i am preparing for my gender reassignment surgery, however im completly unsure of where to start, who to contact and how much i will need to save. I will be in contact with my insurance company today to find out information about that. But after ensuring i can afford it. I have a decent job as well. Where do i go, and what do i do?

It depends on your insurance and what they do and don't cover. Then depending on the surgeon that your going to use and if they accept that insurance or not. So the cost could go from hundreds of dollars to thousands of dollars. On top of that, you have the cost of traveling and the hotel, and food in the city your going to be having surgery in. Sorry that I couldn't give you a more exact response. Hugs
Mariah

I recenly read the insurance company coverage that my company uses which would include grs, breast augmentation, even some of facial hair removal can be claimed as medically necessary, just need to find out if my company has chosen those as a part of their ppo network.. This is my first time getting health insurance so i am very confused about a lot of it.. As i read my plan dictates that my maximum deductible is $700 and my maximum outta pocket is 6k in network and 12k out of network. I will have 15-20 grand for my portion by the time i figure out who what where and when, i just dont know how to start

There's quite a few different surgeons, but a few big names. Personally I think its important to look at the quality of their work. You can find a fair number of photo's online, just not as many as you'd like. You might also like to consider how often problems occur, how serious they are, and how responsive the surgeons is to looking after you post-op.

There's a fair bit of variation in price and in wait list time. Some surgeons have a wait list of a few months, others 2+ years.

You could spend a lot of time reading this site, and searching with generally google. There's a huge amount of information out there.

Work out what is important to you. Perhaps you don't want to travel, have a financial limitation, health issues, want it done now, etc.

Someone wrote up their experience going to one of the Thai surgeons, and it might give you some idea of what to consider.

https://www.the-ress.net/files/SRS-With-Dr-Suporn-2015.pdf

Where are you? There are some insurance improvements in usa from aca obamacare - most cities have lgbt support meetings to direct you to endo, electrolysis, surgeons - thailand has 'big 3' surgeon clinics (chettawut, pai, suporn) - find what is yours.

Hiya
My 2 pence.
I live in UK & am recently postop.
I could have had surgery free on the NHS but went private because most surgeons use non genital skin grafts to add depth to the vagina & this is where issues with necrosis &, shrinkage begins.

Start with the outcome you want.
Then look into the 2 types if GRS: penile inversion or sigmoid colon Vaginoplasty.
Decide which one suits you best.

My recovery time was 1 week. I had a penile inversion with NO skin grafts. Later I plan on getting the colon Vaginoplasty & this way recovery should be 10 days appx.

I travelled to Dr Narendra Kaushik in Delhi who innovated a 2 stage GRS. He's the premier surgeon to all Hijras in India for a reason: he's a genius.

Anyway my depth with dilation is average so I could stick with what I have. But I still want long term functionality so will return in about 6 months.

Just a few thoughts.

Oh yes there's an academic review online comparing health outcomes between the 2 types of SRS. Well worth a read.

Kindness to all
Victoria xx

Re: Prices

Yes sorry forgot to mention.

In India you could do the whole procedure in a single visit. I simply preferred to divide the work. This way allows for revisions too.

In USD Dr Kaushik's fees are roughly $6000 including 10 days in a private room. Medicines/DiagnosticTests & food on top. Expect another 1 - 2k USD.

PS
The biggest cause of complications is smoking. It affects blood supply. So if you smoke beg borrow steal but figure out how to quit!!

Victoria x

Quote from: MasterSifuVictoria on June 05, 2016, 02:07:28 AM
Oh yes there's an academic review online comparing health outcomes between the 2 types of SRS. Well worth a read.

Do you have a link?

Hiya. The link is here

http://www.ncbi.nlm.nih.gov/pubmed/25817066

The review will surprise many. Given how fast I recovered & I'm no Marvel comics super hero, I was up & fine in 1 week not bedridden for 4 - 12 weeks, I can only add my experience to say the skin graft addition is done as a matter of routine but borders on malpractice due to the pain levels, skin failure, utility & long term dilation needs.

For the kind of money involved, we deserve better than lazy GRS surgery IMHO.

Yours kindly

Victoria x

Re: Independent Research Sources

Hi Everyone

Also for those unfamiliar with a wonderful scholarship tool I highly commend Google Scholar be added to your arsenal.

