I want to know if your doctor recommended you start the transition with hormones or surgery? What order did you do everything? Is each thing optional?

Hi Jake, welcome to Susan's. I look forward to seeing you around the forums. Good luck and Hugs
Mariah

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According to WPATH, order is optional. In my situation, I knew HRT was easier to obtain through my insurance, so I went for that first and my doctor had no objections. The other way around would have been a bother when top surgery wasn't covered, and some places won't let you have top at all if you haven't been on hormones for a given amount of time. So really, it depends on cost, which is bothering you most, what's available to you, etc. Lots of variables that are hard to tell without knowing individual situations.

Sorry if this wasn't much help, just stuff to think about, I guess?

Thanks, Mariah.

Andrew that was a good example. All I'm looking for is individuals stories on this.

Everything is optional until you reach the final stages of physical transition. There is no mandated order to anything. I would say most guys start with hormones and then get top surgery, but I think those numbers will very quickly reach an equilibrium in the next few years.

Bigger chested guys may opt for top surgery first in order to help them pass more effectively. I haven't heard of anyone starting with a hysto, but if you had issues with anything internally, I could see making a case for it.

To my knowledge you can't have any kind of lower surgery (meta or phallo) without having been on hormones. I can't think of any surgeon that allows otherwise.

Thank you for this helpful information, ftmax.

I had chest surgery a number of months BEFORE starting Testosterone, since I was uncertain if I really wanted to start hormones.  The process evolves differently for each individual depending on your particular needs. Remember, your physicians play a vital role in helping you achieve your transition goals, but YOU are in charge!  You should figure out what you want, and then present your carefully researched plan to your medical team, not the other way around!

QuoteThank you for telling your story. I like your hair.

My doctor had me start hormones first. I think it depends on what the patient wants and what the doctor is willing to do. My doctor was in his late 60s and probably thinks about the transition process differently than people do now.

The doctor I wanted to see required a letter from the therapist. My order was set based on my circumstances. I wanted my insurance to pay for everything.

Order:
Therapy
Hormones plus 1 year real life experience
Hysto/ooph
Top Surgery
maybe bottom surgery

....happily ever after