I've  been seeing posts over all sorts of internet forms about trans girls claiming that you need a letter or a diagnosis to get FFS or even Breast Augmentation.  Well I called several of the big name FFS physicians and they all told me they don't need any sort of letter or diagnosis to perform a FFS or BA.

They pretty much had the if you pay for it I can do it for you attitude.  You just sign the waiver and pay.  I personally have been working with a therapist, but have not had any formal diagnosis etc.  So this may be a FYI type post. 

I have a feeling that if there wasn't a WPATH standard these surgeons would give someone SRS without any diagnosis. 

This is interesting as many say that they do a psychological evaluation, but cosmetic surgeons aren't shrinks. They don't judge or want to get into too much of the reason as to why you want their services.   

Most surgeons just want money.

you might find some specialists that are actually interested in helping you.

But neither of those are irreversible.  Sure it will cost more money, but you can often undo them.  GCS and even an Orchi are irreversible because the testicles are removed.

Who are these surgeons you called?

Its funny an Orchi can be done without any formal diagnosis.  You pay for it you can get it.  It seems SRS is the only procedure that has the diagnosis steps. 

But I do thinl some surgeons are shy about doing Breast Augmentation on TS patients and won't do them, but I'm seeing plenty that are.  I think thats good though that surgeons don't get into the why of what someone wants. They aren't the therapists.   

But I hope they listen to the patients requests and do as the patient wants. 

Private message me if you want the name of the surgeons. Not sure if I should post it here. But pretty much most FFS surgeons will do it.

Quote from: NCAmazon on May 06, 2012, 06:30:15 PM
Its funny an Orchi can be done without any formal diagnosis.  You pay for it you can get it.  It seems SRS is the only procedure that has the diagnosis steps. 

But I do thinl some surgeons are shy about doing Breast Augmentation on TS patients and won't do them, but I'm seeing plenty that are.  I think thats good though that surgeons don't get into the why of what someone wants. They aren't the therapists.   

But I hope they listen to the patients requests and do as the patient wants. 

Private message me if you want the name of the surgeons. Not sure if I should post it here. But pretty much most FFS surgeons will do it.

Even if you can get all the surgeries you want it is always helpful to have an independent therapist to talk about social issues and double check your plans.

There never has been a letter requirement for facial or breast augmentation surgery, the 18 months thing is a recommendation to ensure breast growth has been tried before augmentation in case there is enough natural development.

The referral (letters) requirement for genital surgery stems from old "mayhem" laws concerning loss of reproductive function.

Quote from: Jeneva on May 06, 2012, 06:01:39 PM
But neither of those are irreversible.  Sure it will cost more money, but you can often undo them.  GCS and even an Orchi are irreversible because the testicles are removed.

You were that kid who ratted everyone else out at school weren't you? 

Quote from: JS04011027 on May 06, 2012, 06:23:18 PM
Who are these surgeons you called?

My PM doesn't work yet. Not sure why. But I guess its ok. Dr Leiss, Dr Zukowski, and Dr Spiegel didn't require letters for FFS and BA.  Although on Dr. Spiegel's website he recommends you go through psychological consult, but I think that's just a disclaimer. If you pay for it you'll get it.

If your an adult I think they will let you do as you wish.

Welcome to Susan's. Your PM and profile features "open up" after 15 posts.

Now while the surgeons you mentioned don't require letters or proof of HRT, you might want to look elsewhere if they don't inquire about HRT at the vey least.

As others have mentioned you'll want to give the hormones time to have feminized your appearance/body.

Also keep in mind BAs. No offense, we all have a male chest wall/shape. There are differences in implant placement, Saline vs silicone, size etc. Vs a natal female.
Good luck in your journey.

The requirements  are also very country dependent.

I can get BA at any time but I would never get the release letters for genital surgery without a psychologists recommendation. And as others have said, wait until the hormones have done their job.

Quote from: Asfsd4214 on May 06, 2012, 08:21:46 PM
You were that kid who ratted everyone else out at school weren't you? 

I'm not sure how you get that from my post.  I was simply trying to explain why we didn't need letters for FFS/BA, but "should" for GCS/Orchi.

Having said that I myself have mentioned a few times that they are ways to get an orchi.  I don't actually have a full year RLE, but I have had an orchi because my Endo recommended it (because I was DIY HRT for a long time before starting RLE).