There's a lot of misinformation out there & to help cut through the chatter to get to the hard peer-reviewed science one can start here.

You can check out all the university level research for SRS/GRS options and make an informed decision based on your health & personal goals.


https://scholar.google.lu/scholar?q=penile+inversion+colon+Vaginoplasty&hl=en&as_sdt=0,5

With all kindnesses
Victoria x

Quote from: MasterSifuVictoria on June 05, 2016, 03:38:12 AM
Hiya. The link is here

http://www.ncbi.nlm.nih.gov/pubmed/25817066

The review will surprise many. Given how fast I recovered & I'm no Marvel comics super hero, I was up & fine in 1 week not bedridden for 4 - 12 weeks, I can only add my experience to say the skin graft addition is done as a matter of routine but borders on malpractice due to the pain levels, skin failure, utility & long term dilation needs.

For the kind of money involved, we deserve better than lazy GRS surgery IMHO.

I found the PDF here

https://www.researchgate.net/profile/Sophie_Horbach/publication/274140536_Outcome_of_Vaginoplasty_in_Male-to-Female_Transgenders_A_Systematic_Review_of_Surgical_Techniques_Systematic_Review_Vaginoplasty_in_MtF_Transgenders/links/55f563db08ae6a34f6613fd6.pdf

Its from VU University Medical Center in The Netherlands, a place that as far as I know is not any kind of leader in trans medicine. I've seen papers from them before, and not been very impressed. I guess they get some kind of academic credit for publishing. Regarding this one, I've only skimmed it, but it doesn't seem to have anything interesting to say. As far as I can tell these results are all from surgeons none of us would have ever heard of.

Quote from: AnonyMs on June 05, 2016, 04:31:09 AM
I found the PDF here

https://www.researchgate.net/profile/Sophie_Horbach/publication/274140536_Outcome_of_Vaginoplasty_in_Male-to-Female_Transgenders_A_Systematic_Review_of_Surgical_Techniques_Systematic_Review_Vaginoplasty_in_MtF_Transgenders/links/55f563db08ae6a34f6613fd6.pdf

Its from VU University Medical Center in The Netherlands, a place that as far as I know is not any kind of leader in trans medicine. I've seen papers from them before, and not been very impressed. I guess they get some kind of academic credit for publishing. Regarding this one, I've only skimmed it, but it doesn't seem to have anything interesting to say. As far as I can tell these results are all from surgeons none of us would have ever heard of.

Seriously?

Big LOL

This is a standard meta review from "The International Society for Sexual Medicine"

And just because the names of surgeons are new to you in no way negates the quality of work.

This is the entire reason why there's the "Peer Review" system in science!! To avoid the fallacy of popularity.

Just because some surgeons are well-known to our community does not - from a scientific point of view - mean these celebrities are actually superior. Not by a long margin!

Too funny

Kindly
Victoria x

Quote from: MasterSifuVictoria on June 05, 2016, 04:48:10 AM
Just because some surgeons are well-known to our community does not - from a scientific point of view - mean these celebrities are actually superior. Not by a long margin!

What relevance does it have if none of us would ever go to these surgeons? Especially when it doesn't compare them to the ones we would go to.

Quote from: AnonyMs on June 05, 2016, 04:55:04 AM
What relevance does it have if none of us would ever go to these surgeons? Especially when it doesn't compare them to the ones we would go to.

Dear AnonyMs

Personally I select a surgeon based on reputation among other surgeons in their field not based on the flashiness of their website or Google AdWords marketing.

The way to look passed the marketing fuzziness is scientific journals & to find the best among the peer group.

If this happens to correspond with a celebrity surgeon all the better but celebrity as a criterion for putting a scalpel to my anaesthetised body ... Never going to happen.

As for those celebrity GRS surgeons I have a good number of friends who have paid shocking sums of money for less than adequate sometimes Frankenstein like results.

Which I feel blessed to have avoided by being lucky enough to find a different way.

I remain absolutely convinced we should use the hard research, locate the best surgeon according to the peer group of other surgeons and request their services.

I sincerely hope I've answered your questio.

With kindnesses
Victoria xx

I think you misunderstand me. Normally I'm all for scientific research, but I don't regard getting published as a good measure of quality. Far too much of it is rubbish.

