mtf, newly researching grs; lost, confused, overwhelmed

9
u/Rare-Philosophy-5146
Thu Oct 1 17:11:33 2020 UTC
(30 comments)

I've known I was trans for years and got a referral about hormones about 5-6 months ago. Now I'm starting to seriously look into bottom surgery.

However, I'm completely lost. I'm well aware of the horror stories and such, but I've spent ages looking around at resources (including the wiki) and trying to pin down anything that seems solid and verifiable and seemingly gotten nowhere. I can't seem to find many reviews or other proofs of a good surgeon for anyone, really, which is of course critical.

I've learned some general information about the options/preparation/aftercare, but all of it boils down to hearsay and in any case it's a lot less than I'd like for such a huge decision, same as the surgeon to pick.

The doctors I'm seeing about hormones told me about a seemingly not terribly helpful website, said they don't offer referrals to surgeons or any such, and sent me on my merry way for three months til I need a refill on hormones.

I feel as though I'm being forced to do all of the back-end administrative work that doctors are supposed to do, all while figuring out the financial aspect as well; I have no idea if I'll be able to cover the costs, even, though I am at least aware of some (surely not all) viable options in that regard. Regardless, I’m, exhausted, overwhelmed, and above all finding it impossible to figure out. Where do I even begin?

It's worth noting that I live in the USA. I'm willing to, ultimately, travel to the ends of the earth, but that's not exactly feasible at present.

all 30 comments


14
u/SarahMerigold
Thu Oct 1 18:23:17 2020 UTC
(6 children)

Doctors dont have much more knowledge than you often.

4
OP
Thu Oct 1 19:18:43 2020 UTC
(5 children)

Please see my response to Seanna86 where I talk about this sentiment, for the sake of having discussion sorted well: https://old.reddit.com/r/Transgender_Surgeries/comments/j3crgd/mtf_newly_researching_grs_lost_confused/g7bhuty/

2
Thu Oct 1 19:57:19 2020 UTC
(4 children)

Your best bet would be to start looking up what your insurance is gonna cover. Then look up surgeons.

For example, i gotta pay 20k for SRS at the Suporn clinic and need 6 month of therapy for 1 of the 2 psychiatrist letters. Im either having surgery done by Dr. Bank or Dr. Prae.

Dont hesitate to contact anyone by email, especially surgeons. They gladly give you cost estimates and other information.

1
Fri Oct 2 01:30:27 2020 UTC
(3 children)

You should be able to get your letter for Suporn Clinic online fairly easily. Six months is bs.

1
Fri Oct 2 06:36:19 2020 UTC
(2 children)

They said so in the email. The other letter i get in Thailand.

1
Fri Oct 2 06:44:19 2020 UTC
(1 child)

You need a letter which meets the requirements on this page

http://supornclinic.com/restricted/Scheduling/protocol.aspx

There’s no 6 months of therapy, unless you mean hrt. There’s also many ways of satisfying the requirements if you read it very carefully. It’s not WPATH either, it complies with Thai law.

1
Fri Oct 2 06:54:04 2020 UTC
(0 children)

I trust their email over you and dont mansplain this to me.

5
u/HiddenStill
Thu Oct 1 17:42:55 2020 UTC
(2 children)

In the wiki start with the surgeons with the most reviews as they are the most popular. Look at the photos of post-op results and try to understand what you’re looking at. Compare among surgeons.

3
OP
Thu Oct 1 19:24:19 2020 UTC
(1 child)

Is there any way to tell who has the most reviews? I'm guessing the longest entries in the listings have the most reviews, on this sub and possibly in general on the wider internet?

3
Thu Oct 1 22:55:06 2020 UTC
(0 children)

Longest list of entries in the wiki here. I doubt you’ll find any significant lists anywhere else.

6
u/BotchedSRS
Fri Oct 2 00:55:17 2020 UTC
(4 children)

I had many complications with multiple surgeons. PI and colonvaginoplasty all failed for me. I dont personally know anybody who has good results but a lot of girls online swear they get wet,cum multiple times and have 9 inch depth. If anything goes wrong surgeons tend to blame your anatomy or that you did not follow after care instructions. Community gonna just blame you for choosing the "wrong" surgeon. Trans community hates when people speak out openly about less than satisfactory results because right uses it to prove their point that we are just confused and transgender is not a thing;(((

3
Sat Oct 3 15:27:31 2020 UTC
(3 children)

Yes its like people don't want to admit poor outcomes happen. They want to rationalize etc.. Sometimes it feels like the technology still needs to advance..

