Quote from: Padma on July 05, 2011, 01:34:38 AM
Actually, there are plenty of gender therapists in the UK - i.e. therapists who have undertaken training in that specific area and who have experience working with clients with gender issues. You can find them on this website (I found my current therapist on there):

http://www.counselling-directory.org.uk/gender-identity.html

I didn't know that! In my early days I went through a local psychiatrist and then six long years with psychiatrists at Charing X GIC.

Quote from: A on July 05, 2011, 11:45:25 AM
Uhm, no, actually, that's where we disagree. You need to go to the general practitioner who will refer you in radiology to see if there's a tumor, and if it's a confirmed cancer, then you're going to be referred to an oncologist. If everyone bothered specialists directly with problems that could possibly not require them, the system would fail.

But it seems to work radically differently over where you are. You are in the US. Since you pay for everything there, whereas if you are poor you get nothing at all, if you have money, you have a lot of freedom. Here, unless you're rich AND you live in a big, big city, you don't "shop" for a physician. Most of them are in the public system. You get the one the system deems the best for you.

As for who I have seen, the three first were not gender-specialized (but I had started seeing them for something else anyway). The last one is. He's actually THE specialist around.

actually, i have to disagree with you about this. I had stage three renal cancer. The only reasons why you would go to a General practitioner first if 1. You had no idea about the cancer and the GP found it and you were referred to the oncologist and 2. Some insurance carriers require you to get a referral from your GP for an Oncologist.

But no, you would not see your General Practitioner for your process of eliminating carcinoma cells from your body.

This is what I meant by comparing it to Psychiatrist. You would not see a general Psychiatrist for a gender specific issue where a general Psychiatrist may have little or no experience with.

So you can't blame all Psychiatrists for being lousy. You would need to see out a gender/sexuality educated Psychiatrist and if there is no one in your area, then you would need to seek out a Psychologist (Ph.D) educated in sexuality/gender related issues per the WPATH.

But don't discount all Psychiatrists. They are all not bad as one would think if you really look for one that can meet your needs.

How could you know about a tumor without seeing a general practitioner first? Oo

Anyway, I'm not going in the right direction here.

I am not discounting them all. Psychiatrists are useful. I just don't think they are a good first step. The gender-specialized psychiatrist in my area has not been very useful yet. Plus, a psychiatrist is a physician. It's not his job to help the person come to terms with their gender identity and treat other conditions, and psychologically support the patient towards transition, etc. The psychiatrist is there to assess, diagnose, prescribe, inform and test readiness. That is what I have been told.

My main point is that seeing a psychiatrist right away may not be the best move, unless he's very soft on the SoC requirements of readiness or the patient is quite fine in every field except gender. Perhaps my psychiatrist is special in that way, but he requires concrete, correctly presented and durable proof of very significant progress in all spheres of my life, probably until every possible cause of mental discomfort is pushed aside and he "has" to give me his approval for transition.

Until now, he has not quite helped me, except with medication for my concentration. He has been requiring things from me, simply. And if I were needing to decide, analyze my problems, understand them and get mentally ready for transition, he would not be the one to help me do so. I would have needed a therapist.

In fact, I did need to see a psychologist to 1. understand his goals and instructions and 2. learn to endure my temporary male status and live functionally regardless. I would have probably caved in without that psychologist. The psychiatrist did not think I needed it.

So perhaps I am absolutely wrong, but my experience seems to show that a psychiatrist is not really the first person one should see. I think this is even more true in the case of a trans person just discovering, accepting and understanding their state such as the topic author. Therapy is useful and even essential for many people, and I regard that as the "true" basic towards transition.

But then again, the psychiatrist is still stalling me. Perhaps when he starts moving I will change my mind.

Quote from: A on July 05, 2011, 07:39:16 PM
How could you know about a tumor without seeing a general practitioner first? Oo

Read my response...i stated you would see a general practitioner if you didn't realize one was there and the GP found it. Then you would be directed to an Oncologist who is better suited to deal with it.

QuoteAnyway, I'm not going in the right direction here.