I have little regard for flashy websites, etc. I actually like Suporn because he doesn't do any kind of advertising or marketing and is still a top ranked surgeon. His website is also very poor.

Quote from: AnonyMs on June 05, 2016, 05:38:42 AM
I think you misunderstand me. Normally I'm all for scientific research, but I don't regard getting published as a good measure of quality. Far too much of it is rubbish.

I have little regard for flashy websites, etc. I actually like Suporn because he doesn't do any kind of advertising or marketing and is still a top ranked surgeon. His website is also very poor.

Dear AnonyMs

I understood perfectly well hun.

But "publishing" in a scientific journal is not quite the same as slapping an article up on a blog. Peer review is a thorough process of vetting quality.

I'll add only this ... having consulted with Dr Suporn directly, I didn't select Suporn due to his GRS techniques of choice, differing beauty aesthetic, and the recovery experience of friends.

However he may be the surgeon for you and I wouldn't wish to dissuade you if he provides what you're seeking.

With kindnesses
Victoria xx

Quote from: AnonyMs on June 05, 2016, 04:31:09 AM
Its from VU University Medical Center in The Netherlands, a place that as far as I know is not any kind of leader in trans medicine.

I think your post reveals something of the trans-atlantic information divide - that is to say that from an American perspective I guess that statement makes sense, but here in Europe it is indeed well known in professional medical circles as a major eurpoean centre of expertise and excellence in transgender medicine. Many european advances in the field came from there and indeed the associated Vrije Universiteit in Amsterdam was the first medical research facility to appoint a Professor of Transgender medicine in the 1980's - which chair was held for many years by Professor Louis Gooren - who has done much to advance understanding of the condition and its management on this side of the pond.

Sadly his work in the 1980's was largely ignored in the USA because it pointed firmly to a purely biological and not psychiatric etiology for the condition, and at the time this did not sit well with the religious and indeed medico-finance vested interests in American society.

Anyway I just wanted to correct your impression that this was not a centre of expertise in the field. At my medical school in London UK you would find that VUMC is indeed regarded as exactly that.

Quote from: Rejennyrated on June 05, 2016, 06:27:57 AM
I think your post reveals something of the trans-atlantic information divide - that is to say that from an American perspective I guess that statement makes sense, but here in Europe it is indeed well known in professional medical circles as a major eurpoean centre of expertise and excellence in transgender medicine. Many european advances in the field came from there and indeed the associated Vrije Universiteit in Amsterdam was the first medical research facility to appoint a Professor of Transgender medicine in the 1980's - which chair was held for many years by Professor Louis Gooren - who has done much to advance understanding of the condition and its management on this side of the pond.

Sadly his work in the 1980's was largely ignored in the USA because it pointed firmly to a purely biological and not psychiatric etiology for the condition, and at the time this did not sit well with the religious and indeed medico-finance vested interests in American society.

Anyway I just wanted to correct your impression that this was not a centre of expertise in the field. At my medical school in London UK you would find that VUMC is indeed regarded as exactly that.

I can't respond to this properly since there's some things I don't discuss here.

I'm in Australia, and don't have a whole lot of respect for trans medicine anywhere. I believe there are a few bright spots, but on the whole its a neglected field.

Briefly looking at that paper and some in the past doesn't inspire much confidence. I don't mean to be rude, but nothing I've read online, and its a fair bit, makes me feel good about the state of trans medicine anywhere in Europe.

Normal inversion is the least hassle and if you had enough donor material that's fine, but all the best surgeons either have mandatory or optional scrotal graft use.

By the sounds of the OP they want it done locally for insurance.

Quote from: Serenation on June 05, 2016, 11:27:05 PM
Normal inversion is the least hassle and if you had enough donor material that's fine, but all the best surgeons either have mandatory or optional scrotal graft use.

By the sounds of the OP they want it done locally for insurance.

Hiya Serenation

Felt I best clarify. Scrotal skin graft isn't the type of skin that presents difficulties. In fact scrotal is ideal.

Unfortunately for trans women who've been on HRT for some time there's a lot of shrinkage. As a result to create depth in the vagina surgeons are using abdominal skin for example. This type of skin is in the main incompatible with genitalia & is too often subject to necrosis, low blood flow, shrinkage etc.

Kindly
Victoria xx