Hi everyone !

I'm currently looking for an affordable clinic that does GRS for 6000 to 8000 USD in Thailand. The problem is that I'm not doing HRT right now and I know that clinics in Thailand need a letter from a psychiatrist in my country and a local one (I think ?). I would like to know if this is something I can easily overpass since I'm not seeing anyone for this right now? I was planning to do HRT after the surgery.

Thank you !

Welcome to Susan's Place! Honestly, you're not likely to get a lot of support for this plan, primarily because so many people find that HRT solves the problem and they decide that surgery isn't necessary for them. Good luck!

Hugs Devlyn

Hi Devlyn. Thank you for your response. In know that this seems to be a little off the grid but searching informations on the web about Anti-Androgens, I couldn't find anything better, or as good as cyproterone wich has a lot of potential side-effects and is also linked with depression. I want my transition to be as effective it possibly can wich is why I thought about doing GRS. Thank you again for the responses !

It might be helpful understanding why no HRT. For example, if there's some kind of contraindication (even non-medical), then some physicians will take that into consideration. But generally there is a lot of benefit from HRT that comes much easier and inexpensive than any surgery. And, as indicated above, HRT resolves much (sometimes sufficiently) for many.

I'm not against HRT, i.e., Estradiol Valerate or Micronized Progesterone. I would rather not engage in anti-androgens since they are linked to multiple side effects and depression and are not as effective as GRS for body feminization and breast development.

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I would say don't knock HRT until you try it. Spirolactone is considered a very safe and effective anti androgyne with only a few manageable side effects. I never noticed any depression from it or estradiol. Most people here will tell you the benefits outweighs the negatives.


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I'm my view HRT is very important. My psychiatrist used HRT as a diagnostic tool as in "if you don't like the effects of estrogen then transition is not right for you" it was very harsh and did upset me a bit and even suggested that I might be just a confused gay male.

These days HRT and anti androgens are very safe (I was on ethyinal-estradiol and androcur) and if you do have surgery then you have to take HRT for the rest of your life. Surgery is a massive life changing decision and irreversible.

Estrogen doesn't just change your body, it also changes how you think and feel. In my experience the person i was before transition is almost a separate person to who i was after transition and that's not just because of the physical changes.

Saying all that, I was on HRT for 2 years before i transitioned, i did my RLT for 3 months then i had FFS and had SRS 3 months later. Surprisingly my psychiatrist agreed to it as i was "adjusted to living life as a woman" and i've never regretted it, even tho i was 20 at the time. 17 years ago the SOC were a bit lax with certain doctors and they used their own judgement.

My advice is start HRT and anti androgens for a year then decide if surgery is right for you.

DIY transition is never a good idea. see a professional doctor that has experience in dealing with transsexualism.

Sam x

You can take estrogen without antiandrogens, it just doesn't work as well for many of us. For some high estrogen blood levels will suppress testesterone and you don't need an antiandrogen at all. If you take estrogen only you'll know if you like it, and pass the hrt requirement.


There's srs surgeons in Thailand all the way down to US$2300, but the problem is finding much out about them. For the big names you can find heaps of posts and photos, so you have a fair idea of what you're getting and the risks.

You can get both psych letters in Thailand, but you may have a problem getting letters with no hrt. I've heard of people getting them without social transition, but not no hrt.

Like the above person stated, certain estradial delivery methods can negate the need for anti androgens. Apart from that, the depressive side effect is mainly the result of having low testosterone which can be mitigated with estradiol and progesterone.