I am not discounting them all. Psychiatrists are useful. I just don't think they are a good first step. The gender-specialized psychiatrist in my area has not been very useful yet. Plus, a psychiatrist is a physician. It's not his job to help the person come to terms with their gender identity and treat other conditions, and psychologically support the patient towards transition, etc. The psychiatrist is there to assess, diagnose, prescribe, inform and test readiness. That is what I have been told.

This is because you had a bad experience. I thought, based on your prior experiences you stated you went to a generalized Psychiatrist and not a gender specific one. It is their job to help people with their gender issues. A Psychiatrist is a Psychologist with the power to Dispense medication.

Many Psychiatrist will also do therapy work with you. All of mine did....they weren't just there to dispense medication. If you went to a general psychiatrist where he or she knew you were also seeing another therapist for the therapy work, then yes, the Psychiatrist will just be there to give you the medication you need. If this person is your sole therapist, then the psychiatrist would also help with therapy. But you need to find one who has the background to help those transition. A psychiatrist is a wonderful first step if you can find one that will meet you needs.

QuoteMy main point is that seeing a psychiatrist right away may not be the best move, unless he's very soft on the SoC requirements of readiness or the patient is quite fine in every field except gender. Perhaps my psychiatrist is special in that way, but he requires concrete, correctly presented and durable proof of very significant progress in all spheres of my life, probably until every possible cause of mental discomfort is pushed aside and he "has" to give me his approval for transition.

Until now, he has not quite helped me, except with medication for my concentration. He has been requiring things from me, simply. And if I were needing to decide, analyze my problems, understand them and get mentally ready for transition, he would not be the one to help me do so. I would have needed a therapist.

In fact, I did need to see a psychologist to 1. understand his goals and instructions and 2. learn to endure my temporary male status and live functionally regardless. I would have probably caved in without that psychologist. The psychiatrist did not think I needed it.

So perhaps I am absolutely wrong, but my experience seems to show that a psychiatrist is not really the first person one should see. I think this is even more true in the case of a trans person just discovering, accepting and understanding their state such as the topic author. Therapy is useful and even essential for many people, and I regard that as the "true" basic towards transition.

But then again, the psychiatrist is still stalling me. Perhaps when he starts moving I will change my mind.

Then I would think you need to fire that psychiatrist and look elsewhere. Also, I do not know your mental background so I cannot comment, but I know some transwomen that have a LOT of mental issues that the transwoman swears they don't have but I can see it clearly. They say their psych is giving them hell and holding back their transition when I am thinking to myself (well, then the psych is smart!).

Now, I am not saying you have mental issues because I do not know you, but if someone comes in being depressed all the time or have really bad depressing moods, then I would be hesitant to let the person transition as fast as they want too. Again, I am not saying this is you but many transgirls I have met truthfully has a lot of mental co morbids they must sift out before the Psych will continue onward.

I recognise my "mental health" issues and do not blame him for considering them. However, I think he is doing the "useful" before the "essential", and as he is very intimidating, I cannot convince him of my advancement if I don't prepare properly.

As for firing him... As I said, this is a psychiatrist, not a secretary. I had the CHANCE to be allowed to see him. I can't "fire" him. He's the one and only specialist.

Hi Anna,
if the whole country (SA) has ONE approved "gate-keeper" so all these good questions (reply # 18) are worth zilch, nada, nothing.
You either take it or leave it.
Unless you can afford to go oversees for GRS etc.

Most folks here JUST DON'T HAVE THE MONEY (say ~US$15k for Thailand, incl. airfair, stay, etc.), and so are FORCED to go to this one and ONLY State hospital approved guy.

I've seen girls with legit "letters" approach the State hospital (Steve Biko Academic Hospital) they are all send back to go to this one and only dude.

Him being gay, I'm sorry to say, does not much help transwomen either. I speek from first hand experience - he actually does not like females as such. Surprised?
Axelle
PS: Reading what A had to say about his psychiatrist is my own exact experience. Also how much "therapy" for 15min a month will you get?! NOTHING. CAN'T BE FIRED AS HE IS THE ONLY ONE.
PPS: As I said earlier also and again as A mentioned, going to Psychologist was one day and night difference, a life saver.
PPS: That "gate-keeper" was nothing other then a point scorer and one unhealthy control-freak to boot. Like if I'd cry (the one time) he ends the session, I'm dismissed!!! He just want to see a happy cheerful woman that has no problems so he may pass you after you seen him 12 month according to the "Bejamin rules" and you may march. Takes your bucks and cheerio.

