Hey everyone!!! So I've been out as FTM for a while now and my family is just starting to be okay with me doing physical transitions. But I have a slight issue in that I have no idea where to start doing research! I know that I want to get top surgery done before I start T but I also have no idea how to go about finding a surgeon/finding the right hormones? So my question is: how did you start your physical transition and what first steps did you take?

I'd suggest searching "ftm (insert your state)" on Google, or maybe a pride center in your state/area. The one for my state had all of that information on our pride website. If not maybe ask your family doctor. I got my hormones from an informed consent clinic so other guys might be able to help you better than I.


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The first step would be to locate a gender therapist. There are thoughts you need to explore, letters that will need to be written to the doctors involved, and transitioning has it's own set of problems. Once you are in therapy, the guys can provide you with information on the surgeons. It's pretty common to start T before surgery as you will have a wait before surgery would be approved. Also T changes somewhat how you view the world had your transsexualism so you will be surer about the surgery. Should you have trouble locating a therapist in your area, the board knows of several who work online.

Little side note -- I'm doing top surgery before T as well.  Most surgeons seem pretty comfortable with it, although I can only really speak with confidence re: Dr. Garramone, as he's the only doc I've had a consult with.

Okay, yeah thanks everyone! I am seeing a gender therapist later this month but she is only a certified counselor I think. Could she still write me the recommendations and such or does it have to be from a psychiatrist/psychologist?

This is actually a lot to answer. This may be a long post, so I apologize in advance if it's all over the place.

The first step I personally took towards physical transition was contacting my local LGBTQ center regarding their need for mental health referrals. I wanted to be sure that if I was going to spend money on a therapist, that they would accept their referral. As it turns out, I didn't need a referral to start T at all, as they're an informed consent based clinic. So I went ahead and started T without a therapists's involvement. For top surgery, I had a few sessions with a therapist over about a month, and he wrote my referral. I had top surgery less than a year after coming out, having been on hormones for 4 months.

You do not need to be on T to have top surgery. It is no longer a part of the guidelines, and many surgeons are totally fine performing the surgery on you pre-T. That being said, a few pieces of advice:

- Figure out what procedure you want to have done. There are several. Some surgeons are better than others at specific procedures. Narrow your search based on procedure and then surgeon. YouTube and Transbucket are great resources for looking at results.

- Figure out how you're paying for it. Some surgeons do not take insurance. Some insurers have certain requirements you need to fulfill before they'll cover your surgery (mental health referrals, X number of years on T, etc.). It is much better to do your research in advance and plan ahead than to jump in and have to backtrack.

- Find a therapist, if not for your mental health just for the sake of getting your referral written in advance. There are very few surgeons who will perform surgery without a referral from a therapist. It doesn't have to be a big ordeal. My sessions were online in a chat box and lasted about 45 minutes once a week for four weeks.

- Start looking for a doctor for T. If there are LGBTQ resources in your area, approach them and ask. They almost always have a good idea of what is available. Planned Parenthood does HRT at many locations, but not all of them. You would need to call and ask at each specific office. Barring those options - anyone who can write a prescription can prescribe HRT. Could be a family doctor, nurse practitioner, an endocrinologist, gynecologist, etc. You would just need to ask around until you find someone willing. They will take care of the specifics as far as what kind/dose/frequency of T to put you on.

Quote from: tarfish on September 22, 2015, 05:56:53 PM
Okay, yeah thanks everyone! I am seeing a gender therapist later this month but she is only a certified counselor I think. Could she still write me the recommendations and such or does it have to be from a psychiatrist/psychologist?

She can write one. Psychiatrists/psychologists (someone with a PhD) is needed for bottom surgery referrals, but not for top surgery.

I began transitioning with chest surgery, as I was not quite sure what other steps, if any, I wanted to take.  I knew that for me, chest surgery was very important for my well being.  My surgeon did not require a letter from anyone.  I started T a number of months following surgery, and had a hysto a few years after starting T (more about medical necessity than dysphoria).

Decide what it is that you really need, prioritize, then focus your research on your priorities.  It is YOUR body, YOUR life, YOUR health...Do it YOUR way!