This happened in May 2022, but I wanted to share an experience with a surgeon offering gender affirming surgeries at Mainline Health in Southeast Pennsylvania. There's not a lot of info online about her since she is fairly young, so I thought this might be helpful for others researching.

I went to a vaginoplasty consultation with Dr. Rose based on a recommendation from my PCP, who indicated that she likely would have surgery openings as soon as a few months out. I decided not to move forward with her based on our conversation during the consultation.

While going over my medical history, I mentioned that I had come out to my dad a month prior. She said that WPATH guidelines dictated that I would have to wait at least a year from the date I came out to him before I could get the surgery. She described this coming out requirement as part of living "full-time" as my gender. This confused me as I had never heard of this being part of WPATH. I also was upset because I was nearly 30 years old at the time of the consultation and barely spoke to my father, so it seemed completely arbitrary and gatekeepy that he should have any part in my ability to get this surgery. I asked her what about people for whom it is prohibitively unsafe for them to come out to their family? She said that people in that situation could never get vaginoplasty.

I was offended by her responses during the consultation, and subsequent research confirmed my suspicion that there is no language in WPATH guidelines that would unambiguously require a candidate for vaginoplasty to come out to their family at least one year prior to surgery. Best I could tell, this seemed to be her personal understanding of WPATH, or some misapprehension of its requirements. I wrote her a letter a letter describing that I felt what she said was offensive and harmful for her trans patients. She responded that she is sorry that our conversation did not go as I expected.

I ultimately decided not to go ahead with her, not because of the wait (pretty much any other surgeon would be booked out for at least a year anyway), but because I felt that her dealing with me was transphobic.

Note that this conversation occurred prior to WPATH Standards of Care Version 8, which was released later in 2022, so maybe her view on the matter has changed with the new guidelines.

Some other details about her practice that I gleaned from our conversation:

• At the time that I spoke with her (May 2022), Dr. Rose had been doing vaginoplasties for 4 years during which time she had done approximately 30-50 (her approximation).
• She would not provide after pictures of her work on previous patients. Her justification was that showing pictures is a coercive marketing gimmick.
• She does penile inversion.