This all sounds very foreign to me, because I did not seek medical help in the US, and there were nothing like WPATH or other protocols in existence. I was living at the time in a Mediterranean country known for its beautiful women and obsession with sex. For married couples, the almost mandatory rule was twice a day.
There being no protocols floating around, and no gatekeepers or therapists, the surgeon designed his own, which, to me, seemed very logical given the culture in which we were living. First, heavy duty T blockers. If you could accept being unable to function as a male with out freaking out (considered by normal males to be the worst possible fate), that meant you were ready for the next step, feminization. A good healthy does of estrogen for several months, during this time the emotional adjustments were made and and skin softening and fat distribution begun. If you were still on board with the new feelings and bodily changes, then directly to SRS. In the surgeon's opinion, which I shared, "real life" as a female was impossible without female sex organs. You continued with the estrogen after SRS and as the bodily changes became more obvious (breasts and facial fat), your RLE became easier, and without a source of T to block, faster. Should you need plastic surgery to the face or a BA, that was the speciality of Parisian surgeons, the only place at the time where trans in Europe could get post-op surgical care.
Regrets? Well, sorry, it was your choice. You can present to the public any way you want, but underneath that, there is a vagina that you can use or not. Learn to live with it. Next.
It certainly seems as if the whole process has become much more bureaucratized with control shifting from the patient to the gatekeepers, and what then would have been called excessive concern for the "what ifs" in life. And I still think the way I did it was the best way. It has been a wonderful and full life after SRS.
The only regretful MtF trans I ever knew were the "bottom" gays who thought that the "top" would love them more if they transitioned. With the trans no longer being the gender that the top preferred to have on the bottom, those relationships did not last -- but these trans soon moved into the life of a normal heterosexual woman, married, and lived happily ever after. And lived long lives because they no longer were at risk during the early AIDS epidemic that decimated their former partners.
I sense that there is a lot of frustration with American and Brit pre-ops over the long delays imposed on them. A very justifiable frustration, as I see it. Some are good little girls and follow the rules, but for those who are not so good, there are workarounds that can be found out there in the big world. Different systems work different ways.
