This comes from a discussion in the post-op forum but the point is not post-op specific.

When looking back at my own transition I realized that my doctors and therapists saw SRS and transition as inseparable - one could not be done without the other. The idea that one might not want SRS was so foreign to them that never, in 20 years of dealing with therapists and 4 of dealing with endocrinologists, was I asked if I even wanted SRS. Sure they spoke much about "when you have SRS..." but it was always assumed that I would.

I had a doctor who did sort of the opposite. He assumed that I wanted SRS because I wanted to transition and tried to talk me out of transitioning to protect me from killing myself because I'd have surgery I'd later regret.

But my competent therapists didn't ask or assume, though I freely came to my therapist once I'd begun thinking about the possibility. She made it clear that she would accept and support whatever decision I ultimately made.

I only ever had 1 gender therapist.

She and i worked through my process as i needed.

It was my decision based on my body dysphoria and suicide attempt.

I was never pushed into anything in my entire process.

I also was totally informed of the process when the time came, risks and also the possible of regret.

I am a adult and i made the decision and responsibility for my own needs be it happy or not.

Quote from: mrs izzy on September 15, 2014, 12:58:08 PM
I was never pushed into anything in my entire process.

I also was totally informed of the process when the time came, risks and also the possible of regret.

I am a adult and i made the decision and responsibility for my own needs be it happy or not.

I'm truly impressed with your providers. Mine pushed me heavily on a lot of matters that just don't make any sense, e.g. that I didn't wear skirts, heels, and full make-up was a major problem to the endos, and motorcycle riding was a problem to the main therapist. The lack of real information about risks and regret was a major problem with the providers in my area, going in both directions. They seriously oversold the DVT risk (not that it doesn't exist, but I did not have the aggravating factors and was only on very low E doses,) and insisted that nobody who completes RLE ever regrets transition or surgery.

My therapist has asked me about SRS exactly once...

When I was having a really awful self-critical bout of depression, and went on whining and whining about how I couldn't see a girl in the mirror, she asked me "is it the penis?"

That's it.

During our very first session I might have mentioned that I felt uncomfortable with my genital anatomy, but pretty much her entire mantra through this whole process has just been helping me sort out my own thoughts. She said she'd write me a hormone letter or a surgery letter any time I wanted, even if she didn't agree with me. She'd let me know if she ever saw a red flag and disagreed with me, but she believes that it's not her job to tell me what I need to do with my own life if that's what I want.

So yeah... she would have written me an HRT letter even if I had not wanted the surgery, and she's only mentioned it once or twice total in the 18 months I've been seeing her.

I went into the process knowing I wanted GCS, and I was made aware from the outset of the risks and what I had to do in order to get GCS. I wasn't forced into anything and actually fudged the dates of my RLE in order get surgery two months earlier than I should have done. At every step of the process the risks and benefits were discussed. I think things are different in the UK compared to the US, the whole process is more structured.

Quote from: Dread_Faery on September 15, 2014, 02:25:32 PM
I think things are different in the UK compared to the US, the whole process is more structured.

I found it to be extremely structured, but in the most restrictive way. For example, my gender therapist effectively made misrepresenting the data of starting RLE extremely difficult because she would only count it as beginning with the first session after I went FT and presented her with the documentation of having done so (so I lost a month of actual RLE there...)

That said, they were far less structured when it came to my benefit. After satisfying all of her requirements for a surgery letter she still refused to write it for six months. No reason ever given; she just went incommunicado for that time. I actually saw another therapist and another first surgery letter was mine for the asking (she actually said, "give me the fax number of the surgeon and I'll write and fax it today" an hour after I received confirmation that my first therapist had finally done so.) It's like in the US many approach it as "the rules are only for you, not for me. I can do whatever the heck I want."

No, I was never asked.
During my last session I expressed how I did want top surgery.
She asked if I had a surgeon in mind and I told her Dr. Garramone. She knew him and said she worked with him often and was glad that I had him in mind.
She then said the following, I will have a letter for HRT (T) for you in about 2 weeks. You will probably start T in October.
She also said: I recommend you wait at least 6 months before getting top surgery. Not because I am afraid you will detransition but because I would like to see you back in my office in about 5 months. If you are doing well on T I will be more than happy to write a letter for Top Surgery at that time. Now, by law, you don't have to wait if you don't want to. So in actuality, if you are ready and have the money for Dr. Garramone, and want to have the surgery in 2 months all you have to do is let me know.

My plan is: Get on T  and be on it for 6 months because I know that the typical time period for fat redistribution happens around this time and also I'll be building up my chest muscle. Then, once I have all the funds, ask for a letter for top surgery to Dr. Garramone. I told her this and she said that this was a good plan. That I obviously thought about it and I am well on my way.

I've had 2 GT appointments. I have 1 more to go. Then she will write my letter for T. Then I will have another appointment with her in 5 months. Since I am doing well there is no need to see her so often. We won't have things to talk about. But if I really need to see her all I have to do is make an appointment and she will see me.

I couldn't be happier. My therapist has been amazing. She knows more about me than my own family. It makes me a little sad but I know that I have my therapist to help me work things out if I need to talk about the changes going on.

