I should start by saying that I am 23, I have never had surgery before, no have I taken any medications for MTF. I have been "Living" as a woman since I was 16 and changed my name officially when I was 18.

1. Is it ill-advised to get breast implants prior to starting HRT/SRS Treatment?
2. Roughly, (and please, be brutally honest) How much does it cost?
2.1 How have any of you Post-op's afforded it? (Suggestions?)
2.2 Are there ANY healthcare insurance providers that don't see it as purely "Cosmetic"?
3. What are the basic requirements for going through SRS/HRT?
3.1 What is the ideal time for this all to take place? (HRT, Surgery, Recovery) Not the FASTEST mind you, but the most IDEAL and SAFE
4. I live LITERALLY in the middle of BFE Alaska (Basically like a village). Population 2000-ish. Should I wait until i move back home to the lower 48 to start?
5. Assuming I move back soon, how do I start? I have no insurance and I don't have my family doctor anymore. Do i just walk into the hospital and say
"Hi, I'm a transgender who has been in transition since I was 16, can I get my weekly doses please?"
(I'm seriously not trying to be funny, I am literally ALONE when it comes to this subject!)

I am not NEW to the idea of Transitioning at all. But I have been researching the heck out of every website I could find and have talked to a few counselors... The information has now jumbled around in my head for far too long and I feel like I just need the FACTS. I've been alone with no family support whatsoever and my friends, (Bless their hearts) yes, they're close by, but they have no input. I do not have a community of Trans (Or even Gay/Lesbian/Bi) around me... So please, any help would be GREATLY appreciated.

Well im the other side of the pond so most of those questions i cant help with but 1. I wouldnt advise it as you can probably expect breast growth for the first 2 years or so of HRT so you dont wanna get implants then loads of natural growth and end up with massive gonzo-boobs.
The rest im afraid i have no idea how it works in the States.

~And the time-line is down to you and your healthcare providers, no 2 transitions are the same rememeber!

I'm still fairly new here and not on any hormones yet either but I'll give these a go.

1. Yes, HRT will likely give you some breasts. It might not be as much as you want but you should wait until they're done growing naturally to augment them. Also depending on how well you pass now you might be better off spending that money on things like FFS or a hair transplant.

2. SRS in the states is in the ballpark of $20,000. Surgery is quite a bit cheaper in Thailand, but you have to budget for a month long vacation in Thailand too.
2.2 - do a search here there is a thread about it, but I don't recall any off the top.

3. You start with a therapist, after talking to you for some time they will determine if you're a good candidate for it or not. If they believe you are (if you've been living as a girl and had a legal name change already I don't think you'll have any trouble with this) then the therapist will write you a letter/referral for the Endocrinologist. The Endo. will be the doctor that figures out your hormone script, everyone is different so there is no 'starter dose'. As for basic requirements beyond the steps, I'm not sure. I'm on my 2nd therapist, the 1st one didn't think I was a good candidate for it.
3.1 - You will usually be on HRT for no less than a year before having SRS. SRS will also require a letter from your therapist.

4. You may not have anyone who specializes in this type of thing in your town. You can always do therapy online/via phone though.

5. See my answer for #3, unless you can get someone to finance things for you, you should plan on trying to get some sort of employment. You would do well to make sure Gender Identity is protected when you're reading through the fine print on your employee handbooks.

Hi BS,

Let me see what I can do in so much as sorting things out for you. BTW, I'll make reference to GCS throughout my response which basically means Gender Correction Surgery.

