Hi Becca Anne You are welcome to the kind words, anytime, anywhere, by doing so we are showing you that we are very supportive of what you are doing.
You have mentioned that you have an issue or problem and you say:
Quote from: becca.anne on July 10, 2024, 10:02:53 PMThank you for the kind words. I do however have an issue I am working through. I am with Mayo and I have having a bit of a challenge getting referred to the Surgeons for vaginalplasty the orchi is no sweat and can be done locally. I am still trying to figure out her inner workings of the "establishment". My contention is Mayo is Mayo. Each site has a speciality which its great so I should be able to go where the specialists are. Sure there will be some cost on my end which I am happy to pay. Arg... My preference is to have it done all at once but some surgeons say doing the orchid first is in some respects better because your body gets used to the new configuration.
Becca
(I need to do some tickers for a signature...)
The following surgery letters, allowed me to get my surgery. I mention them, so that you can understand where I'm coming from. As far as I know I needed at least two letters, I had three, at the time for my surgery to go ahead. This is Australia and nearly 34 years ago. According to the SOC at the time.
This is the first letter.The following letter is from my first psychiatrist virtually verbatim to my surgeon, I do not know when this letter was created, it was certainly after May 1990:
Dear Peter Haertsch (surgeon)
Re Sarah B
Sarah B was referred to me in March 89. She has been seen by Alf and Orsmand, both of whom have written to you. She is a male to female transsexual who is, I believe suitable for gender reassignment surgery.
Regards
Cornelius Greenway (first psychiatrist)
This is the second letter.The following letter is from my second psychiatrist virtually verbatim to my first psychiatrist and surgeon, this letter is dated May 1990:
Dear Cornelius Greenway (first psychiatrist)
Re Ms Sarah B
I have seen this transsexual several times now, and feel quite the appropriateness of recommending gender reassignment surgery.
She has proved herself as a capable and competent person with a realistic expectation from the operation, and I have little doubt that this will improve the quality of her life.
I would recommend that the operation be done later on this year, since that would closely approximate living permanently in the preferred sexual role.
I hope this will be of some interest and help to you.
Regards
Tony Orsmand (second psychiatrist)
CC Dr Peter Haertsch (surgeon)
These two letters are not as in depth as some letters that I have seen.
Regardless of which surgeon you choose, the surgeon is going to request from you at least one or two letters from different 'therapist/s' doctor/s, psychologist/s, psychiatrist/s or other qualified practitioners. Depending upon which version of SOC they are going by. Stating whatever the surgeon requires, that needs to be stated in those letter/s.
The Standards Of Care version 7 or version 8 are basically outlined in the following paper and I quote:
QuoteIn SOC7, the criteria to undergo breast or chest surgery was one referral letter by a qualified, licensed mental health provider. This referral needed to include well-documented, persistent gender dysphoria for an age-of-majority individual with capacity to make informed decisions and consent to treatment, with any medical comorbidities reasonably well-controlled. Genital surgery candidates required two referral letters. For those seeking hysterectomy, ovariectomy, or orchiectomy, they are required to have been on 12 continuous months of hormone therapy as appropriate to the patient's gender goals, unless a medical contraindication existed. For those seeking metoidioplasty, phalloplasty, or vaginoplasty, the guidelines stipulated that the individual must have been living 12 months in their gender role that is congruent with their gender identity. Such a requirement was recommended in order for patients to be able to experience and socially adjust to their desired gender role before undergoing an irreversible surgery.
SOC8 guidelines for GAS in the adult population (age of majority, 18+ in United States) recommends only one letter of readiness for medical or surgical treatment, provided it is written by a health care provider experienced in assessment of gender diverse individuals. While this reduces the number of documents, it stresses the knowledge of the assessor as pertains not only to mental health and medical preparedness for treatment, and encourages a unique evaluation of each patient, combining the expertize of the assessor and the "lived experience" of the individual patient. Furthermore, the recommended time frame in SOC8 for consistent hormone replacement therapy (HRT) before GAS contracts to 6 months, rather than the previously recommended 12 months, with a caveat that prolonged hormone therapy may be indicated to maximize surgical results, such as the case with breast budding before breast augmentation. SOC8 also recognizes that HRT may not be indicated for patients for whom HRT is medically contraindicated, or for gender diverse individuals for whom HRT does not support their gender identity goals.[1]
Which brings me to your problem. I had never heard of orchiectomy or genital hair removal during those two years while I pursued my surgery. My surgeon did not require them. Let me repeat that, my surgeon did not require those procedures. However, here I am, walking around perfectly normal without any problems, with a healthy vagina.
So as you say,
"My preference is to have it done all at once". Then I'm going to say,
"find the surgeon that is going to do all of it at once, according to your wishes.Where surgeons are saying
"doing the orchid first is in some respects better because your body gets used to the new configuration." I'm saying,
"absolute rubbish". (this is my opinion only). There may be reasons for going down this path, stopping testosterone, a step to consider if you want to go down this step before the final irreversible operation, gate keeping or more expensive, meaning more money for them. There maybe reasons for not going down this path, loss of tissue, two operations more risk and saving money.
What ever path you decide, it is your decision and no matter what you decide to do, we at Susan's will support you in your decision.
Please ask questions, whether here at Susan's or with your 'therapist'. Your wishes are paramount and make them known. So if you "want it all done at once", then seek that option.
Take care and all the best for the future.
Love and HugsSarah BOfficial GreeterPS I changed the following from
"I would like to tell you just a little about my surgery," to
"The following surgery letters, allowed me to get my surgery. I mention them," To clarify what I wanted to say.
@becca.anne[1] World professional association for transgender health guidelines: 2022 surgical treatment updates in the standards of care for transgender and gender diverse people