For right now I don't want bottom surgery and it never came up in conversation with my therapist.

I think i was asked once, right at the start if that was my intention - at that stage my answer was "unsure". My answer has since changed to "yes" but to my recollection it hasn't been discussed - too many other things to talk about at the moment I guess. In any case none of the professionals I'm seeing seem interested in pushing me into SRS, they're happy that my transition is going well and the choice of how far I take it appears to be up to me.

Quote from: 2fish on September 15, 2014, 02:47:26 PM
She asked if I had a surgeon in mind and I told her Dr. Garramone. She knew him and said she worked with him often and was glad that I had him in mind.

I've had 2 GT appointments. I have 1 more to go. Then she will write my letter for T. Then I will have another appointment with her in 5 months. Since I am doing well there is no need to see her so often. We won't have things to talk about. But if I really need to see her all I have to do is make an appointment and she will see me.

Nice! My top two choices were Bowers and McGinn; my therapist said "then you'll have to start over with another surgeon" (this was after I had finished the RLE - she told me she would only write a letter for Brassard or Djordjevic.) She and the endos also required that I stay in therapy at least monthly until I had SRS.

My therapist did ask, but in the context of exploring what I wanted from her. I thought that was reasonable, because she made it clear that the answer didn't affect her willingness to treat me. When I said I probably did want GRS eventually, she said to let her know when she'd need to write the letter. (Same thing for HRT; she said I was clearly stable and well-adjusted and she'd write whatever I wanted, whenever I needed it.) I was lucky to get one like that on the first try, but I was willing to walk if I got a therapist who tried to thwart me.

She also basically let me stop coming after the first year, so long as I checked in occasionally until I needed the letter. Once I'd had GRS, I was done with therapy too.

I liked this method, really. It gave me some support if I needed it, but for the most part I was "informed consent in actuality if not on paper" : my endo also never bothered to read the letter, and my GRS prep consisted of reading the required paperwork on potential complications, etc. *very* carefully.

Just the opposite.

Both therapists, lead and second opinion, and my surgeon were very clear. Don't have SRS unless YOU want it. Your decision don't be rushed and don't let anyone talk you in to it. Unless you are 100% clear that you want SRS don't - and that was from my surgeon

I will admit that I had no discussion of the sort with my surgeon..The first time that I spoke with him was for maybe 5 minutes immediately before I was ushered into the OR.

The reason I stayed with that one was at least getting some progress. The only other gender therapist then active in the area had denied friends HRT letters even after they were FT for more than a year.

I informed my doctors and therapist that I wanted srs, so no they never asked 

I was never pushed into any decision of any kind. Through our therapy sessions I became more sure than ever because it was right in my situation. They were very happy just to provide enough treatment HRT, etc., to help my Dysphoria. Full time does not start until you present as your gender, so I was in therapy a few months before I did. The first day I ever presented was my last as a male. They have been amazed by my progress because they did not tell me how I should feel, but let me figure it out on my own. I would recommend mine to anyone struggling with this issue. They were respectful, caring and made sure the path I was on was right for me. Kudos Oklahoma State University Psychology department!!! 

my therapist and  I  talk about it  all the time, but  it's  totally my  call.

I thought that I had information, but I had well-disguised persuasive propaganda. Lack of information is better than misinformation, IMHO.  I have never said that I was forced, but I was pressured in the extreme, including being denied continuation of HRT more than once, etc. In the same way many argue that I consented to orchidometer exams, which were unnecessary, but when the choice is to go without HRT... I was only able to change doctors when I went HIPAA on my therapist's rear for a copy of my file because she directly refused to give me a copy of my HRT letter.

My first day presenting as myself was the day I transitioned at work. That I never did "part time" was a serious issue to my providers for reasons I don't understand.

I was asked by my Endo once. Actually, it was more of like an assumption: "So you'll be having Gender Reassignment Surgery then?" once he heard my full story, to which I answered with a resounding "yes!"

While I do wish I had a therapist to talk to about difficulties when they arise. None with gender experience are close to me. I'd like to find a therapist who'll see me virtually. since there isn't one close enough for me to drive to.

Ally

The reason I asked this is mostly that my "main" gender therapist (she was by no means the first, but she was the first who didn't feel that being trans made one a danger to oneself and/or others - the whole "mutilation" BS) and my first endo asked me about my plans for SRS at length, even years before I was FT or prescribed any HRT. Though they never directly said it, it be came apparent from the preponderance of evidence that they felt wanting to have SRS was somehow important for getting HRT and social transition.

After the point that I had started HRT, however, they simply assumed that I did (and, I believe, that anyone who got that far automatically wanted SRS, too.)

I think I was given the advice to "really consider if I really want surgery" (meaning GCS/GRS) much more often than people assumed that I would do that as well. There was in Germany at that time the "small solution" and the "big solution" to the issue of being transsexual. The "small" one was to go on without a surgery and just hormones and maybe non genital surgeries. It meant however to not get a legal gender marker change, just a name change. Sadly many people at that time did surgery for that reason alone - to have a legal gender marker change. In 2011 that was dropped on human rights basis and now one can choose.