Howdy & welcome,
My blog (link in signature) has a pretty lengthy explanation of my whole bottom surgery planning experience. I will answer your questions listed here as best I can, but feel free to come back and ask follow up questions. There are some great surgery related information and support groups on Facebook, but unfortunately for you most of them are 18+ only. You're welcome to send me a friend request and I can add you to them once you've had one more birthday. Now for your questions:
Where do I begin in planning this?
- Make a list with 3 columns: things you need from bottom surgery, things you don't care about, and things you absolutely don't want. Start listing potential goals/outcomes from surgery that you have in each of those columns. That should help guide you towards which specific procedures you're looking at getting. For me, that looked like
Need: Stand to pee, male in appearance, no female reproductive organs, no vagina
Don't Care: Erections
Don't Want: Limited sensation
So when we add all that up I need: a hysterectomy, a vaginectomy, phalloplasty OR metoidioplasty with urethral lengthening and microsurgery (if phalloplasty), plus scrotoplasty. Then it was a matter of choosing primary procedure - I've opted for phalloplasty. Now, there are loads of different options in terms of donor sites for phalloplasty. So I'd need to go research all the pros and cons of each and choose one (ideally with input from a surgeon - most ideally, with input from the surgeon you want to go to). I've done that research and will be having RFF phalloplasty with all of the above bells and whistles. Once you know what exactly you want, you can start surgeon shopping.
I've heard from some sites that people fly out of the country to get their surgeries done because it is cheaper, can anyone confirm this?
- If you are going to have to save up money anyway, I'd highly recommend finding an employer who offers inclusive coverage (Apple, Starbucks, Best Buy, etc. all have it) OR buying a plan on the ACA marketplace. You're young and all of those places I listed offer benefits to folks working part-time. If I were in your shoes, that's what I'd be doing. I live near you and I know there are also loads of great options available in terms of health insurance. Finding a good insurance option is going to be cheaper than going overseas.
If insurance is absolutely not an option, overseas would be the cheaper route. Again, you'd have to go surgeon shopping and ensure that you'd be getting exactly what you want from an overseas surgeon. Also keep in mind that with phalloplasty, you're looking at a minimum of 2 stages, usually 3-6 months apart. So that's 2 separate trips to a surgeon at a minimum. Many people have 3 or more stages depending on what all they want and what complications they experience. Many insurers here will cover travel expenses to and from your surgeon, but not if you're traveling overseas.
For reference, before getting insurance I was planning to travel to Serbia for surgery. The total cost of everything I wanted would've been right around $30,000 plus travel expenses for 3 separate round trips. That came out to around $36,000. With insurance in the US, I pay $40/month regardless of whether or not I'm using the insurance. With an in network provider for phalloplasty, I will pay no more than $6,000 provided all of my stages can be completed before my annual premium rolls over. So all in, my cost would be $6,480. My insurance is reimbursing my travel expenses and may be subsidizing the cost of my local stay in my surgeon's city.
I know I need a vaginectomy and hysterectomy, but does the requirements vary per surgeon?
- Requirements for bottom surgery are very firm across the board. All surgeons I've spoken with want one letter from a Master's level therapist, one letter from a PhD level therapist or psychiatrist, and a letter from the doctor who prescribes your hormones. You don't necessarily have to have a vaginectomy and hysterectomy, but some surgeons may require those things in order to do other procedures (as an example, there is a higher chance of complication with urethral lengthening if you do not have a vaginectomy, so many surgeons will not perform urethral lengthening if you don't have a vaginectomy).
In the US, I can't think of a surgeon who will perform the first stage of phalloplasty with a hysterectomy at the same time. So you would need to have the hysterectomy done in advance (typically 3 months ahead of phalloplasty at a minimum). Overseas you may have more luck with someone including it in their stage one, but again, all really depends who you go to. Every surgeon is a little different in what all they offer and how they structure the order of procedures.
Hope that helps at least get you started. Again, I'm happy to answer follow up questions. My biggest piece of advice would be to work on getting your referral letters, and research as much as you can so you know exactly what you want to have done.
