Is a therapist letter needed for top surgery?

[d0omrider]

I know it is required for hormonal replacement therapy, but how about top surgery? Also, I remember there was a site that showed results from top and bottom surgeries and users could compare and see which doctor they wanted to go to. Does anyone remember what that site is called? Thank you.

[Alexthecat]

It depends if the surgeon requires it or not and hormones don't always need a letter, they can be done via informed consent. I think you mean transbucket.

[Bimmer Guy]

I know it is required for hormonal replacement therapy, but how about top surgery? Also, I remember there was a site that showed results from top and bottom surgeries and users could compare and see which doctor they wanted to go to. Does anyone remember what that site is called? Thank you.

If the surgeon follows WPATH standards, then yes, you need one letter.

WPATH's standards actually says you don't need a letter for hormones.

[Lyndsey]

Hi All

I do not believe that you need a letter for top surgery

Lyndsey

[Arch]

I've been out of the local community for a few years, so everyone I know who has had top surgery had it done by about 2012 or so; but I don't know anyone IRL who DIDN'T need a referral letter for top surgery. Almost everyone in that group did the procedure out of pocket. If you go through insurance, you will surely need a letter.

I have heard that Toby Meltzer doesn't require a letter if you are legally male, but I don't know how accurate this information is. If it's true, there may be other surgeons who have similar policies. But a lot of us don't change our documents until after top surgery, so that kind of policy might not be helpful for you.

I believe that we have an old thread or two on this topic, so you might want to do a search. Apart from that option, I think that your best bet is to start researching surgeons and ask them one at a time. But you have also started your own thread; guys who know of surgeons who don't require a letter are likely to respond here.

[FTMax]

I had a letter, but my surgeon only required a letter from my doctor detailing my transition and that they supported me undergoing top surgery as the next step. I went to Dr. Fischer in Baltimore, MD.

[Bimmer Guy]

I had a letter, but my surgeon only required a letter from my doctor detailing my transition and that they supported me undergoing top surgery as the next step. I went to Dr. Fischer in Baltimore, MD.

FTMax, for the OP's information... are you saying that Fischer will accept a letter from a medical professional other than a "licensed mental health professional"?  For example, a person's primary care physician?

EDIT:  I just looked it up.  Fischer will accept a letter from a gender therapist, psychiatrist, or a primary care physician.

She requests the same language be used as Garramone.  The letter needs to state something along the lines, "Transgender surgery is the next step in the transition process to treat Gender Dysphoria".

[Lyndsey]

Hi All
I do know that if I wanted to have breast enlargement surgery I do not need a letter Here were I live. Earlier I check this out and was going to do it till after being on hormones for a year and a half have gained enough with out going threw all the stress of it. I would say to all the girls let the hormones work for a while before you make this decision. There is a good chance you can save a lot of time, pain and money honey. 

Hug's
Lyndsey

[FTMax]

I had a letter, but my surgeon only required a letter from my doctor detailing my transition and that they supported me undergoing top surgery as the next step. I went to Dr. Fischer in Baltimore, MD.

FTMax, for the OP's information... are you saying that Fischer will accept a letter from a medical professional other than a "licensed mental health professional"?  For example, a person's primary care physician?

EDIT:  I just looked it up.  Fischer will accept a letter from a gender therapist, psychiatrist, or a primary care physician.

She requests the same language be used as Garramone.  The letter needs to state something along the lines, "Transgender surgery is the next step in the transition process to treat Gender Dysphoria".

Yes. I already had a letter from a PhD level mental health professional, but Dr. Fischer would've accepted a letter from my primary care physician. I only found out after the fact.

[Jak]

Not everyone requires a letter. Dr. McLean in Mississauga does not. Dr. Steinwald, in Colorado, says, " I generally do not require a letter from a therapist."

I know that not everyone agrees, but I really appreciated not having to bother with a letter. Nobody would have required a letter had I wanted augmentation or even a "reduction." But, true top surgery/chest masculinization? Oh, my. "Get thee to a therapist." Honestly, when I talked with a therapist about it last year he was so non-plussed I think he would have been puzzled as to why he even had to write. #rantoff

So, yes, there are folks out there - skilled, reputable folks - who do not require a letter. The question of insurance coverage is a different kettle of fish.

[HeyTrace19]

I had top surgery in 2010, paid out of pocket...My surgeon did not require a letter. 

[dylm]

Hey, the site your thinking of is http://www.transbucket.com/ there are also some yahoo groups as well idr them off the top of my head.

Also HRT in some cases can be informed consent and no letter is required ie clinics like callen lorde for example but most have age requirements or have more restrictions for those under a certain age.

Also there are top surgeons one comes to mind steinwald and a few other I cant remember. Here's a list http://www.topsurgery.net/surgeons/informed-consent.htm

Steinwald does full top surgery and doesn't require any type of letters works on informed consent. there is also garramone who if i remember correctly just asks for a letter from your HRT doctor. One thing to keep in mind however is most who will perform surgery on informed consent model will not take insurance and as far as i know for bottom surgery cases there are no informed consent surgeons at least in US that I know of so if you plan on bottom surgery later on you will still eventually need to get letters.
hope this helps
-dylan

[Muscle Matt]

If the surgeon follows WPATH standards, then yes, you need one letter.

WPATH's standards actually says you don't need a letter for hormones.

This.

I just had my consult with Dr. Fischer. She will accept a letter from EITHER a therapist or a primary care physician (I don't see a therapist so they said my doctor is perfectly acceptable).

UNFORTUNATELY, my doctor's office is run by a bunch of morons, and they switched me to a "trans specialist" who is going to write my letter (mainly because my doctor is a part-timer with too many patients, and can't be burdened by it). She refuses to believe that I don't also need a letter from a therapist and is trying to make me go see one before she'll write my letter. I will do no such thing (I've already missed soooo much work from all my pre-op appointments, and I need the money since I just dumped my entire savings account to pay for this surgery). Multiple people at the office AND the paperwork all say I only need one of the two. So I guess we'll see how things go with this "trans specialist" tomorrow. I may or may not end up making a scene over this bull.

[Arch]

UNFORTUNATELY, my doctor's office is run by a bunch of morons, and they switched me to a "trans specialist" who is going to write my letter (mainly because my doctor is a part-timer with too many patients, and can't be burdened by it). She refuses to believe that I don't also need a letter from a therapist and is trying to make me go see one before she'll write my letter.

Hunh. She can be a trans specialist without being a trans advocate (and without actually knowing much about us). Definitely stand your ground. Let us know what happens.

[RaptorChops]

I was allowed to bring a letter from my Endo. I went to Fischer in MD. I paid everything out of pocket so I'm not sure if that would make a difference. Probably not though.

[Muscle Matt]

Hunh. She can be a trans specialist without being a trans advocate (and without actually knowing much about us). Definitely stand your ground. Let us know what happens.

She still didn't believe I only needed one letter even after I showed her the paperwork that stated in multiple ways that only one letter was required. Tried to get me to see the trans specialist therapist that works in the building so I could get my second letter that I didn't need. The therapist that I didn't like the first time they tried to send me to her 'cuz she kept trying to force me into trans group therapy that I was not going to even pretend I would ever go to. I just told the woman I'd see the therapist, got my letter from her and left. And now I'm trying to find a new doctor, 'cuz she seems like she's going to try to push a higher T dose on me once I get out of surgery, and I really don't feel like I need a higher dose at this point. I don't think they're even judging my progress on my personal T levels, they just prescribe everyone pretty much the same thing and call it a day.

I cannot stress this enough. Chase Brexton is NOT the LGBT specialists that they like to act like they are. Do not at all recommend.