Mostly a giant worry-fest.

[SnailPace]

Alright, so this is probably going to span quite a few topics. You can pick and choose what to respond to if you wish. 

The first thing that's been on my mind lately is the whole fat redistribution that comes with T.  I just lost a lot of weight, so I'm quite happy with how my body is right now (fat-wise, not gender-wise).  In British Columbia, where I live, MSP insurance will cover top-surgery but only after two years of heavily documented "real life experience".  However, T is still at the usual three months of therapy.  If money wasn't a problem, I would definitely get top surgery much earlier, even before T.  I'm worried that two years on testosterone, not only will my thigh and butt fat move to my stomach, but also a lot of my boob fat.  Preferably, all of that boob fat would just be surgically removed... or does breast fat not redistribute as much?

Another related thing I am worried about has to do with that same picky insurance I have.  For the real-life experience to count, I would need multiple letters of reference from either a) A full-time employer I had been working for for the full two years or b) from a learning institute I had been attending the whole time.  The only way you don't need these letters of reference is if you are physically disabled, but even then they would like quite a few volunteer hours spanning the time.  The problem with this is that I have a young son (7 months) that I take care of, so full time work is out of the picture.  Even when I do start working in the future, I am planning on starting up my own company.  What the heck?  I don't have a therapist yet, but I will definitely talk to them about this when I have one.

Ehh... I think I'll leave my other worries for another time.  Please discuss though!

[kyril]

re: the fat, my understanding (not first-hand experience) is that if you're planning to go on T at all, it's best to have been on it for some time and have your upper body in fairly good shape before top surgery so that the surgeon has a good idea of the shape of your chest with male musculature. That helps them decide how much fat and breast tissue they need to leave behind to give you a chest shape that will stay proportionate. If you have the surgery pre-T or when you're very out of shape, they might leave too much - a near-complete mastectomy on a female frame leaves a very hollow-looking chest.

And if you're physically active right now and you maintain the same level of activity on T, your body fat will probably not just redistribute, but be reduced significantly. Men with the proper hormone balance just have less body fat than women (with similar genetics and lifestyle). So don't worry too much about ending up with a giant potgut from your breast/hip/thigh fat.

As far as the real life experience, I can't really help, but your therapist probably has an answer for you, or knows where to find one.

[Katelyn-W]

I live in BC too

I know you don't have to do 2 years of RLE for MSP to cover MtF SRS, only one year. This was changed relatively recently, I'm pretty sure top-surgery should only be one year of RLE as well now. The 3 months of therapy is just a guide-line, if you seem ready for it you can start HRT a lot quicker (say you've already gone out as your preferred gender, or living as your preferred gender already, came out to friend/family, etc).

[SnailPace]

Re: kyril, Yeah I was thinking that, actually.  I'm glad to know that T might help me lose fat.  The weight I had on was pregnancy weight, not unhealthy weight, and I'm in quite good shape now.  I was just thinking, "Gee, even though I'm in good shape, I still have quite a bit of fat on me, if this all redistributes to my stomach... ugh, that'd suck!"  So thanks!

Re: Katelyn-W, Looking at it again, I see that the information I've been reading (from VCH) is copyrighted 2006.  I'm glad to know that it's been changed, because it seemed a little unreasonable to me.  I think 1 year is much more doable.

[Al James]

in some places (i e the clinic i'm going to be going to) they uphold the one year RLE for MTFs but make the FTMs do the two years because of the irreversible nature of some of the changes on hormones

[SnailPace]

Re: al james, Well, for hormones here, you don't necessarily need any RLE at all.  Your family doctor can prescribe them to you or refer you to an endocrinologist.  You don't actually need a letter for that.  I would be confused if they wanted one year of RLE for MTF top or bottom surgery, but two years for FTM top surgery.  They both seem quite irreversible to me.  But I will talk to someone around here, definitely. 

[jmaxley]

So don't worry too much about ending up with a giant potgut from your breast/hip/thigh fat.

I've been really worried about this myself.  I have LOTS of fat in those areas.

[kyril]

I actually have a semi-related question for those who know the BC system. I'll be doing my hormones, name/gender marker change, and general transition stuff here in the States, but at some point I'm planning to move home to BC and it would be awfully nice if I could get them to pay for my top surgery. But this "heavy documentation" of the RLE could be a stumbling block - anyone know what exactly I'd need to assemble from my school? And if I graduated and got a job after, would the employer have to know I'm trans in order to help document my RLE? Because that sounds sort of counterproductive, if I'm over a year on T and passing well and have my documents in order.

[Katelyn-W]

I actually have not heard of a need for "heavy documentation". I know of two women who are getting everything ready for SRS (one of them has had MSP confirm they are covering it), I can ask them about this next time I see them (week from now).

[zombiesarepeaceful]

Yeah...your chest may change alot on T or not at all in some cases. Personally I've developed hardcore pecs from T that I didn't have before and my fat in that area has subsided a little and yeah it went to my gut but doing sit ups has kept that from bothering me too much. I haven't gained/lost weight at all...it's just all gone to different places. So it's ideal to be on T before surgery so your surgeon can see your muscle development, cause they try to hide the scar line in your pec crease.

[SnailPace]

This is the information I was reading: http://transhealth.vch.ca/resources/library/tcpdocs/consumer/surgery-FTM.pdf

It says that your employer doesn't need to know that you're trans, but does need to write a letter of reference using a male name and pronouns.