1.) Yes
2.) As mentioned in the States roughly $20,000. Thailand is relatively close behind at an average of $15,000 plus accommodation and airfare. Anything cheaper immediately enters you into a very high risk category of surgery. Basically ending up with a less than good job, requiring considerable cosmetic surgery by others at a later time.
2.1) Full time employment
2.2) Yes. The following thread has some excellent information provided by both Annah and Jesse regarding Health companies and Corporate organisations in the States that include GCS in their employee benefits health plans. You may wish to go through a lot of Annahs' posts on GRS. She has a lot of information pertaining to USA matters and is very knowledgable on local and national issues. Apart from being an exceptional woman. 
https://www.susans.org/forums/index.php/topic,109227.msg823092.html#msg823092
3.) See reply #1 from Jesse from the above link
3.1) Generally speaking you need to be on HRT for 2 years prior to surgery. During this period you need to be living 24/7 as a woman. Your RLE experience. During this time (2 yrs HRT) you can be seeking GCS approval through your therapist. They will determine how many consultations you require to convince them you are a suitable candidate. So basically budget for a 2 - 3 year timeframe from go to woe.
4.) Really depends on how TG friendly this village is. What is extremely important throughout this process is your support group. It's imperative you have a strong, effective support group, physically close at hand. And you need to be in a safe environment.
5.) Prior to relocating, find an appropriate area that is TG supportive and has all necessary facilities within a reasonable area to your prospective employment. Unless you have some other way of affording GCS. Then contact a GP who is both familiar with and is attending to TG patients. They should be able to refer you to a therapist who will refer you to an endo. You can do your own research on your preferred GCS physician.

Your therapist should be able to sort you out with respects to the procedural matters for GCS, (how, when, where, why. What boxes need to be ticked) as well as referring you to local support groups. It's these support groups that are going to provide the much needed 'glue' to keep you together thoughout this journey. HRT can do some really weird things to you, as far as your thought patterns are concerned.

Hope this has clarified some issues for you. Don't be surprised if it has created more questions than its answered. This is a major transformation in anyones life. It can never be underestimated.

Whatever happens, keep in touch and let us know how you are coping. Susan's is a big warm hearted family; here for you. You are family; much loved and appreciated. It's there for the offering. In the meantime, be safe, well and happy.
Lotsa huggs
Catherine 

Eh, most your questions have already been answered, but I'll chime in my two cents regardless.  I'm not sure whether I'm really offering anything further, but it's worth the reassurance to you I'd imagine.

---

1. Is it ill-advised to get breast implants prior to starting HRT/SRS Treatment?

Yes.  There is no doubt when on HRT your breasts will grow.  Due to this, if you had prior implants, there could be negative ramifications involving both physical looks and health issues.  As a result, you'll most likely lose them anyway...though I have no personal experience.  Personally, I advise against it because you have no idea how well HRT will fill you out in that aspect, so it's best to wait.

2. Roughly, (and please, be brutally honest) How much does it cost?

Breast implants?  I don't know.  GCS is on average $18,000, excluding costs for travel and possible other costs.  Though each surgeon is different on their prices and what is included in their price, so it's best to do research per surgeon.  Nonetheless, choose wisely on a surgeon (though you're just starting, you've got plenty of time to figure this out), it's permanent and suffice to say, needs to be done correctly.

2.1 How have any of you Post-op's afforded it? (Suggestions?)

Either you save your money, have a very generous family, take out a personal loan or find an insurance policy that covers it.  As Catherine Sarah suggested, check out the links she posted in relation to which employers have GCS covered in their insurance policies.

2.2 Are there ANY healthcare insurance providers that don't see it as purely "Cosmetic"?

GCS or breast implants?  If GCS, see above.  If breast implants, unlikely.

3. What are the basic requirements for going through SRS/HRT?

As mentioned, you'll likely need to be on HRT for at least two years and living full-time for at least one year before receiving the letter of recommendation for being a candidate for GCS.  As for HRT, start by being seen by a gender therapist to tell your story.  The therapist will make the determination whether you are knowledgeable about HRT and are ready for HRT (this is of course, after the therapist has determined you do in fact suffer from GID (Gender Identity Disorder)).  After that, find an endocrinologist, bring your letter of recommendation for HRT (issued by your therapist), and viola - you'll likely have your prescription.  Regular visits to your endo to check blood levels, etc. are required; usually every three to six months.  As per the cost, if you do not have insurance (as I don't), ask the pharmacy for the generic version; I pay roughly $30 a month for both my estradiol and spironolactone.

3.1 What is the ideal time for this all to take place? (HRT, Surgery, Recovery) Not the FASTEST mind you, but the most IDEAL and SAFE

There is no ideal time.  Some people are capable of having everything finished in two years, others take five, others take ten, etc.  There are far too many variables to add up to give an accurate "typical" time.  The majority of us work as fast as we can to complete our transition.

