Surgeons/No Letter

[Jak]

I've had a consult with Dr. McLean in Mississauga, ON and a consult with Dr. Tholen in Golden Valley, MN. I was leaning toward McLean because the exchange rate causes $7910 to become more like $6500 and even with travel expenses it would be less than the $9800 for Tholen. But, I'm not a fan of McLean's preference for straight line incisions, though I do like his no-drain approach. I started to consider Dr. Steinwald, now in Denver, but given that I have little sensation as it is, the inverted-T is no big appeal. Argh! What to do.

So, why am I posting? I'm wondering if there's anyone you'd like to "make the case for" who does NOT require a therapist's letter. I'm willing to travel anywhere in North America. I've seen work that I like, but really don't want to start down the road of therapy, etc. as I have no personal need, save the requisite letter.

Thanks, in advance, for your info re others to consider.

[Ian68]

Having a therapist's letter is required by doctors who operate under the guidelines of the WPATH Standards of Care, which has been developed with health a safety in mind.  Having the letter would also make more doctors available to you as most require one.  Obviously, it is your choice but I do recommend seeing a counselor just because it's good to "check in" before having any sort of life-changing surgery, trans related or not.  Having a counselor also means that you have someone on standby should you experience any post-operative depression (as does happen to some people).

Best of luck regardless.

[AeroZeppelin92]

I'm having my surgery with Dr. Scott Mosser in San Francisco in July. I have never attended therapy (for anything gender related anyways) and simply asked the doctor who prescribed me testosterone to write me a letter of recommendation, which Dr. Mosser accepted. 

[Alexthecat]

You can get a letter no problem in like 3 sessions of telling your life story at http://gendertherapist.com/

[HeyTrace19]

I'm wondering if there's anyone you'd like to "make the case for" who does NOT require a therapist's letter

Just wanted to share with you that I had top surgery with Dr. Tholen about 5 years ago and am very pleased with my results and the level of care and concern I experienced throughout the process.  I think he is a very skilled surgeon. It was expensive, yes, but the very best investment I have ever made.  Good luck to you...

[FTMax]

You can get a letter no problem in like 3 sessions of telling your life story at http://gendertherapist.com/

I can vouch for this. I personally felt like I didn't need therapy, and during our first session, he agreed. I just answered the stuff he needed to put in the letter. It took 2 sessions. Spent our last session just answering questions that I had. He also offered a similar arrangement for my bottom surgery letters in the future. Would highly recommend. It cost me $320, and it enabled me to go to any surgeon I wanted.

[AleksiJason]

There are no top surgeons (at least not in the USA) who will do surgery on you without a mental healthcare professional's letter of recommendation

[AleksiJason]

you can get hormones through informed consent....but any trans surgeon requires at least one letter from a mental health pro.   Some require 2.

[FTMax]

There are no top surgeons (at least not in the USA) who will do surgery on you without a mental healthcare professional's letter of recommendation

That is not true.

[AleksiJason]

That is not true.

Name one.

[FTMax]

Name one.

Dr. Lawton in San Antonio. Dr. Steinwald in Chicago. Dr. Mangubat in Bellevue. Dr. Horowitz in Huntington Beach.

I also know of two local plastic surgeons who were willing to do mine with no letter, which I'd imagine is easily replicated in other large cities. It's becoming more common to not require a letter period or to not require a letter from a mental health professional. If you're planning to use insurance though, you'll likely need a therapist letter to prove the medical necessity of the procedure.

[AeroZeppelin92]

There are no top surgeons (at least not in the USA) who will do surgery on you without a mental healthcare professional's letter of recommendation

like I said, I'm having it done and never saw a therapist in regards to gender.

[AleksiJason]

I'd rather go to a more well known and good surgeon with better results that require a letter than one just because they don't require a letter.  You only have one shot i'd rather not risk not being happy with results.

[Ayden]

 

Let's keep this civil, guys.

The OP asked for recommendations and names of surgeons who would do surgery without therapist letter requirements, not to debate on the validity of surgeons or the path that some take in their transition. Ultimately, it is a personal matter and there isn't one "right way" or one "good surgeon". Just because one doctor has different requirements of their patients than another doesn't make one better, it means they ask for different things.

There are indeed surgeons who will accept a patient without a letter from a mental health professional, and some names have already been given. I myself am not familiar with all of them as I went to Dr. G, but I have heard of Dr. Horowitz and Dr. Lawton and folks seem pretty happy with their results. Have you tried looking at Transbucket to see reviews of all the surgeons you are considering?

[JulianWS]

Just wanted to share with you that I had top surgery with Dr. Tholen about 5 years ago and am very pleased with my results and the level of care and concern I experienced throughout the process.  I think he is a very skilled surgeon. It was expensive, yes, but the very best investment I have ever made.  Good luck to you...

Hey thanks for sharing this.  Tholen is nearby to me, I'll look into him more.  I had just settled on that I needed to save up extra money to travel to medalie or garramone, but maybe not.

[Jak]

HeyTrace19 - Thanks for the "thumbs up" on Tholen. And thanks, Ayden, for chiming in.

Thanks, too, for those who offered 'corrections.' In fact, as has been stated, any number of surgeons do not require a therapist's letter. And, WPATH recommends a letter that it then says should be required prior to physical intervention. These are suggestions, not requirements. It's up to the surgeon. I can understand why some would require it, especially for younger folks.

I find it intriguing that women are not required to have such documentation for a breast reduction, nor a breast enlargement. But, because of the gender identity issue, and - I suspect - fear of a lawsuit, a majority of surgeons require them for FTM surgery. But, I digress. I did visit a therapist, because I thought I would need a letter. It ended up me spending $300 to educate him. No thanks. At 58, I know who I am and what I want. 

Thanks for mention of others' names. I've spent a fair amount of time on transbucket. And, short of researching everyone, just wanted a few others to consider. Thanks, again!

[Jak]

And, for others who might stumble across this thread - Steinwald is now located in Denver, CO.

[Ian68]

Jak - I suspect that part of why a letter is no required for many types of plastic surgery is that it is not considered "sex changing" or even truly "life changing."  Breasts are a (secondary) sex characteristic, and because we live in a society in which only two genders are recognized, and they are most often aligned with a single sex, removing this trait as part of a social gender transition (as opposed to physical necessity) does result in a change in physical sex from female to, effectively, intersex.  I suspect that is why this decision is weighted more heavily than many others.  Undoubtedly, sexism and transphobia color the medical guidelines, but that doesn't negate the real difference between top surgery and cosmetic surgery.

Just wanted to add this since you brought it up.  I agree that each person's case is different, and you should do what's in your best interest.  Best of luck with everything; it seems like you've got several good options.

PS
I have heard that Steinwald does a very good job.  You might consider contacting the gender center in Denver, and asking what his current reputation is.

[Jak]

Thanks for your post, Ian68! Yes, I used to teach gender and sexuality. That's the "problem," LOL! As you note, sexism colors the guidelines. Take care!