so on the fifth I'm most likely being taken on by a new therapist, that specailizes in sex, transgenders, and depression and disabiliatys. since she specailizes in Transgender people do you think she'd be capable to write up the ok for my chest surgery?
No idea. That's all up to her and the clinic she works for, if she isn't independent. My guess is she probably can, but it'll be best to ask her.
Also depending on the surgeon you are using you might not need a letter.
It depends on your surgeon. He may want a referral from just a therapist, or some type of medical doctor like a psychologist/psychiatrist, or he may want a referral from both your therapist and psych.
From what I understand, it depends on the surgeon and also the therapist. My therapist had a headquarters that is specific to trans related issues. After being in therapy for so long, the therapist recommended me to the headquarters. I then had to go in front of the committee to be approved and then the entire committee sent off letters to my surgeon. It was a bit of a pain of a process, but that way, the surgeon couldn't ask for more referrals since I already had 8 or so. Some surgeons only require one referral while some require two: one from a therapist and one from a medical doctor. Hope that helps!