hausboy
Posts: 2360
Joined: 9/5/2010 Status: offline
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Hi Steven You are correct. I was holding off on this link...but well, what the hell. http://www.wpath.org/ It used to be called the HBIGDA or the Harry Benjamin International Gender Dysphoria Association Standard of Care. Certain guidelines are given to healthcare providers before surgery and hormone therapy. My transition was a considerable time ago, but all of my providers adhered to the HBIGDA SOC. I required a minimum of 6 months of therapy and GID screening by a therapist experienced with GID. As it turns out, one of the members of the Executive Board of Directors is also a gender therapist where I live and my surgeon was also on the Board. Therapy involves much more than just mental well-being, it included an assessment of my full history, substance abuse/recovery, a screening to ensure there were no underlying existing mental health issues that would impede, interfere or be contra-indicated for transition. My therapist also evaluated my home life, relationship with partner, family and workplace, finances, and determine what support systems I had in place. There used to be a cross-living requirement--that was eliminated. once determined to be an appropriate candidate for hormonal treatment, I had to be screened by a physician--again, I was fortunate to have a provider who was experienced with TG patients. A full physical, bloodwork, lab series and evaluation of my health habits. (nutrition,exercise, smoking, drug/alcohol, etc) My physician required a letter from my therapist, confirming I was cleared and my entire first year of injections had to be performed in his office, under his supervision. (no longer a requirement) After being on hormonal therapy, I had to undergo a second series of psychological screenings and health screenings before I was cleared for surgery, and my surgeon required letters from both my physician and my therapist, verifying and detailing the appropriateness for surgery, my current health (physical and emotional) and I had to meet with the surgeon to "interview." and yes, it's not one surgery--just as you said--for both men and women, it can be a long series of surgeries. There are many more very good options (cosmetically and functionally) that didn't exist ten years ago, and ten times the number of skilled surgeons out there. While in some cities (San Fran), there are health plans to cover the surgery and hormones, most insurances do not. Surgeries often require cash up front. So for many like myself, it required a few years of saving, plus extensive financing, and yes--before they wheel you into surgery, they ask you: Cash, check or charge? It took me two years to save for my first one, and about five years to pay it off. Worth every single penny--I love my results, even my physical therapist who was working on my shoulder/chest had no idea. The surgeries are complex, expensive and often painful with long recovery times in some cases. I'm glad I did it but wouldn't want to go through it again--it was pretty rough.
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