I was wondering if anyone can give me any information on what's a requirement for top surgery with Dr. Garramone and Dr. Medalie. I haven't decided 100% yet on who I might go with just yet, but I'd like to get all the information I can first to help me out. Do they require more than one letter? Does it have to be phrased a certain way? What kind of insurance do they work with (if they do)?

Thanks if anyone can help make things a little bit smoother so I don't get any misinformation. I'm going to try to talk to my therapist next time I see her about arranging a letter for top surgery.

Dr. Garramone only requires one letter from a therapist.  Here is a quote from his website concerning the letter:

"We will need a signed copy of the Letter of Recommendation for Transgender Surgery from your therapist, psychologist, psychiatrist, or Primary Care Physician. The letter must state "Transgender Surgery is the next step in the transition process." "

He lists all of the steps here: http://drgarramone.com/before-surgery-info/

As far as insurance goes, he does not directly take insurance, but he may provide acceptable CPT codes for reimbursement.  The link about that is here:

http://drgarramone.com/insurance/

I'm not sure about Dr. Medalie though, but here is a PDF link from his website explaining the steps if you go with him:

http://www.clevelandplasticsurgery.com/wp-content/uploads/2010/12/bf2837698a453e60521d950a7fc77fcd.pdf

Medalie requires only a letter from a mental health professional. No requirement of pre-op physical/labs etc.

Garramone doesn't even require a letter, it is a simple check off box.  All your therapist has to do is check off the two required boxes, and sign it (it actually appears as though he has already checked them off, too!).  He has the "recommended" section, but it isn't necessary.

http://drgarramone.com/pdf/apsiftmrecommendation.pdf

You do have to have medical clearance for Garramone (means going to your PCP for a medical clearance visit.  Easy).

The letter or check off box doesn't really need to be from a therapist either. It can be from PHP.

--Jay

Thanks guys!