Quote from: Axelle on July 06, 2011, 01:37:41 AM
Hi Anna,
if the whole country (SA) has ONE approved "gate-keeper" so all these good questions (reply # 18) are worth zilch, nada, nothing.
You either take it or leave it.
Unless you can afford to go oversees for GRS etc.

Most folks here JUST DON'T HAVE THE MONEY (say ~US$15k for Thailand, incl. airfair, stay, etc.), and so are FORCED to go to this one and ONLY State hospital approved guy.

I've seen girls with legit "letters" approach the State hospital (Steve Biko Academic Hospital) they are all send back to go to this one and only dude.

Him being gay, I'm sorry to say, does not much help transwomen either. I speek from first hand experience - he actually does not like females as such. Surprised?
Axelle
PS: Reading what A had to say about his psychiatrist is my own exact experience. Also how much "therapy" for 15min a month will you get?! NOTHING. CAN'T BE FIRED AS HE IS THE ONLY ONE.
PPS: As I said earlier also and again as A mentioned, going to Psychologist was one day and night difference, a life saver.
PPS: That "gate-keeper" was nothing other then a point scorer and one unhealthy control-freak to boot. Like if I'd cry (the one time) he ends the session, I'm dismissed!!! He just want to see a happy cheerful woman that has no problems so he may pass you after you seen him 12 month according to the "Bejamin rules" and you may march. Takes your bucks and cheerio.

Oh, I am anything but rich. Trust me.

I make about 5000 US dollars a year and I have no medical insurance either. I also lived in an area where the closest Gender Psychologist was 3 hours away. Trust me, I had to be very resourceful.

I kept searching for a gender psychiatrist that payed on a sliding scale and I did find an awesome one. She charged me 40 dollars a session for two one hour sessions a month.

For my HRT and SRS costs, I have various churches helping me with that income. So yeah, i know how hard it can be to transition.

40 dollars a session. One-hour sessions. Two sessions a month. This is luxury, a dream. It does not exist here. Psychiatrists are busy and if you are lucky, you get one 30-minute session every two or three months. They don't have time to do things like therapy. And here, there are free psychiatrists. If you want to choose, to "shop" for one, you get one of the few private practitioners. Those charge hundreds of dollars an hour because private things are for the rich.

Here, 40 dollars an hour is what a BEGINNER, VERY CHEAP psychologist charges. Not one physician, especially a psychiatrist, will charge that low.

Hell I don't charge that low.

Quote from: A on July 06, 2011, 10:56:41 AM
40 dollars a session. One-hour sessions. Two sessions a month. This is luxury, a dream. It does not exist here. Psychiatrists are busy and if you are lucky, you get one 30-minute session every two or three months. They don't have time to do things like therapy. And here, there are free psychiatrists. If you want to choose, to "shop" for one, you get one of the few private practitioners. Those charge hundreds of dollars an hour because private things are for the rich.

Here, 40 dollars an hour is what a BEGINNER, VERY CHEAP psychologist charges. Not one physician, especially a psychiatrist, will charge that low.

have you called them and asked if they charge based on a sliding scale?

Also, my Psychiatrist is not a beginner nor is she "very cheap." She has had years of experience and she has a very good reputation. So don't think because a Psychiatrist is charitable makes them desperate or new.

Also, A, have you looked into these Psychiatrists..,there in your area:

http://www.mcgill.ca/cosum/about-us

Quote from: Annah on July 05, 2011, 11:31:47 AM
Did you hire a Psychiatrist that was specialized and trained in Gender Issues? Or did you picked a Psychiatrist that was a "general" psychiatrist?

When it comes to gender transformation, you need to pick a psychiatrist that has notable experience in the fields of gender studies and sexuality. Personally, I would never pick a Psychiatrist from a generic medical clinic. I shop for mine...make sure they do have the experience to help me transition.

I'm glad you found such a great therapist/Psychiatrist. I've seen you post many times in favor of the present standards of care etc. I personally think it's insulting and abusive. No other elective treatment requires this sort of craziness.

