Why 1 year wait for SRS

[Dena]

About a year and a half ago I had several email exchanges with a person who had surgery and now feels nobody should have it. From what I gather, surgery was obtained by spoofing the surgeon about RLE. Most of us need surgery but there are those who it will do much damage to surgical programs and RLE is the only way to filter them out. Failure to do so could result in something like the bathroom bills where it becomes near impossible for any of us to receive treatment. The name of the person I had the conversation with? Walt Heyer. Google that name and you will learn a story of caution.

[AnonyMs]

Can you answer this question. Supposed you are one of a number of board members who's surgery failed for some reason and are unable to have normal relations. Can you build a life where you can still be happy or would you regret ever taking this path. I answered the question before surgery and have had a life without sex and without regrets.

I don't think waiting an extra year is going to make it any easier to cope with that. People can cope or not, they will think or not, what difference will a year make except add to the stress. Its not like you'll suddenly get cured and no longer be trans.

About a year and a half ago I had several email exchanges with a person who had surgery and now feels nobody should have it. From what I gather, surgery was obtained by spoofing the surgeon about RLE. Most of us need surgery but there are those who it will do much damage to surgical programs and RLE is the only way to filter them out. Failure to do so could result in something like the bathroom bills where it becomes near impossible for any of us to receive treatment. The name of the person I had the conversation with? Walt Heyer. Google that name and you will learn a story of caution.

Unless you're going to have someone follow you around for a year, all I get from that is you may as well lie, because it works. The interesting question is hows he got past a psych evaluation, but I don't suppose that's too difficult either. Psych's are only human, and I'm pretty sure I could like my way though one of those if I wanted (not that I need to). I'm quite sane though, and he doesn't appear to be.

I think both these points are based on worst case assumptions about what may happen and how people think. If everyone lived their lives like that we'd live in a police state to protect ourselves from what might happen.
Its not helpful to the majority of us, and actively harmful to a minority of us. Those kinds of policies would harm me in particular as I'm interested in SRS and to present male both before and afterwards.

[Emileeeee]

I feel like it's kind of like the therapy requirement. When I first started the process, I was furious about all the stuff that seemed like gatekeeping to me. In reality, I absolutely needed that therapy. Without it I would not have been prepared for the transition. I didn't have the self esteem to cope.

Now that I'm full time, I'm realizing there are a lot of situations I hadn't expected and each one takes a bit of coping power to get over it. I was very reclusive prior to this, now I'm very outgoing. I get invited out to bars for happy hour and it still scares me to death to actually go. I hate sand, but I love swimming in the ocean. I haven't had to experience that as a woman yet. My spouse has family in the deep south and every time we go to visit, I'm just as nervous as the last time. I always find a way to find that 20 seconds of courage, but what if I couldn't? What if I had rushed through the process to SRS thinking that would make me indisputably a woman and take these fears away, and it didn't? At that point, there's really no going back.

Do I really want to have to wait a year? Not at all, but I think it's kind of a blessing in disguise. I have to wait almost a year on a waiting list just to get a consult. I added myself to the list about a month after I went full time. Like it or not, I'm waiting for about 1.5-2 years, not because of rules, but because of the long line of people before me.

[Jenna Marie]

I don't think anyone should have to wait. Cis people are allowed to make "mistakes" with their bodies; so should we. And I didn't learn anything about *having a vagina* from living as a woman; I learned a lot about living as a woman, and something about the very real dangers of doing so WITHOUT a vagina, but I didn't need a vagina to have male coworkers talk down to me or be told that my political column was better when my "brother" wrote it.

Essentially, the rest of the world assumed I had a vagina already; getting one installed was purely for my own peace of mind.

(Oh, and as a private pay at least, Brassard offered me a date only three months away...)

[suzifrommd]

From https://www.susans.org/2015/08/03/rle-civil-rights-issue/ :

I came across no data that indicate better outcomes by forcing transgender people to wait before our bodies are made whole. In fact, the data I came across indicated exactly the opposite. Every study seemed to show that the existence or duration of RLE had no effect at all on the outcome. According to a study posted by NIH, "Compliance with minimum eligibility requirements for SRS ... was not associated with more favorable subjective outcomes."