4. I live LITERALLY in the middle of BFE Alaska (Basically like a village). Population 2000-ish. Should I wait until i move back home to the lower 48 to start?

I've never lived in Alaska.  Do online research to see whether there are any gender therapists in your area as well as endocrinologists.

5. Assuming I move back soon, how do I start? I have no insurance and I don't have my family doctor anymore. Do i just walk into the hospital and say
"Hi, I'm a transgender who has been in transition since I was 16, can I get my weekly doses please?"
(I'm seriously not trying to be funny, I am literally ALONE when it comes to this subject!)

As far as how to start, see the above answers to your previous questions, your answer is there.  As per no insurance, again, see above answers.  As for family doctor, I don't have a general practitioner either, so no worries there.  If it is a worry, you can always find one I'm sure.  The hospital has nothing to do with the prescription for hormones.  As previously mentioned, that's what an endocrinologist does.  However, as also previously stated, you need to first start therapy, obtain a letter for recommendation of hormones, and then worry about the endocrinologist.

Hope this helps.

Ah, I can't really answer your questions since I am a transguy, but I can answer one of them. As someone who has lived in Alaska since I was a kid (I'm down in Fairbanks), I would say wait until you are closer to a big city. I don't know how long you've been out there, but for a lot of the villages their doctors come and go, and sometimes the doctors are not much more than PACs.

I have had a really hard time even finding a doctor in Fairbanks that would monitor me after starting HRT, though I finally lucked out. I doubt you will find someone in the village who is knowledgable enough. If you want, I can give you the name of the doc here that will be monitoring me after I start T in a month or so.

Also, (like I said, I don't know how long you've been there), but keep in mind that the cultures of the villages are dependent on which native group lives there. Since we have 17 different Native Alaskan groups, most of the villages are really different. Some groups have strict views on how medicine is supposed to be practiced, some are very against body modification, etc. Also, I don't know if you are in a dry village or not, but in my experience, the dry villages tend toward the older lifestyles. At least, the people I have met from dry villages.

I should also add that the docs in Alaska require 3 months of therapy or a letter from a therapist to start hormones, and the closest actual gender therapist is down in Anchorage. My therapist is in PA and we do Skype sessions.

I regularly chat with a person who lives so far out in Alaska that floatplane is only contcat and she managed to transition so it can be done.
get some input from a therapist and stay away from inplants until a couple of yeras of HRT.

Doctors are trained to deal with every humna condition or refer onwards those they are unfamiliar with.

back in dark ages my family doctor ran out of house rather than talk about my gender problem.

I would like to thank all of you for taking the time to answer my questions. I've been working two jobs recently, one full time and the other a tip-earning part-time job. I' suppose that the reason I asked is probably due to the fact that, to me at least, $20,000 is quite a large number. And as daunting as it, that number hangs over my head, EVERYDAY and it's quite a discouragement.

I think the only problem I'm having is kind of like the old saying "You are the only one standing in the way of your own happiness"

I need to buckle down and JUST DO IT I suppose.

That number really should not be a worry of yours right now, as it is years away before you'll even need to consider it, though I do recommend beginning to save as much money as you can if it's something you're committing to.  I agree with you, if you feel this is right, take the first step - find a gender therapist.  I wouldn't put a huge emphasis on having a specific detailed plan; it doesn't always work that way.  I don't mean to suggest not to have any type of plan, as a broad outlined plan should exist somewhat, but overall things tend to unfold as they should when the time is right.  Best of luck.

Quote from: Brain_Storm on November 28, 2011, 05:02:10 AM
I should start by saying that I am 23, I have never had surgery before, no have I taken any medications for MTF. I have been "Living" as a woman since I was 16 and changed my name officially when I was 18.