The "gate keeper" I dealt with was a post op TS, so I would assume she knows about transition. She has written several books on the subject and regularly gives speeches at events etc. She also runs a TG support group. I had been living full time for over a year, had my name changed etc etc before I went to see her to get "my letter" to start HRT. Actually my Doc had prescribed spiro at HRT levels (for my blood pressure....) about a month before so I explained I liked what those were doing, that I have been full time for over a year, I'm not depressed, actually I've never been happier. According to the "standards of care" I met all the requirements for HRT before we ever talked.  I had no idea what to talk about so just told her about what going full time was like and the challenges I had faced. She started telling me how my dead mother was still controlling my life and other nonsense in response O.o  I babbled through multiple sessions before she finally gave in and gave me a letter, after spending hundreds of $$. I even told her "I feel like I'm fighting for your permission to do HRT" which she got all huffy about. Maybe some people have other mental problems but I think if someone has ALREADY done the "real life test" full time for over a year, has transitioned to living as a woman etc,  having to see a therapist to get permission to do anything is WRONG.

Being TG isn't a "mental disorder" IMHO, anymore than being Gay is. Us being in the dsm iv is NOT something we should want or stand for, yet some people seem to embrace it. They used to have Gay and Lesbians as a mental disorder but they finally got themselves taken out and we should be as well.

I think the TS's who LIKE this being called a mental disorder have convinced themselves "I am not TG, I am a female who was born with a birth defect". Even in that case it's not a mental disorder. Or want to believe that they lack any free will about this, "Don't judge me, this is a medical problem like cancer or some other disease". That they refuse to just say "I am happier living as a woman, end of story". I honestly do NOT want people to pity me for having some "uncontrollable disease", they simple have to accept I am happier living as a woman. God doesn't make mistakes and I was intended to be this way. No excuses needed.

Maybe at one point it helped a VERY few people get GRS paid for by insurance early on being classified as a metal disorder, so it was medically necessary to correct. But those days are over. Now it's treated like a boob job or any other elective surgery by insurance. The only thing that might be covered is this unnecessary therapy O.o Being in the DSM just complicates everything and creates a situation where perfectly sane people are subjected to mental therapy because it is ASSUMED anyone who want to live the opposite of their birth gender clearly must have a mental problem, i.e. must be crazy! These rules were written by cisgendered people, just like it was straight people that included Gays and Lesbians in this same diagnosis years ago.

We -should- be fighting against this being considered a mental disorder but instead it seems many people embrace this, which I really just don't understand at all. All these treatments we desire should be set up under informed consent and have someone (the doctor should be able to do the following) go over in detail that we understand what we are doing, the possible problems that could arise and that we are of sound mind when we agree to this. I can get FFS by this model, which is going to change my appearance more than HRT ever would. Why do I need to be diagnosed as having a mental disorder for one but not for the other?

No one here charges on a sliding scale. Either you charge, either you don't. If you're charitable, you go on the public system and get paid less on top of having an unpleasant work schedule. If you're greedy, you open a clinic and charge a fortune.

As for MUSIC, it states they are public, so they don't charge but and you need a referral and a long wait (and to live close to them) to see them. Plus, they are in my province, but still a 6-hour drive away... But thank you for trying.

Also, I did not mean your psychiatrist was cheap in the sense of "bad". It's just cheap in the sense of unexpensive. As for new people, well, it is true that here, the only people who charge less are usually younger and have yet to have a reputation. Plus, private psychiatrists here are a rarity, and most of them, if not all, charge a fortune.

Stephe: The reason for GID to be in DSM is to give doctors a reason to help us. If it's not a (mental or not) problem, they won't treat us, end of story, let alone operate us to alter perfectly working organs, which is basically against Hippocrates' thing. You can't just remove this from the DSM. You must find WHAT it is, else it won't be treated because if it's in no medical book, it's not a medical problem and thus will not be treated. Plus, being a transsexual alone is detrimental to an individual's life, contrarily to being homosexual.

Homosexuals were removed from the DSM because they simply did not required any help. We do. The whole basic concept of transsexualism is to wish to be the other sex physically and REQUIRES a medical intervention.

It is not comparable in any way to homosexuality in that regard.

