Susan's Place Transgender Resources

I just start full time from this Feb, just wonder if I can have SRS operation by Dr. Brassard around September this year? Is it this 1 year rule very restrictly followed by the top surgeons? I have live full time outside my works for couple month before my complete fulltime, are those month count?  Just can't wait to make myself complete. 

Yes you do.  He follows the guidelines very closely

I wouldn't be surprised if his waiting list is longer than 9 months. That puts you around December. Factor in the holidays and your looking at February anyway.

Yes, one year rule. I had to live two years in the UK for the NHS to fund my GRS. I thought it was cruel but the time went really fast and I had not appreciated the reason until I had lived the two years real life test. So I kind of agree with it as its life changing and its for your own protection. I know some peps here will not agree with it but looking back I can see the reasons and the surgeon also wants to make sure you're not making a mistake.

Stardust

Make sure that the start of your full-time is truly full-time and well documented.
Name change and coming out at work is good documentation.

Cash is king.

If you have your two SOC letters, there isn't any reason why a surgeon wouldn't work on you, unless of course the doctor gets inquisitive and has a problem with your therapists' definition of "RLE".  Technically, I have only been full time for a month with no name change, but on hormones for a year, and I have my surgery in a few weeks.  My surgeon is not Brassard though.

Not everyone has a one year RLE. What was important to Dr. Brassard was having two letters of recommendation from therapists prior to SRS.  The details of the RLE are between the client and the therapists, the surgeon only needs the letters, usually one letter to schedule SRS and the second letter prior to the procedure.

WPATH is a medical protocol guideline, it is not required except to the degree that the doctor and their insurance carrier wants it.

Quote from: tekla on March 15, 2011, 08:08:21 PM
WPATH is a medical protocol guideline

That's the whole point of the WPATH Standards of Care; that they're guidelines, rather than rules written in stone. Think about the requirement for HRT, some get their letter of referral before 3 months, some see a therapist for a longer period of time. Each person is different, and the guidelines simply suggest a flexible approach for everyone to consider.
It would be unrealistic to state a specific timeline for each transitioner...there are too many variables.

HAHA, I am glad you all asked how I am getting surgery before one full year of being "full time" and also still don't have my name changed.

I am not going to say who my therapists are until after my surgery, but I'll just say that both of them are rock stars when it comes to gender therapy.  They know I have my sh*t together and that I am ready.

What some of you people tend to not think of is that yes, the SOC is like the rule of law for this kind of stuff.  But like the rule of law, the SOC is also open to interpretation.  If you have your stuff together and a therapist sees you are ready, then there isn't a reason why they wouldn't sign a letter.  A lot of trans people don't know this and is also why the trans community itself is often less progressive than many in the professional community. Atheris and Tekla get it though.

Dee, but sorry, I will not be taking any advice from you.  But glad to see you have recognized and come to some sort of terms with your post-op depression.

Understanding does not depend on gender, it depends on intelligence + effort.

And in places that use informed consent, and have a long running structure of professional support in place that time can be cut down.  I've seen girls in the Bay Area go from zero to surgery inside of a year.

Yes, the WPATH SOC are just guidelines, not rules.  They are primarily designed to set expectations, and reduce patient regret.  Additionally, they protect the medical establishment by documenting due diligence in case of litigation.  Yes, the system can be gamed, many have.  And if the patient then has regret and turns around and sues for malpractice, this process can be used to show that the patient may very well have lied and their claims would be reduced or denied.

For example, I was offered my letters after only 6 months of RLE and had my surgery 4 months after that.  I'm one of those "less than a year" girls that Tekla was talking about, though I don't live in the Bay Area  ;).

But by that point, I was full time, I had transitioned at work, and had my name change, bought a house, and had an orchi.  It was never my intention to short cut the process, I had set my expectation to the one year guideline and I was more than pleasantly surprised when my therapist offered them to me without my requesting them.

But even then it is still up to the surgeon to agree that the patient is in the proper state of mind for the operation.  Having the letters does not *require* the surgeon to do anything.  If they think that the patient is still not ready, they can decline to perform the procedure.  That is one of the reasons for the pre-surgical consultation.  It allows the surgeon an opportunity to interview the patient and allow them the ability to decide whether or not to take on the risk of the operation.

If you are convinced you are ready and your therapist agrees, then I wish you the best of luck.  Keep us posted on your progress!

-Sandy

i would say they are verry loose guidlines and really dependant on who writes letters for you. I would not like to repeat my story but if i said i went under the radar and still got my surgery off a world class surgeon that is a good summing up. If you are ready, its your life, your body all this regret, we all regret how we was born thats real regret. I am living my life verry happily

Btw, Tekla certainly needs no one to defend them, but i was under the impression they know a great deal and decided a transition was not in the best interests long before many of us even considered it. I have every respect for Telkas opinion, good or bad

I think that it is a mistake to view RLE as a barrier – something to surmount or avoid, something to overcome as quickly as possible.  RLE is part of the process of transition, as much or more for the person transitioning as for the medical establishment.

Although we all wish to wake one morning transformed, we have to transition rather than be transformed.  And transition is a process that takes time – time that we use to adjust and adapt and learn and become.

Most of us have lived most of the time in our assigned gender.  No matter how much we are of the other gender in our heads and hearts, we don't have the experience with its many learning experiences of living in our needed gender day after day, in all sorts of different circumstances, doing the thrilling things but also the mundane and burdensome.  That's what RLE is for.

There are many nuances to living as a gender you weren't raised as and didn't experience through childhood and growing to adulthood.  You can't learn them from a book or just thinking about them.  You learn them by doing.  You have lifelong habits that you have developed and probably aren't aware of.  RLE is a time to shift those to the habits of the other gender.

After surgery you will live as your true gender.  You won't live in the way you are used to at work and the new way away from work.  You won't live in the new way all of the time except when you go to the public restroom.  You won't live your new life except when you visit your family.  You won't live part-time but day after day through good times and bad.  RLE is the time for you to practice for your much-desired new life, but it is also a time for those around you to adjust as well.

Unless you live in a nudist colony, very few people will see whether you have a vagina or a penis.  What they see is how you present yourself.  RLE is when you learn to consistently present yourself in your true gender.

Surgery brings all sorts of new challenges – pain, discomfort, the rigors of dilation, learning to pee, healing, caring for a changed body to keep it healthy.  Post-surgery can be a wonderful time, but it too is a time of challenge and adjustment.

Don't cheat yourself by trying to avoid RLE.  If two competent, experienced therapists say you are ready before the year, then you are probably ready, but for most of us there is a lot of work to be done so that we will be more likely to succeed.  RLE is a process that will help you live better and more fully.  Use it for your own benefit.

- Kate