1. Is it ill-advised to get breast implants prior to starting HRT/SRS Treatment?
  - as stated yes they WILL grow for first 6 months all i had was tenderness and little to no growth the last 6 have got me a small B
2. Roughly, (and please, be brutally honest) How much does it cost?
      ---My Srs is in July i am going to thialand for DR Pichet Cost 6500/air 1500/hotel for 2 weeks 500/food $12 a day now some people might say pichet is too cheap and therfore no good
           money for me is not as bad of an issue as it is for some. all surgeons i have read negative and positive of reviews of. I have talked with a girls who have gone to pichet and loved his work.

Thanks for the advice on the money issue. I suppose that I have seen so many people around me, peer especially, struggling to survive off their paychecks, that, even though I save mine, it seems like I'll never get out.

I think that the only other problem I'm having...

Is that I feel like I did everything backwards. I've been living as a woman since I was 16 years old and changed my name at 18. I haven't had the opportunity to see a gender therapist due to lack of resources and time/money situations. It's consuming me I think, that I've done all this work... and now I'm now on a plateau. I haven't made any progress and it's worrying me.

Passing for me is not even a thought, because I roll out of bed every morning and think "I'm a beautiful woman". But that's only until the clothes come off. Then it's a look downward and BOOM, my smile is now a frown... haha However, I think I'll wait until I move back home to actually pursue this. It's not that I am not fully committed or that I'm even second guessing. But in my current surroundings, in the village I'm in, and my HEALTH and MENTAL WELLNESS at stake, I'd rather be of sound mind. It's only 6 months away so I'll definitely be okay.

Quote from: Brain_Storm on December 05, 2011, 11:29:21 PM
Thanks for the advice on the money issue. I suppose that I have seen so many people around me, peer especially, struggling to survive off their paychecks, that, even though I save mine, it seems like I'll never get out.

I think that the only other problem I'm having...

Is that I feel like I did everything backwards. I've been living as a woman since I was 16 years old and changed my name at 18. I haven't had the opportunity to see a gender therapist due to lack of resources and time/money situations. It's consuming me I think, that I've done all this work... and now I'm now on a plateau. I haven't made any progress and it's worrying me.

Passing for me is not even a thought, because I roll out of bed every morning and think "I'm a beautiful woman". But that's only until the clothes come off. Then it's a look downward and BOOM, my smile is now a frown... haha However, I think I'll wait until I move back home to actually pursue this. It's not that I am not fully committed or that I'm even second guessing. But in my current surroundings, in the village I'm in, and my HEALTH and MENTAL WELLNESS at stake, I'd rather be of sound mind. It's only 6 months away so I'll definitely be okay.

I think it's awesome you've been living full-time for so long and have no issues passing.  By far that's not so much backwards as it is a blessing.  If you feel waiting until you move is best, then that's perfectly alright.  There is no rush, there is no deadline.  It's all about transitioning at a pace that is most comfortable for you.

Thank you! That actually helped me a lot to read that. "My own pace". You're right. I guess I was just thinking that there was a direct and mapped out "Plan" that I should follow and it all had to do with "time limitations" and "how long until..." but now that you mention it, it's all up to me!

Yup.  No worries

Ayden,
Hey I'm up in FBX too, I sent you a message with a coulple questions about finding a doctor up here.
lisa

Quote from: Ayden on November 28, 2011, 07:20:40 PM
Ah, I can't really answer your questions since I am a transguy, but I can answer one of them. As someone who has lived in Alaska since I was a kid (I'm down in Fairbanks), I would say wait until you are closer to a big city. I don't know how long you've been out there, but for a lot of the villages their doctors come and go, and sometimes the doctors are not much more than PACs.

I have had a really hard time even finding a doctor in Fairbanks that would monitor me after starting HRT, though I finally lucked out. I doubt you will find someone in the village who is knowledgable enough. If you want, I can give you the name of the doc here that will be monitoring me after I start T in a month or so.

Also, (like I said, I don't know how long you've been there), but keep in mind that the cultures of the villages are dependent on which native group lives there. Since we have 17 different Native Alaskan groups, most of the villages are really different. Some groups have strict views on how medicine is supposed to be practiced, some are very against body modification, etc. Also, I don't know if you are in a dry village or not, but in my experience, the dry villages tend toward the older lifestyles. At least, the people I have met from dry villages.