more extreme category that couldn't cope at all with life as a male. Now if your perfectly happy living as a male but just want to have a vagina. Something tells me this is something you can work out in therapy just saying.
Third if were just going to let anybody have the surgery and it's totally a choice we automatically no ground to stand on as far as getting insurance to pay the surgery.
And finally this seems like such a bad idea I've already witnessed how disastrous just allowing anyone to be hormones can be. And it's been made far too easy and I've met far too many mentally unstable people on hormones. This is just asking for trouble letting anybody have the surgery.
It's not just as simple as having a surgery oh now I have a vagina! Were talking about your hormones are going haywire because your body no longer produces testosterone. Which brings up another point how does one plan on staying a male when they're body doesn't produce testosterone? What do you do if you have complications and your having trouble finding a doctor who will treat you because they've never dealt with a post op trans woman?
I'm not just saying this stuff just to say it or make a point these were questions I have asked myself many times that lead me to thought out decision as to whether surgery is right for me or not. And also as someone who has taken the time and the effort to jump through the hoops and fully thought out the ramifications of this decision. 

[Missy~rmdlm]

To answer the question.

NO.

My personal opinion.

People are not ready for normal paths to GCS. Not alone fast tracking.

Been holding way to many hands from some who went through the system who are struggling post op.

It's not a game. It's real lives being effected.

No magic wand to make it all better.

Being it seems to be issues of late, just so not to confuse anyone. That is Izzy the forum member talking.

A large portion of people struggling aren't just dealing with dysphoria, but trouble with the social transition side of things. As I have already stated, I personally know a non-transitioning post-op (MtF type SRS just to be clear.) This individual has proceeded just fine with domestic relations and job, kid relations etc. More power to them. I personally deeply wanted the social transition, and the srs is a defining part of the transition package for me. I don't pretend to know how the non transitioning person properly stated their case for SRS, but I do know it was developed over a very long time. The [big name] US surgeon performed the operation right along side more typical cases.

[mrs izzy]

A large portion of people struggling aren't just dealing with dysphoria, but trouble with the social transition side of things. As I have already stated, I personally know a non-transitioning post-op (MtF type SRS just to be clear.) This individual has proceeded just fine with domestic relations and job, kid relations etc. More power to them. I personally deeply wanted the social transition, and the srs is a defining part of the transition package for me. I don't pretend to know how the non transitioning person properly stated their case for SRS, but I do know it was developed over a very long time. The [big name] US surgeon performed the operation right along side more typical cases.

Anyone who knows the system can buy there way to anything.

As I said I do not agree with anyone fast tracking.

[Missy~rmdlm]

Anyone who knows the system can buy there way to anything.

As I said I do not agree with anyone fast tracking.

Nah the individual prepped for over a decade, and in the end their work insurance covered their SRS. I'm not privy to how the insurance claim worked, as I had my work insurance cover my surgery simply through a medically necessary statement from multiple doctors.

[Abby Claire]

No. Some of my reasons have been stated, but I'll say this:

I have heard post-op regret stories. Dressing in public isn't permanent. The effects of HRT can be reversed. SRS is irreversible and permanent.

Now, if you are a man, you recognize as a man, and there is something that is compelling you to remain a man with a vagina, then okay. Maybe you can get the op.

But if you're planning on transitioning, doing HRT and other ops, then it seems like you are putting the cart before the horse. How can you know you're ready to live your life as a woman if you haven't done it yet and you still want to present male? I know some will respond to that question by saying they would know the same way someone starting HRT knows. Again though, HRT does not have to be permanent IF you discover this isn't the path you want to take with your life.

[Sammy]

I dunno if that one was directed towards one of my recent threads or it is just a coincidence or my post had triggered other posts or this is the  "hivemind" effect, but I feel a need to address some of remarks made.
1. Umm, of course not. All those who are different from the rest should be killed with extreme prejudice (preferrably with fire) and their bodies burned afterwards.     Oh, wait...
Stupid kiddin' aside..
Let's try once more.
1. As was noted, every system can be bypassed and circumvented. You just really need some depth of understanding, little lies and (probably) lots of money. Sometimes, lots of money would be enough. So, there have always been and always will be exceptions. Point is? Do not bring up system and guideline requirements, because the cases we are examining now will be outside of their scope of influence.
2. I am totally not a fan of fast tracking... could not be further from true. I was speaking about individuals who are years into this and have reached a stage when for some objective reason (physical, visual whatever, which is not surgically fixable for different reasons - complications, costs, or surgeons simply dont do that kind of thing) are still "not exactly there". I mean, HRT has its limits and while it can be generous at times, it is not the ultimate panacea.
3. I did not really see any of the posters denying that dysphoria for such individuals is still not there. And we all know what it means, it is just it manifests itself differently.
4. That post which I made had one specific difference - I was talking about legal issues, not visual stuff. Namely, having surgery but opting to stay legally male. There is a slight difference but it is quite important.
5. I have issue with the phrasing "not planning to present as a female", because that does not equal "is presenting as a male". Or is it? Ah, I forgot about binary perceptions of this world - "if You are not X then You surely must be "Y".
6. This discussion is mostly directed towards non-binaries who are contemplating SRS (like me, but in my case that decision is still 4-5 years away. So no fast tracking again. Just thinking and playing with options and what I want and dont want to - so please do not instantly rage, ok?) And yeah, MTF binaries usually dont have those thoughs running around in their heads and just follow the rules and protocols.
7. The issue of social life aspects was raised - that is indeed quite an important aspect, but as all others, it can be avoided at a cost, bigger or smaller. Just dont go to that public gym/swimming pool/locker room and do not other things which might feel You uncomfortable... we are all sane and adequate adults here. Or are we not?
8. Also, please do not this as an attempt to undermine the transition issues which are faced by binary folks... It was totally not meant to. I am getting this "them tryin' to steel our precious" vibe (or - "They Took Our Job!") - it is totally not. It is just challenges and issues binaries and non-binaries are facing are a bit different, yet - at the material time - tools and measures to address them are kinda same. It's degree, amount and intensity of their applications, which is different.
What else? Probably there was something left out, but that's it folks for now and thanks for reading .
Sometimes You do act funny, but I still love all of You.