RLE is a patronizing, paternalistic hurdle devised by cisgender doctors. That it persists despite being scientifically indefensible from observed results is a testament to how far transgender people have to go before the scientific community sees us as intelligent, mature human beings capable and not children they can order around as they please.

[liz]

An advice to save some time with Brassard if you are from quebec is to take your appointment at least a month before the year mark. This way the CHUM will get to evaluate your paper sooner (it usualy take 30-60 days for them to peek at it anyway).

There is a LOT of cancelations so if your schedule let you you, just accept the new date everytimes they call you.

I got my srs about 2 months and a half after the year mark because of cancelations and earlier sent papers.

I must admit that this waiting time is a needless stress. T blockers are pretty harmful also, some scientists are proposing to do srs before even starting HRT to avoid the problems that t blockers bring.

[AnonyMs]

T blockers are pretty harmful also, some scientists are proposing to do srs before even starting HRT to avoid the problems that t blockers bring.

I never heard that before. Where did it come from?

[Rejennyrated]

Two points come to mind.

Firstly in a world where trans patients can, and regularly do, successfully sue their doctors for compensation when they "change their minds" for whatever reason after surgery, you can hardly blame the doctors for wanting a "cooling off" period. Perhaps if there was some way to make patients sign some sort of cast iron waiver of the legal right to sue if they changed their mind then it might seem less risky...

Secondly I could turn the tables and ask how long it took you to make the decision to come forward for treatment. Anyone answering that they came forward at the age of 16 (which in the UK at least is the minimum age at which a patient can be treated without parental consent) I will grant has possibly got a point - however if that didnt happen then clearly there was some hesitating - and hesitation implies doubt... which raises the legitimate question what if the doubt later returns... which bring us nicely back to point one.

Now of course in under a year's time now I shall be fully medically qualified and hence possibly being the one asked to write the letters or wield that knife... Now I KNOW what its like to be trans, and from my experiences about 30 years ago I also know what it is like to have somebody delay your surgery, and yet... if you came to me asking me to operate on you without an RLE I would tell you politely but very firmly no way! Not because I am ignorant or cruel - but because I now recognise that much as I hated the gatekeepers they were right - and they made me think about what I was doing and WHY.

Trust me, in the years that follow surgery it wont all be a barrel of laughs - and when it isnt, THAT is when you'll be grateful that you waited out that hateful extra year - because the fact that you did, and the memory of how miserable that delay made you feel is the thing which will make you realise that however bad things may be in the future, pre-operatively it was worse - and therefore you will be sure you made the right choice.

[AnonyMs]

Now of course in under a year's time now I shall be fully medically qualified and hence possibly being the one asked to write the letters or wield that knife... Now I KNOW what its like to be trans, and from my experiences about 30 years ago I also know what it is like to have somebody delay your surgery, and yet... if you came to me asking me to operate on you without an RLE I would tell you politely but very firmly no way! Not because I am ignorant or cruel - but because I now recognise that much as I hated the gatekeepers they were right - and they made me think about what I was doing and WHY.

But you won't be qualified to make that decision since you're not a psych, and you also get to pass off legal responsibility on to that psych.

I'm curious your thoughts on non-binary people who want SRS?

[Laura_7]

I thought Dr. Brassard had a long wait list anyway.

About five months from booking ...


*hugs*

[Laura_7]

I never heard that before. Where did it come from?

Some meds can have side effects ...

technically SRS seems the better solution ...

by the way there were children who were strongly dysphoric and got srs ...


*hugs*

[Maybebaby56]

I don't think anyone should have to wait. Cis people are allowed to make "mistakes" with their bodies; so should we. And I didn't learn anything about *having a vagina* from living as a woman; I learned a lot about living as a woman, and something about the very real dangers of doing so WITHOUT a vagina, but I didn't need a vagina to have male coworkers talk down to me or be told that my political column was better when my "brother" wrote it.

Well said, Jenna! 

RLE is a patronizing, paternalistic hurdle devised by cisgender doctors. That it persists despite being scientifically indefensible from observed results is a testament to how far transgender people have to go before the scientific community sees us as intelligent, mature human beings capable and not children they can order around as they please.

I agree completely.  My transition is my business.  It's hard enough as it is.  There is nothing "real life" about RLE.  Cis-women don't worry about getting clocked, or possibly being subjected to physical violence for anything from using the ladies room to simply existing in public.  Cis-women don't have to walk around with a penis between their legs and deal with the dysphoria that causes. I could go on and on. 

