He requires both, i'll cut and paste you the checklist he give the second line says gender therapist or primary care physician but thats just for the therapy aspect, if you look down towards the bottom you also need medical clearance. hope this helps
Check off each line after you have confirmed we have received these REQUIRED documents
in our office:
Signed copy of the Financial Policy included in this packet.
Gender Therapist or Primary Care Physician Letter, one letter is required for breast
surgery and must state "Chest Surgery is the next step in the Transition Process".
The Mental Health Professional or Primary Care Physician Documentation Letter
for Surgery Should Succinctly Specify:
1. The patient's general identifying characteristics;
2. The initial and evolving gender, sexual, and other psychiatric diagnoses;
3. The duration of their professional relationship including the type of
psychotherapy or evaluation that the patient underwent;
4. The eligibility criteria that have been met and the mental health professional's
rationale for surgery;
5. The degree to which the patient has followed the Standards of Care to date
and the likelihood of future compliance;
6. Whether the author of the report is part of a gender team;
7. That the sender welcomes a phone call to verify the fact that the mental health
professional actually wrote the letter as described in this document.
The organization and completeness of these letters provide the surgeon an important
degree of assurance that mental health professional or primary care physician is
knowledgeable and competent concerning gender identity disorders. WORLD
PROFESSIONAL ASSOCIATION FOR TRANSGENDER HEALTH STANDARDS OF CARE AVAILABLE
AT
http://wpath.org/Documents2/socv6.pdf Copy of your Drivers License and Birth Certificate (no exceptions, although a valid
passport copy is acceptable)
Medical Clearance (includes a physical examination by an M.D. or D.O. licensed
physician done within 30 days of the date of surgery)
Lab Work (done within 30 days of the date of surgery)
Mammogram (only if you are over 35 years of age or otherwise instructed to get a
mammogram by Dr. Garramone)
Digital Photographs of your chest emailed directly to Dr. Garramone
(drgarramone@drgarramone.com)
Edited to add, thats everything you need and he requires 500 down payment to hold surgery date and everything must be paid in full 2 weeks prior to surgery, but he takes credit cards which is great
