So tomorrow I have the big appointment at KEMH with the head of gynaecology and the head surgeon to discuss my hysto and try to convince them to do it. I have a new, very emphatic and detailed letter from my pshrink outlining my medical and gender history and stating that in his opinion I am well-adjusted in my gender role and that the surgery is medically necessary, so I'm quietly optimistic
I have also had contact from the Chief Medical Officer for Western Australia, who has taken a personal interest in my case and based on what I have had to go through so far trying to get my surgery, will be looking at whether he needs to rewrite WA Health Department policy for surgery for transmen (he's the guy who determines the state's health policy and writes it, so because my case has been so difficult, now that he has the figures from my pshrink of how many transguys the current policy affects and renders unable to access surgery, he's looking at changing it to make it fairer and less discriminatory).
So while this may not directly assist ME to get my surgery, it WILL help to make it easier for all the guys who come after me who are on low incomes and cannot currently access surgery privately because of the cost and the fact that it is not currently covered by Medicare because it's deemed "elective" and "cosmetic". (This despite the fact that it is a legal requirement to obtain a GRC that you have been on T for a minimum of 2 years, shown that you are functioning in your gender role and have had 2 irreversible surgical procedures relating to your gender - so currently it excludes all but the wealthiest of transmen in Western Australia from being able to complete their transitions and be legally recognised as male - you can't even change your gender marker on any of your documentation without a GRC, not even the driver's licence or Medicare card or any other paperwork). There is also an inherent bias in the West Australian medical system whereby if the surgery you are seeking involves organs or body parts which are not actually diseased, they will refuse to remove them or alter them because they don't want to interfere with healthy body parts.
Hopefully I will find out tomorrow if the hospital are going to do the surgery (unless they have to take the info from the meeting back to the board and discuss it further, in which case I will probably have to have another appointment to find out how it all went, or be informed by letter). But I'm optimistic that with the strong backing of my gender pshrink (who also happens to be a senior member of the Gender Reassignment Board here so knows what is required for me to obtain surgery and has been extremely helpful in providing it) and the interest of the CMO, I won't be refused a third time.
The hospital requested a ton of information from the pshrink in order to determine whether I am an appropriate candidate for surgery - aside from the usual standard medical, gender and psych history (which my pshrink provided in detail to illustrate that in his opinion I have identified and presented consistently as male since August 2007, and that I have undergone sufficient therapy around both my gender issues and all the other non-gender related stuff that he is satisfied that I am both stable and still an entirely appropriate candidate for surgery), he has stated what my plans for transition are (hysto, chest surgery and I am considering genital surgery as well pending financial situation, and that I intend to apply for my GRC), and that in his opinion I am not at risk of ever reverting to a female gender role. He also stated that in his opinion the surgery I am seeking is absolutely medically necessary (since the hospital told him that they require a "medical indication" of the surgery being something that is required and not just elective).
So altogether the pshrink's letter was pretty good, I was quite happy with it - we will see how well it flies with the hospital tomorrow though LOL