My girlfriends warn me about what it's like to get ignored, disrespected, talked-over, not getting credit for work accomplishments, passed over for promotions, etcetera.  I get some of that already, and being near the end of my professional career, I don't care about the job-related stuff or other social shortcomings of being female. It's a small price to pay for the chance to transcend a lifetime of unhappiness.

With kindness,

Terri

[AnonyMs]

Some meds can have side effects ...

technically SRS seems the better solution ...

by the way there were children who were strongly dysphoric and got srs ...

True enough, but I've never heard a scientists/doctors suggest SRS before HRT.

Funny how WPATH says you can get an orchi without RLE though. I wonder why the difference...

[melissa_h]

Actually that logic applies to any form of elective surgery. There's usually an expensive way to undo it if you regret it later, and every plastic surgeon protects themselves legally from "change of heart" patients a few months later.

To suggest that SRS is somehow different doesn't fit logically.

Again, there's huge value in being right about why we all transition... But arbitrary timelines and gate keeping aren't the answer.


Sent from my iPhone using Tapatalk

[abd789]

I want to get eaten , penetrated And I REALLY dont want My butt involved ...

Oh, I hear ya...

[Maybebaby56]

Can you answer this question. Supposed you are one of a number of board members who's surgery failed for some reason and are unable to have normal relations. Can you build a life where you can still be happy or would you regret ever taking this path. I answered the question before surgery and have had a life without sex and without regrets.

I'm not sure what you're asking.  I already don't function as a male sexually. Are you asking if I would have SRS if my vagina were non-functional?  No, probably not.  I can be sexually dysfunctional right now, without the pain and expense. What I want out of SRS is to fix that.

With kindness,

Terri

Edit: You know, under those conditions, I might have SRS regardless.  I don't like having male genitalia.  Even a non-functional vagina would be better.

[OCAnne]

After an initial psychiatric evaluation I was given OK to seek SRS prior to starting HRT.  Still had to jump through  the WPTH 'suggestions' including two letters but no RLE.  That was negotiable based on time served as a man.  No further prison time was deemed necessary.  Was able to satisfy everyone's requirements in a much shorter period than 1 year.

I would say getting name and gender legally changed and starting genital electrolysis made an impression on all those involved.  Did use the penetration without my butt involved line, it appeared to work!

Thank you,
Anne

EOM

[Jenna Marie]

Rejennyrated : I would not assume, at all, that "hesitation implies doubt." If anything, it might imply the stress, difficulty, and fear of going through the selfsame hurdles (set by cis people) that this thread is about.

I figured out that I needed to transition in June; I was seeing a therapist by October, on HRT by February, and would happily have had SRS and HRT from basically the day that I knew I was trans. Those delays were caused by having to jump through all the hoops. I never changed my mind, and I never hesitated about those things - what I *did* doubt, constantly, was whether I was "trans enough" by the rules set out by the gatekeepers. And again, nobody makes a cis woman undergo half the medical supervision or demands any of the proof we have to provide in order to get HRT; I can pretty much guarantee that if a cis man lost his penis, nobody would make him wait a year to be really sure he wasn't happier without it before phalloplasty. Do trans people make medical and/or life decisions they later regret? Sure. Do cis people? ...absolutely.

Imagine the outcry if we made people take tests, go to therapy, and wait a year before having kids! But that's at least as life-changing, albeit in a different way.

(And I, at least, am on a dose of HRT that is well within the range provided to cis women, so it's a direct comparison. My cis friend who had a hysterectomy at 35 left the hospital with a prescription - for a dose twice what mine is! - and did not have to go to therapy for three months and get a letter to prove she deserved it. Nor did anyone suggest that perhaps she doubted herself or her womanhood or had made a catastrophic mistake of some kind when she wondered if she'd rather stop taking it, either.)

[Jessica Merriman]

Honestly a lot of the answers, deception of RLE and palpable anger in this topic scare me. We all have to play by the rules. They are set by WPATH and adopted by most countries. You don't have to agree with them, but they will remain anyway. Channel that anger somewhere constructive.

[AnonyMs]

Jessica, I'd  like to point out that the rules are not what they appear to be. I know of a number of surgeons who'll do SRS without RLE, and I believe there's a lot more. I think you still need the letters.