I think this has gone a little off topic. Some are luckier than others. I personally had a terrible time and delayed a lot because I couldn't burden my mom with my costs, but I ended up finding a community sexuality center that even subsidized my therapy sessions for 15$ a week (30 min drive). Actuallly, I lived for another while in a city where there was a trans clinic providing endocrinology, bloodwork and hormones for free. It was a bit chaotic and hormones ran out and regimens were a bit odd but you could really just buy those out of pocket without much burden. Those places were not easy to find!

I almost graduate in psychology myself. The standard view is that psychiatrists take medication-oriented approaches. The practice of medicine is pretty conservative so it can be hard to find someone willing to help you- and more often than not people leave with psych meds after a couple of sessions. Neither the meds nor therapies are guaranteed to work for a given x problem, and there's tons of skilled intelligent people in both fields. The best advice in my opinion is what has already been said. If possible, pick someone with previous experience on this. I wouldn't rush towards a psychiatrist like that.

If you ask me, my therapy didn't do a thing except me talking my lifestories to an awestruck therapist. I would've gone straight to hormones (which you can do if you really really really really don't need therapy), but you have to be really careful. Some problems are bigger than others.

Quote from: A on July 06, 2011, 05:53:29 PM

Stephe: The reason for GID to be in DSM is to give doctors a reason to help us. If it's not a (mental or not) problem, they won't treat us, end of story, let alone operate us to alter perfectly working organs, which is basically against Hippocrates' thing. You can't just remove this from the DSM.

So they can do boob jobs and all sorts of radical plastic surgery that isn't solving any sort of disorder but they can't modify -our- bodies for what reason??

In the past they would remove the  female uterus on a regular basis without their being any life threatening reason to do so. In my own case they wanted to remove my gall bladder because "there is a chance it could cause you problems in the future". There are more than a few docs who will do an orch without demanding a bunch of hoops to be jumped through, why is going further so much of a difference. Oh yeah "OMG you can't cut off their dick!!!"?  lol

They can give a female breast implants but some docs do require a shrinks letter to do the same if the person is male. Doesn't that strike you as a bit odd? I had one electrolysis place say they refuse to remove male facial hair without a GID diagnosis but do it regularly on females without question. That's just crazy.

Basically all we are asking for is cosmetic surgery. I don't feel I should have to admit to -them- "yes I'm crazy so please deal with this before I kill myself" to have this work done. YMMV

Quote from: A on July 05, 2011, 07:39:16 PM
How could you know about a tumor without seeing a general practitioner first? Oo

Anyway, I'm not going in the right direction here.

I am not discounting them all. Psychiatrists are useful. I just don't think they are a good first step. The gender-specialized psychiatrist in my area has not been very useful yet. Plus, a psychiatrist is a physician. It's not his job to help the person come to terms with their gender identity and treat other conditions, and psychologically support the patient towards transition, etc. The psychiatrist is there to assess, diagnose, prescribe, inform and test readiness. That is what I have been told.

My main point is that seeing a psychiatrist right away may not be the best move, unless he's very soft on the SoC requirements of readiness or the patient is quite fine in every field except gender. Perhaps my psychiatrist is special in that way, but he requires concrete, correctly presented and durable proof of very significant progress in all spheres of my life, probably until every possible cause of mental discomfort is pushed aside and he "has" to give me his approval for transition.

Until now, he has not quite helped me, except with medication for my concentration. He has been requiring things from me, simply. And if I were needing to decide, analyze my problems, understand them and get mentally ready for transition, he would not be the one to help me do so. I would have needed a therapist.

In fact, I did need to see a psychologist to 1. understand his goals and instructions and 2. learn to endure my temporary male status and live functionally regardless. I would have probably caved in without that psychologist. The psychiatrist did not think I needed it.

So perhaps I am absolutely wrong, but my experience seems to show that a psychiatrist is not really the first person one should see. I think this is even more true in the case of a trans person just discovering, accepting and understanding their state such as the topic author. Therapy is useful and even essential for many people, and I regard that as the "true" basic towards transition.

But then again, the psychiatrist is still stalling me. Perhaps when he starts moving I will change my mind.

well, it's very possible for an emergency medicine physician to pick something up during a trip to the ER? Or, possibly a radiologist picking something up during diagnostic testing?

