surgery letters

[arbon]

What I wanted to do at the beginning of 2013 did not work out, which was getting an orchiectomy and trachea shave.

But, financially, I think I can do it the first of 2014. I decided to go with Lázaro Cárdenas in mexico, even with travel its still a few thousand cheaper then in the US (why is it so expensive for such simple operations?)

The doctor is requiring just one letter for the orchiectomy but it needs to be from a psychologist or psychiatrist so I need to find one that will do that for me.



My question is what kind of screening or evaluation will they do to give me what I need for the surgery? Will they take into account the therapy I have had and that I have been living full time, or are they going to make me jump through hoops to prove all over again I am ts and this is needed?



I really don't want to go through months of appointments and talking again, or spending lots of money on that part of it.


Locally there are four psychologists - one I have seen before and will never ever go back to, one tells me she is the most expensive in the state and seemed to do her best to dissuade me from seeing her(after I tell her I am TS), one just writes books I guess and does not actually want patients, the fourth is a possibility but she has not called me back. There is one psychiatrist here and I called his office yesterday they told me he would not do that type of evaluation. So its looking like I will have to travel again to Boise to find someone which adds a lot more expense. My therapist is there, but have not seen her in over a year but I am making an appointment with her to see if she can help me get through this part.

[I Am Paula]

Ah yes, gatekeepers again. Just when you thought that part was over.
You would think that since it's absolutely OK to cover your body with tattoos and piercings,(rendering yourself unemployable) that the simple job of ridding us of useless parts (removing our obviously defective genes from the gene pool) would be a cake walk. But no. Since I grudgingly still have two testes, I cannot offer you any concrete advice. Did you try your closest LBGT resource center? Good luck in your search.

[Kathryn Martin]

I think you have the wrong idea about the assessment. The surgeons require an assessment that addresses issues of stability of the patient, successful completion of a period of living full time in your target gender, the absence of axis 1 and 2 mental health issues and diagnosis under DSM criteria. At this stage it is more about facts rather than biographical accounts (although they form part of the anamneses undertaken by the psychiatrist/psychologists. Part of this is an assessment that you can be successful living in your target gender.

I had to have two letters independently for my SRS. One from my clinical psychologist (PhD) and one from a MSW or qualified gender counselor. It took 3 sessions for the second assessment. First appointment biography and anamnesis, second appointment elaboration but through questioning (issues of sexuality and orientation) and third to discuss the letter that was prepared for correctness of the biographical or medical account etc.

[arbon]

What I find ridiculous about it is if you want your face reconstructed so no one will ever see you as male again and get big breast you don't need to go through the same requirements. But an orchi no one else will ever see they need to make sure your not crazy

[Kathryn Martin]

It is irreversible, that's why. Think from the perspective of a medical service provider who has sworn an oath to do no harm. Castration is essentially viewed as extreme harm unless it is indicated for psychological reasons. It's a fruitless debate to be upset about it. Informed consent as a basis of surgical decisions will never be accepted by the medical service community and in my view for good reason.

[arbon]

Has anyone ever tried to reverse ffs? Would not be easy

I'm not upset, more wanting to get an idea of what to expect from a psychologist to get their blessing

Omg I hit a thousand posts! Only took 4 years lol

I'm a senior now!

[Angela Campbell]

My question is what kind of screening or evaluation will they do to give me what I need for the surgery? Will they take into account the therapy I have had and that I have been living full time, or are they going to make me jump through hoops to prove all over again I am ts and this is needed?.

Perhaps contact your original therapist for a referral letter to a new one with the intent of getting the surgery letter.

[CharleneT]

You mention the therapy you've had, go to that person and ask for a letter. Of course they will take into account the time you have spent living full time etc... Your medical doc could also write one (primary care doc, or whatever the term is in your area).

[arbon]

After some more calling around I found a psychologist in twin falls id who sounded friendly and said she had done these letters before for transsexuals (surprising considering where she is located)

Today was my first appointment and I felt it went well. I was very comfortable with her. She asked lots of questions and I was very open with my answers and talked a lot as we went over my history. It felt good to talk some more about some of it again.

When the session was over she said she thought we would only need one more session to finish and she would write the letter for me.

Oh she also said I was a beautiful woman, I hesitated a bit before responding and then she asked " you know that don't you?" I said I don't know, I have a hard time judging myself (really i judge myself pretty harshly about my looks and usually don't believe people when they stuff like that) but her comment did make me feel good.

Anyway I think it is all going good, and not a big deal like I thought it might be.

[Angela Campbell]

If the actual act was as tough as the anxiety beforehand much of this would be unbearable. For me it is never as bad as I expected, at least so far.

[Maryanne_sa]

I'm glad for you that it is seems to be working out. By the way, judging from your photo, she is right, you are beautiful.

[arbon]

Yesterday I had my second appointment. She is going to write the recommendation. She said there was no reason to see me again unless I felt like there was something else I needed help with.

While the first session was more centered around my history and how I got to the point of starting transition, this 2nd session was much more focused on how I have been living since starting transition and how my life is as a woman. I liked talking about it, I wanted to keep talking lol. I talked about all the heartachs and stress, but also the victories and successes, the biggest of which is that I am comfortable with who I am today. I realize I am doing alright, and that I'm living a life I never thought I would be able to.

I just don't have much to complain about anymore, I think I am doing pretty well. I mean yeah I still get crap sometimes but nothing that makes me regret doing what I have done or that really impacts how I feel about myself or how I am living. I'm still growing, defining myself as a woman and there are still issues and challenges but thats okay.

Thinking about how it is now and seeing this psychologist compared to how I was in January 2010 when I first went to a therapist for help with the issue. Back then just making the appointment was a huge scary undertaking, I was so filled with shame and hating my life. I spent a good chunk of that first session just crying. I was such a wreck.

So much has changed.

[CharleneT]

My therapist told me we would meet over a few months, or years to work thru my issues and determine if I should proceed with surgeries etc... At the beginning of our second meeting she told me that she was already to write whatever letters I needed. Proofs in the pudding I think. Seems like you had a similar experience !

[Suzanne F]

Congratulations! Isn't it nice to receive such am affirmation from someone you have been open and honest with? I received an email from my therapist this week. She told me how beautiful it was to watch me be happy about who I really am. It touched me at such a deep level and made me glow. I felt so hopeful and happy when I read the email. Please keep sharing your journey with us!
Suzanne