Top surgery before hormones?

[KarlMars]

Are you allowed to get top surgery before hormones? My breasts are very loathed and have been all my life and I keep thinking I'd most like to have them removed first.

[Alexthecat]

Yes, I've done it.

[KarlMars]

Yes, I've done it.

Are you American? Did you have to get the referral from your therapist or what?

[Alexthecat]

Yep American. It depends which surgeon you go to if they require a therapist letter or not. You can get one here for $320 guaranteed. http://gendertherapist.com/

Paying out of pocket scenario is pretty much that but if you want insurance to cover it you will have to see what they require (therapy, hormones, etc.)

[FTMax]

You can, you would just need to get a referral for top surgery. Like Alex said, I would start by figuring out if your insurance will pay for it, and if so, what they require in order to deem it medically necessary. Then I would find out what surgeons are in network so that you can get in touch with them and see what they require. Most just want a single referral from a therapist, but mine would've taken a note from the doctor that does my HRT.

[KarlMars]

You can, you would just need to get a referral for top surgery. Like Alex said, I would start by figuring out if your insurance will pay for it, and if so, what they require in order to deem it medically necessary. Then I would find out what surgeons are in network so that you can get in touch with them and see what they require. Most just want a single referral from a therapist, but mine would've taken a note from the doctor that does my HRT.

The doctor that diagnosed me with tourettes said I should wait until my movements get under control before I try any surgery like that. He said I needed to avoid stress. I'm on medicaid.

[KarlMars]

Yep American. It depends which surgeon you go to if they require a therapist letter or not. You can get one here for $320 guaranteed. http://gendertherapist.com/

Paying out of pocket scenario is pretty much that but if you want insurance to cover it you will have to see what they require (therapy, hormones, etc.)

Is that $320 out of pocket? My medicaid might cover a therapist. Does the therapist by law have to be one that deals with transgender issues?

[FTMax]

You would need to call your state's Medicaid office and see what they tell you. I'm only familiar with my plan and plans I've had in the past, and those all required very specific steps to have things covered. Like for my hysterectomy and bottom surgery, I had to get a referral from a therapist, a referral from a psychiatrist, and a referral from my primary care doctor that all said I had a diagnosis of gender dysphoria and was healthy and stable enough to have those procedures.

The link Alex posted would be out of pocket. I would hold off on therapy until you're sure what insurance will require and who they would have you go to, that way you can make sure you fulfill everyone's requirements and you're not wasting time/money.

[KarlMars]

You would need to call your state's Medicaid office and see what they tell you. I'm only familiar with my plan and plans I've had in the past, and those all required very specific steps to have things covered. Like for my hysterectomy and bottom surgery, I had to get a referral from a therapist, a referral from a psychiatrist, and a referral from my primary care doctor that all said I had a diagnosis of gender dysphoria and was healthy and stable enough to have those procedures.

The link Alex posted would be out of pocket. I would hold off on therapy until you're sure what insurance will require and who they would have you go to, that way you can make sure you fulfill everyone's requirements and you're not wasting time/money.

I already see a psychiatrist regularly. I'm on a lot of psychiatric medicine.

[FTMax]

I'm just saying what your insurance may require. And it's not necessary to be seeing them regularly for the purpose of surgical referrals unless you have other issues they want to work out before they'll refer you. I didn't see a therapist before starting T. I saw Dr. Graham (the link Alex posted) 3 times before I got my top surgery referral. And I saw my therapist and psychiatrist once each before getting bottom surgery referrals.

Insurance is ultimately the one you need to be catering to. They call all the shots.

[KarlMars]

I'm just saying what your insurance may require. And it's not necessary to be seeing them regularly for the purpose of surgical referrals unless you have other issues they want to work out before they'll refer you. I didn't see a therapist before starting T. I saw Dr. Graham (the link Alex posted) 3 times before I got my top surgery referral. And I saw my therapist and psychiatrist once each before getting bottom surgery referrals.

Insurance is ultimately the one you need to be catering to. They call all the shots.

Thanks for the idea, Max. I'll definitely call Medicaid and ask. I also have a mental health case manager that could help me with resources. I asked if they had a significant number of transgender patients and she said they do. So I guess they know what they're dealing with.