Quote from: Stephe on July 06, 2011, 04:09:00 PM

I'm glad you found such a great therapist/Psychiatrist. I've seen you post many times in favor of the present standards of care etc. I personally think it's insulting and abusive. No other elective treatment requires this sort of craziness.

The "gate keeper" I dealt with was a post op TS, so I would assume she knows about transition. She has written several books on the subject and regularly gives speeches at events etc. She also runs a TG support group. I had been living full time for over a year, had my name changed etc etc before I went to see her to get "my letter" to start HRT. Actually my Doc had prescribed spiro at HRT levels (for my blood pressure....) about a month before so I explained I liked what those were doing, that I have been full time for over a year, I'm not depressed, actually I've never been happier. According to the "standards of care" I met all the requirements for HRT before we ever talked.  I had no idea what to talk about so just told her about what going full time was like and the challenges I had faced. She started telling me how my dead mother was still controlling my life and other nonsense in response O.o  I babbled through multiple sessions before she finally gave in and gave me a letter, after spending hundreds of $$. I even told her "I feel like I'm fighting for your permission to do HRT" which she got all huffy about. Maybe some people have other mental problems but I think if someone has ALREADY done the "real life test" full time for over a year, has transitioned to living as a woman etc,  having to see a therapist to get permission to do anything is WRONG.

Being TG isn't a "mental disorder" IMHO, anymore than being Gay is. Us being in the dsm iv is NOT something we should want or stand for, yet some people seem to embrace it. They used to have Gay and Lesbians as a mental disorder but they finally got themselves taken out and we should be as well.

I think the TS's who LIKE this being called a mental disorder have convinced themselves "I am not TG, I am a female who was born with a birth defect". Even in that case it's not a mental disorder. Or want to believe that they lack any free will about this, "Don't judge me, this is a medical problem like cancer or some other disease". That they refuse to just say "I am happier living as a woman, end of story". I honestly do NOT want people to pity me for having some "uncontrollable disease", they simple have to accept I am happier living as a woman. God doesn't make mistakes and I was intended to be this way. No excuses needed.

Maybe at one point it helped a VERY few people get GRS paid for by insurance early on being classified as a metal disorder, so it was medically necessary to correct. But those days are over. Now it's treated like a boob job or any other elective surgery by insurance. The only thing that might be covered is this unnecessary therapy O.o Being in the DSM just complicates everything and creates a situation where perfectly sane people are subjected to mental therapy because it is ASSUMED anyone who want to live the opposite of their birth gender clearly must have a mental problem, i.e. must be crazy! These rules were written by cisgendered people, just like it was straight people that included Gays and Lesbians in this same diagnosis years ago.

We -should- be fighting against this being considered a mental disorder but instead it seems many people embrace this, which I really just don't understand at all. All these treatments we desire should be set up under informed consent and have someone (the doctor should be able to do the following) go over in detail that we understand what we are doing, the possible problems that could arise and that we are of sound mind when we agree to this. I can get FFS by this model, which is going to change my appearance more than HRT ever would. Why do I need to be diagnosed as having a mental disorder for one but not for the other?

I do not ever recall posting how much i love the standards of care...if you can link some of my posts where I said I am for the standards of care or that i declared we are a mental disorder, then I would love to see it.

While i do not love the standards of care and hug it to bed every night, I have no quarrels against it. If it goes away or if it stays, I could really care less. I guess that would make me in the middle of it all. With that said, I think the standards of care actually helps weed out those who are truly suffering from GID and those with a multi personality disorder. Hate me if you must, but I met a lot of men and women who thought they were trans and it ended up being something else entirely other than trans related issues in their lives. If it wasn't for WPATH, then you would have quite a lot of people who were mentally disabled claiming to be transgender and getting all kinds of surgeries and HRT.....if that happened, then try to convince the public that TG isn't a mental disorder because it would certainly look like it.  WPATH, at least tries to make sure you are sane to go through with the procedure. If you were cleared for HRT or SRS (if you desire it) then congratulations, you are sane by medical standards. I am aware that TG is listed as a mental disorder and just like the gay and lesbian mental disorder in the 60,70, and 80s, it will take education to the masses to get ours taking out of the DSM as well.