I do think we need to be careful so as to not draw too much attention to resources that are willing to bend the rules for us so we don't loose them.

So what did I say that makes you think I was tattling?

Quote from: Jeneva on May 07, 2012, 06:30:17 AM
I'm not sure how you get that from my post.  I was simply trying to explain why we didn't need letters for FFS/BA, but "should" for GCS/Orchi.

Having said that I myself have mentioned a few times that they are ways to get an orchi.  I don't actually have a full year RLE, but I have had an orchi because my Endo recommended it (because I was DIY HRT for a long time before starting RLE).

I do think we need to be careful so as to not draw too much attention to resources that are willing to bend the rules for us so we don't loose them.

So what did I say that makes you think I was tattling?

Sorry I forgot about this topic and didn't notice this reply till now.

To answer your question, I made that comment because of your viewpoint that we should 'need' a letter for any of it. The belief in an establishment to save us for ourselves. Faith that our superiors know better and that the system is both needed and works.

It's the same system of beliefs that you see in children who rat someone out to the teacher for going in the out of bounds area.

Except at least they're children whom we as adults, and hopefully well meaning children, really do feel a duty to protect from themselves.

But I am not a child, I am an adult, I should have a right to conduct my own affairs with other adults whom are complicit, without a third party giving the ok or not when it's nothing to do with them and never will be.

Personally I think the letters are silly, but they are the rules of the game today and in the absence of a "better" system then I will play.

I was not saying the letters are sacred, but rather saying that gcs/orchi require letters today BECAUSE they are irreversible.  That statement doesn't mean I agree 100% with them.  It is just a statement of fact.

My therapist and I both are "putting in the time" for her to write the letter according to the rules so it cannot be questioned, but she had no problem with me having a letter-less orchi.  In fact she said if that was what I wanted then I should do it and she wasn't going to take points away from some magic score I had to reach for a letter.  Overall I suppose that following the rules for gcs will cost me $200 total.  For that matter when I hesitantly told her I had been started DIY HRT she only expressed concern for my health.  It was not until I told her that the "rules" said she should be mad at me that she even "pretended" to be mad and then we both laughed at the silliness.

Now I do have anxiety issues and find it helpful to talk to her anyway.  So does the gcs letter really even cost me $200 if I were to see her those times anyway?  I suppose I should still count her $75 document fee, but her $25 copay would have been spent anyway.

So since you feel that you should not have to get clearance from a mental standpoint, how do you feel about physical clearance?  Even though I could get my FFS/BA without any letters from my therapist, I DID in fact have to have tests run and a letter from my PCP saying I was healthy enough.  Should we also do away with that rule?

Quote from: Jeneva on May 13, 2012, 07:49:10 PM
So since you feel that you should not have to get clearance from a mental standpoint, how do you feel about physical clearance?  Even though I could get my FFS/BA without any letters from my therapist, I DID in fact have to have tests run and a letter from my PCP saying I was healthy enough.  Should we also do away with that rule?

It's simple really. The surgeon should be free to require you be physically healthy in order to operate on you for ethical reasons.

If both sides are willing to take the risk, and are aware of the risks, then I don't think it should be prohibited by a third party.

Quote from: Asfsd4214 on May 13, 2012, 08:55:18 PM
It's simple really. The surgeon should be free to require you be physically healthy in order to operate on you for ethical reasons.

If both sides are willing to take the risk, and are aware of the risks, then I don't think it should be prohibited by a third party.

As my orchi without letters shows there are no magical enforcement armies for the SOC (i.e. no prohibiting third party).  The surgeon is requiring you to provide letters, so how is that different from them requiring you to show you are physically healthy.

Quote from: Jeneva on May 13, 2012, 09:02:18 PM
As my orchi without letters shows there are no magical enforcement armies for the SOC (i.e. no prohibiting third party).  The surgeon is requiring you to provide letters, so how is that different from them requiring you to show you are physically healthy.

It's not. The problem is the system of responsibility and fear of prosecution.

If you have a doctor willing to do it, and you know the risks, I think you should be able to do it.

Surgery requires a 2nd party obviously but HRT for example doesn't. The 2nd party is a pharmacy who would happily sell you whatever they want if they were legally able too.

It's the fear of the system at fault.

My doctor s did not request a letter either