As we know the surgeon needs two recomendations. Is it possible that both come from psychiatrists?
Because the system thinks that I go to my surgeon here they do not write international recomendations. What kind of recomendations I should ask that they are internationally valid?

It seems to me that the SOC simply says that the second therapist should evaluate and confirm the first therapist's diagnosis.
The requirement that the second therapist should be a psychiatrist if the first therapist is only at a master's level
does not rule out them both being psychiatrists.
Neither of the letters are inherently limited in scope, they should work internationally.
I would insist upon having them in English, though.

It seems to me that generally somebody sees a therapist specializing in GID to have most of their therapy.
After they have received their first SRS recommendation letter, they visit a psychiatrist.
The psychiatrist's job is to be more of just a "sanity check" on the diagnosis and the patient.

The Standards of Care covers this on page 8.

Most Thai doctors have a "pet" psychiatrist who'll do an evaluation for you. Canadian and USA surgeons tend to be a bit more rigorous with the requirements. But there's no problem having two shrinks and the letters do cross international borders.

Just make certain that they are recent and have the shrinks send them to the prospective surgeon, that will give them an air of reliability that mailing them yourself will not.

Nichole