1
Tue Oct 6 22:50:39 2020 UTC
(2 children)

It is not advanced at all when it comes to this surgery. Don't try to convince me otherwise.

3
Wed Oct 7 00:14:55 2020 UTC
(1 child)

They still do same surgeries from the 80s.. PI.. Some experimental stuff out there but not really proven yet..

1
Wed Oct 7 00:25:07 2020 UTC
(0 children)

Exactly. But community is treating a few surgeons like Gods.

5
u/Forgetwhatitoldyou
Thu Oct 1 18:13:59 2020 UTC
(5 children)

I'm assuming that you have insurance? You could put together a list of 10-20 possible surgeons in the US - as /u/HiddenStill said, start with the most popular ones - and see which ones are covered by your insurance. It could also help if you decide whether you want PI or PPT, or something else.

No matter what, don't go to Dr. Kathy Rumer.

3
OP
Thu Oct 1 19:25:33 2020 UTC
(3 children)

I have medicaid under North Carolina rules. I don't even know if it pays for surgery.

1
Thu Oct 1 19:42:35 2020 UTC
(2 children)

If you are not looking to go to Thailand, or one of the US surgeons who operate on a cash basis, then contacting your insurance, to see what they cover and with what restrictions, should be your first step.

1
OP
Thu Oct 1 19:51:06 2020 UTC
(1 child)

I tried calling some medicaid bureaucracy to ask, but they said they need some arcane procedure identifier I don't know. I then tried to ask doctors and such what that identifier actually is, and no one ever actually told me at any point. This was an effort that took days and accomplished nothing some time back, mind.

Expecting straight, human-interpretable answers out of a government agency is folly in general, as I've learned. Remember that government bureaucrats are not actually human beings who understand human being things any more; at some point their soul was removed as a requirement of having the job they now do along with a large portion of their brain, and all they understand is inscrutable alphabet soup designations and long forms that exceed War and Peace in character count. Meaningful communication with their kind has never been established, far as I'm aware.

1
Fri Oct 2 03:20:49 2020 UTC
(0 children)

I would refute that, actually. The people that work for government agencies are mostly overworked and underpaid. They don't make the rules. Congressional "representatives" do. Point the finger of blame where it belongs: your discriminatory state congress. (They did pass HB-2, afterall.)

The problem inherent with Medicaid is this: though it is a federal program, its governance is left to the states (for some stupid reason). The problem I've found trying to go for surgery is I had to move to a state with progressive trans laws to even have a PRAYER in getting my needs met. I'm fortunate to live in a state where I have a choice of two surgeons, both covered by Medicaid.

Yet, I'm still a bit confused as Dr. Stiller is still new to offering SRS and thus no one really has testimonies or results photos. Dr. Bowers is well known and has been doing surgery for YEARS... but has a 3-year wait list. It's been 18 years already. I don't wanna have to wait that much longer.

3
Fri Oct 2 01:01:19 2020 UTC
(0 children)

Kathy Rumer is a mess. She should be canceled for good. Please community cancel Kathy Rumer.

2
u/Cassady1AndOnly
Thu Oct 1 21:40:53 2020 UTC
(1 child)

I feel you on the lack of help. Recently, I had lab's I paid over $200 for, I'd been taking lower doses of injections to get my bodies balance better, and ended up with labs showing normal male levels of T and higher estradiol levels, i figuredthere was a mix up. Waited 2 months for an answer from my Dr, nothing. Went in in person for an answer and she still didn't have one. I finally called the labs myself and they answered with "We don't make mistakes". My last Dr, I explained I was suffering from extremely painful genital atrophy and requested a testosterone cream to counter it, she refused saying it'd 'reverse my transition' and that dealing with atrophy was part of what I signed up for. At least my most recent Dr. got that for me, no more issues, and my T hasn't gone up one bit. I'm sick of Dr's who offer Healthcare for trans patients and then give shitty advice and bare minimum help. In the heart of a very progressive city in Washington State, no less.