[TeeBoi]

I don't think offering a route to treatment for people outside of the binary should be seen as fast tracking. I, for one, think being made to wait at least a year for surgery is an excellent idea. However, the idea that what you wear and how you act during that year should be proscribed to you, on pain of exclusion from medically necessary treatment, is absolutely barbaric.

[TeeBoi]

Basically, everything that Emily just said

[suzifrommd]

Been holding way to many hands from some who went through the system who are struggling post op.

I'm interested in this. Most of the health professionals that engage in what we call "gatekeeping" cite protecting from potential regret as their motive.

I'm really interested in your opinion. What sort of measures would help prevent the struggles you've seen? How would you recommend the process be changed to bring regrets down to a manageable level?

I'm also interested in a statistical view of this. What is the rate of regrets that you're seeing? Double digit? Single digit? Less than a percent? What would be an acceptable level of regret? I bring this up, because numbers are important, right? There will never be a zero chance of getting into a serious car accident, but we get on the road anyway because we assess the risks and they're acceptable.

[mrs izzy]

I'm interested in this. Most of the health professionals that engage in what we call "gatekeeping" cite protecting from potential regret as their motive.

I'm really interested in your opinion. What sort of measures would help prevent the struggles you've seen? How would you recommend the process be changed to bring regrets down to a manageable level?

I'm also interested in a statistical view of this. What is the rate of regrets that you're seeing? Double digit? Single digit? Less than a percent? What would be an acceptable level of regret? I bring this up, because numbers are important, right? There will never be a zero chance of getting into a serious car accident, but we get on the road anyway because we assess the risks and they're acceptable.

40% in this year's group I know personally,

I feel there is not enough information given to anyone seeking GCS before there surgery to prepare them for after.

The attempts on life are stemming from prolonged aftercare infections or lack of post GP or GYN acceptance of responsibility in providing care.

So to answer your question more education on HRT ( most start truly do not know why)
More education on GCS, how it is done and what is removed and what is used. 90% that I know have not a clue what old structures are used, where they are used.
Way more pre education in After care. Most even with instructions have no idea of the magnitude of possible complications, infections or issues.

So I feel the system is flawed in it is fast tracking to many who are not ready even with what some call gatekeeping.

Aftercare issues in post ops I feel is why there is regrets and deaths.

As a mentor one can only try and pick up the pieces in the end.

In short, get mental help to get letters for surgery then just dumped to handle all that can go wrong in aftercare alone. No real after GCS care SOC.

[Heather]

40% in this year's group I know personally,

I feel there is not enough information given to anyone seeking GCS before there surgery to prepare them for after.

The attempts on life are stemming from prolonged aftercare infections or lack of post GP or GYN acceptance of responsibility in providing care.

So to answer your question more education on HRT ( most start truly do not know why)
More education on GCS, how it is done and what is removed and what is used. 90% that I know have not a clue what old structures are used, where they are used.
Way more pre education in After care. Most even with instructions have no idea of the magnitude of possible complications, infections or issues.

So I feel the system is flawed in it is fast tracking to many who are not ready even with what some call gatekeeping.

Aftercare issues in post ops I feel is why there is regrets and deaths.

As a mentor one can only try and pick up the pieces in the end.

In short, get mental help to get letters for surgery then just dumped to handle all that can go wrong in aftercare alone. No real after GCS care SOC.

I completely agree I know several women in real life that have had the surgery and have had trouble with getting care post-op. I've heard enough to make me give more serious thought about to whether this was a risk I was willing to take. I've concluded it was but I've put a great deal of thought into it. And I honestly can't get why someone would want to jump into this major life altering surgery without even committing fully to transitioning first.