Breasts: Jas Thoughts!

There's no legal requirement for counseling that I'm aware of.  However, the surgeons may require it.

Ask your health  insurance about how the Standards of Care apply according to their coverage. Last time I checked one needed a psychologist to write a letter supporting one’s medical need to start HRT, two letters from two different psychologists supporting one’s medical need for BA, FFS and GCS. I have a trans man friend who recently removed his breasts. I would guess he had two supporting letters from two psychologists but it never came up to ask him. Your health insurance would be the opinion to listen to on this.

Thank you for the responses. Now what bothers me about all this.

Why?

Woman and Men, who are not trans can make decisions on body modifications as they please. Tattoos and body piercings or even enhancements of body features without psychological referrals.

Bottom line, I go to counseling to help myself make competent decisions. Not to get someone's referral cause they have been convinced what I say is true.

True equality, I am a person who knows who I am and how I want to see myself. I don't believe I need to convince anyone of who I am. This is what I struggle with. All my life I have been trying to convince myself to be something I knew I wasn't, but here I am trying to convince people that I am who I am. Trading one act for another!

Just a rant, maybe you feel the same way or you don't!

To an extent I agree with you. However, anything that is considered an elective surgery, or cosmetic and not medically necessary, insurance will deny. You cantc get a facial reconstruction surgery with insurance money unless it is medically needed for your health somehow, such as a burn victim. Not if you just want to look prettier. You will be denied. Unless you are paying with your own money, then you can get any surgery you want if you can find a doctor that is willing. The problem is that trans people aren't always recognized as needing it medically, even though it is a necessity for our mental health. That's the problem I have.

Jasmine,

I hear you about the gate keeping we have to go through. It's a lot. It's also more cost, more time and can be frustrating. Regardless of having my letter from my psychologist and having had my psychiatrist diagnose me with gender dysphoria before that I was denied HRT by the first medical doctor I approached. It can be exasperating. What kind of problems are being thrown at you? Any roadblocks in your transition or is this just about feeling the Standards of Care are unjust?

I found some snippets from the Standards of Care to try and have it answer your "Why" question:

"The overall goal of the SOC is to provide clinical guidance for health professionals to assist transsexual, transgender, and gender nonconforming people with safe and effective pathways to achieving lasting personal comfort with their gendered selves, in order to maximize their overall health, psychological well-being, and self-fulfillment."

"As for all previous versions of the SOC, the criteria put forth in this document for hormone therapy and surgical treatments for gender dysphoria are clinical guidelines; individual health professionals and programs may modify them. Clinical departures from the SOC may come about because of a patient’s unique anatomic, social, or psychological situation; an experienced health professional’s evolving method of handling a common situation; a research protocol; lack of resources in various parts of the world; or the need for specific harm reduction strategies. These departures should be recognized as such, explained to the patient, and documented through informed consent for quality patient care and legal protection. This documentation is also valuable for the accumulation of new data, which can be retrospectively examined to allow for health care – and the SOC – to evolve."

And just one more exerpt:

"The SOC are not intended to limit efforts to provide the best available care to all individuals. Health professionals throughout the world – even in areas with limited resources and training opportunities – can apply the many core principles that undergird the SOC. These principles include the following: Exhibit respect for patients with nonconforming gender identities (do not pathologize differences in gender identity or expression); provide care (or refer to knowledgeable colleagues) that affirms patients’ gender identities and reduces the distress of gender dysphoria, when present; become knowledgeable about the health care needs of transsexual, transgender, and gender nonconforming people, including the benefits and risks of treatment options for gender dysphoria; match the treatment approach to the specific needs of patients, particularly their goals for gender expression and need for relief from gender dysphoria; facilitate access to appropriate care; seek patients’ informed consent before providing treatment; offer continuity of care; and be prepared to support and advocate for patients within their families and communities (schools, workplaces, and other settings). "

Here's a link to the SOC copy I took these from:

https://www.wpath.org/media/cms/Documents/Web%20Transfer/SOC/Standards%20of%20Care%20V7%20-%202011%20WPATH.pdf

Okay so if you've not gotten too flustered with the exerpts and have made it this far I want to tell you an answer to your question from my perspective. I think what's going on is the psychological, health insurance and medical fields are trying to give us the best chance against transphobia. I think the psychological field has us in their Diagnostical Study Manual, DSM, in order for insurance companies to consider our medical needs as actual medical needs. Overall I think the medical field wants to make sure it will be paid for services rendered. I also think the medical field wants us to be as successful in our lives as possible post surgeries. And voila, there's a Standards of Care! Honestly, once the hoops have been jumped through you might just forget about it like I have.

We have some great information from this thread, and I notice that no matter how vague I try give a chance for our non TG members to participate, I am striking out here. And you all have been respectful not to comment from a non transgender view. Which brings me to my next issue I deal with.

How do you accept standards made up from the medical field based upon observational theory?

I just feel, that many I chat with struggle to validate who they are. And in my time with CDH and TGH, I recognized a consistent trend of trying to reconcile with memories of our child hood.

A little background here on this question, I question how professional those who provide care for trans people and those trans people that blame the medical community for their failed transitions.

Jasmine,

I just accept medical transition assistance and be thankful I'm getting any. I look the other way.

I wish my general practioner would have more credentials than a one semester class on us. I wish they would actually know other transition medical professionals. I mean, at least have read their research! I wish there were much more research! I'm tired of having to find and vet all of my medical specialists for transition. I'm a laborer how the hell am I supposed to know medical stuff?! It's like they pin all of this information I need to know like a hatchet in my back even though I'm paying them for medical advice(and I think they offer almost none so why am I paying them). That's like if I want to go for a drive in my truck I better research how rubber is made, the history and proper formulation of steel and how those materials form a tire. And oh yeah, don't forget to know what Greek genious invented pnuematics so we can have the technology of tires at all.

Frustration. Knowing what I want is easy. Getting what I want...now that's the trick!