Then again, I heard of doctors who prolong therapy to milk all the money they can...hence, it is a neutral subject for me. It depends on many different factors whether Standards of Care is successful or not, and it usually boils down to person to person,

For me, I did enjoy my therapist. I could not transition by myself and I could not do this on my own. If you could do all of this by yourself, then good for you.

My point in this thread is try not to bash all Psychiatrists....because all Psychiatrists being useless is simply a false statement.

Quote from: Stephe on July 06, 2011, 10:35:26 PM
So they can do boob jobs and all sorts of radical plastic surgery that isn't solving any sort of disorder but they can't modify -our- bodies for what reason??

In the past they would remove the  female uterus on a regular basis without their being any life threatening reason to do so. In my own case they wanted to remove my gall bladder because "there is a chance it could cause you problems in the future". There are more than a few docs who will do an orch without demanding a bunch of hoops to be jumped through, why is going further so much of a difference. Oh yeah "OMG you can't cut off their dick!!!"?  lol

They can give a female breast implants but some docs do require a shrinks letter to do the same if the person is male. Doesn't that strike you as a bit odd? I had one electrolysis place say they refuse to remove male facial hair without a GID diagnosis but do it regularly on females without question. That's just crazy.

Basically all we are asking for is cosmetic surgery. I don't feel I should have to admit to -them- "yes I'm crazy so please deal with this before I kill myself" to have this work done. YMMV

there are ethical reasons why the docs do it.  personally, I'd want a doc that adheres to the WPATH requirements and recommendations regarding the letters

and another thing about WPATH...if they were to to take it out of the DSM, then sooo many companies in the US that covers SRS will rescend the surgery benefits because it would go from a "surgery to enhance the well being of an individual" to a cosmetic surgery.

Over a dozen companies a year are picking up SRS in their costs because they see it as a necessity for their employees transition. If it is taken out of the DSM language then that "necessity" is no longer there and would be regarded like FFS.

If you worked for a company that currently offers SRS benefits, then I am sure you would be looking at it in a WHOLE new light.

They do not refuse hair removal to men. Many cisgendered men undergo this either because their skin is too sensitive to shave, they are tired of doing it or their job requires a hairless face more than what they can achieve with shaving (for example, someone with a very, very heavy and dark beard in the army sometimes gets scolded because they look like they have not shaved even when they did).

As for denying breast augmentation, it is possible that they do deny it. But here, anyone can have this and no letter is required whatsoever.

SRS, though, is another story. It implies the destruction/modification of healthy organs without a medical reason. One of physicians' primary guideline is "do no harm" and, without a medical reason, they should not do something that would harm the patient more than it will help them. Without any diagnosis (without a problem), however, medically speaking, SRS is removing the patient's fertility and, to some extent, removing some possibilities from them. Medicine is an exact science, and for a problem requiring a medical intervention that have some negative consequences on one's health, a diagnosis is required, end of story.

And until we know better, transsexualism is a condition that causes a generally high degree of discomfort and requires a medical intervention for its effects to be negated, partially or entirely. And no physical anomaly has been found. Therefore, unless another cause is identified, it is a mental disorder.

You can't remove the diagnosis from the DSM altogether. If you do, no invasive/organ-damaging/destructive surgery - namely SRS - will be performed, as in medicine's eyes, if there is no diagnosis, there is no (medical) problem, thus no treatment is required, and there is no justification for damaging the body. If you decide it's not a mental illness, you have to state exactly what it is, or else it's like you declare it's not a problem and individuals with it have absolutely no need for a physician whatsoever, like homosexuals, which is false.

The issue here is not whether it is a "mental" disorder, it's that it's an innate problem that cannot be classified as physical unless some breaking evidence is found, as every bodily system works well, and therefore falls in the mental disorder category unless it fits elsewhere.

Theorically, this does not apply to breast augmentation, as no definite harm is done to the body in the procedure and the body keeps all of its functions intact. The person is merely exposed to consented, limited risks, and this does not justify its being blocked. If it did, all purely cosmetic interventions would be blocked.

Apart from that, if no diagnosis justifies an intervention such as SRS, it will logically be regarded as facultative and purely cosmetic, just like botox injections. This poses serious insurance issues.