1
Fri Oct 2 03:24:01 2020 UTC
(0 children)

I'd say look up Dr. Powers. He could have some insight. There's a subreddit: r/DrWillPowers .

1
u/CasraTX
Thu Oct 1 18:30:47 2020 UTC
(0 children)

I started by looking on line, found dr's in Texas where I am, and then researched those. I settled on the Crane Center, and made an appt after talking to my insurance. After meeting Dr. DeLeon, I booked my surgery. Next month I'll pass on how it went but for now I'm just in wait and see. That's how you start. Find doctors near you, research the hell out of them. this sub has been great with the "avoid this doctor" some of them have had some really terrible results. We get one shot to "fix" our genitals to meet our needs. I know some like the overseas docs, I have too many issues with going that route, so I chose stateside. your choice of course is yours.

Ultimately, you have to first decide "is this what I NEED". Then you put aside emotions and buckle down, doing the leg work now, yourself gives you control not puts you at the mercy of admin pukes.

1
u/Wittenbergthrowaway
Thu Oct 1 18:33:09 2020 UTC
(0 children)

Check out my blog for some of the nitty gritty daily type stuff

https://mygenderconfirmation.wordpress.com/

1
u/Seanna86
Thu Oct 1 18:45:11 2020 UTC
(4 children)

I also had the feeling that a good portion of the medical community still doesn't know how to treat us (or have limited experience doing so). I think they try, and they want to be helpful, but sometimes they don't have the knowledge or training.

With that said, when I first started going down the surgery road, I, too, only thought there were a handful of surgeons in the country that performed GCS, and even more so, thought if i wanted a really good result i needed to go to Thailand.

Well fast forward to now, I've realized that there are a TON of really great surgeons out there but you just dont hear about them. For example; i have my GCS scheduled with Dr. Gast at University of Wisconsin Hospital. I had no idea this women existed until a little over a year ago and I literally live in a Madison suburb. The information can be hard to find for many of the surgeons. I couldn't find a single example of Dr. Gast's work, however from what I have seen as well as personal tesitimonials I've received, really gave me the confidence to schedule with her.

It does feel like we are feeling around in the dark for information with this, but then again, it seems that the medical community is too.

Good luck!

1
OP
Thu Oct 1 19:16:38 2020 UTC
(3 children)

It does feel like we are feeling around in the dark for information with this, but then again, it seems that the medical community is too.

Doctors dont have much more knowledge than you often.

If this is true I wonder if surgery is even right for me. I don't seem to have anywhere near as severe genital-related dysmorphia as many trans women, I more just hate my body hair and masculine, breastless physique, which is finally starting to be sorted out thanks to an at home laser wand and steadily increasing estradiol + already maxed spironolact. I'd certainly like to have a vagina, and no doubt my fiance would love to have piv sex, but I'm reluctant to try not strictly necessary surgical intervention if it's risky and the medical community only just barely knows what it's doing.

I'm curious about an orchiectomy, whether as a long-term solution so that I don't need spironolact (It makes me have to pee a lot and in 20 years or so I'll be at an age such that it, with estradiol, could pose risks to my health) or as a precursor to GRS, but I'd heard that it limits the options available for surgery.

I've also heard about Thailand, and what I understand is that there are plenty of very good surgeons available that are also very cheap (nominal currency exchange rate does not match purchasing power on the ground in general, in great favour of tourists, apparently), which may be important because I have medicaid under North Carolina rules. The only thing I've been able to find about NC medicaid's rules for transgender treatment suggests that it just doesn't have any explicitly stated. I figured it might not even cover hormone appointments, but it seemingly does.

2
Thu Oct 1 20:02:09 2020 UTC
(0 children)

Just another note, the surgeons are very knowledgeable from what I've seen/experienced. I have no reservations going under the knife knowing what I know about my surgeon now. It's the medical community at large that seems puzzled with us. There are also SOME PCPs/endocrinologists that really know their stuff, it's just definitely not the norm from what I've experienced.

1
Thu Oct 1 21:48:36 2020 UTC
(0 children)

It's not that surgeons that work with trans people don't know what they're doing, it's that doctors that have not specifically worked with trans people (and even some endocrinologists who do) usually dont know anything about trans healthcare.

Anyone who performs bottom surgery and isn't a butcher will be very knowledgeable.

Also gender dysphoria != Body dysmorphia