I was thinking about how my transition would map out over the next few years, and wondered if anyone has heard of getting top surgery prior to HRT? Also more generally, how do you go about getting scheduled for top surgery? Is it through the same gender therapist that would prescribe HRT? The reason I wondered is because I would almost rather get top surgery first before hormones. I feel like stepping toward a more androgynous, prepubescent male body first would make it easier for me to adjust while transitioning. Lastly, does anyone know what the rough wait-list time is for top surgery in the USA (or California more particularly)? And is there a list anywhere that tells which insurances cover the cost? This is a lot of questions I realize. But now that I'm getting closer to actually transitioning socially, I'm starting to think more seriously about these things.
I don't have a list of surgeons off the top of my head, but it's a thing where they can work with you to get top surgery if you're pre-T or you don't want to go on T. The process of going about that depends on the surgeon, since some don't require a letter from your therapist, as far as I know. As for the wait list time, it depends on the surgeon. I think Dr. Garramone in Florida and Dr. Medalie in Ohio are backed up until 2018--however, I'm not sure about the insurance companies that cover said issues. If you google "transgender insurance usa", you should get results. In some states, like mine, transgender exclusions in health care are officially outlawed. I was told by my provider that they don't have all the details, but surgical procedures are covered; however, the copay information they weren't sure of.
I've heard of getting top surgery without T. (Something I was thinking about, maybe, right now my chest is bearable, but if it grows some more I'm not so sure) Yeah the gender therapist gives recommendations for that as well.
I don't know the process of it in the US but in the UK, surgeons generally like you to be 6+ months on T before being referred for surgery and that's nationwide. However I know of a couple people who aren't considering T or their chest is the thing that causes them the most dysphoria and there are exceptions made for people to get top before starting T. You've got to consider that if you do then go on T, fat redistribution may then effect the surgery result which is why surgeons here like you to be on hormones for a certain amount of time, to achieve the best result. I'd definitely make sure getting surgery before starting T is the right thing for you, especially with how much it costs.
I don't know about in the US, but in this country there's a lot of misinformation around at the moment regarding top surgery because they're moving us over to a different health system. As far as I know, pretty much all the public and private surgeons won't accept anyone under 18 and most need you to have been on T for 2 years at least. Getting top surgery through the public system without being on T would be pretty much impossible. I'd say you're best bet is to go private if the guidelines in the US are anything like they are here
I have heard of several people getting top surgery before T. I believe that surgeons prefer you to have been on T, as the effects of T can make it more clear to surgeons where the best place for the incision is, but I don't believe it is mandatory to have been on T. As far as I'm aware, top surgery functions slightly similar to the process of getting T, in that some surgeons require a therapist letter, and others operate on a more "informed consent" type basis. A lot of this probably varies surgeon to surgeon, maybe some surgeons do require you to have been on T and have a therapist letter, whereas others do not.
I think it works this way too but I wonder if it's easier to see how surgery fits in with your body if you go on T? I am considering top surgery but I don't want to go on T. Saw some horror photos today and I think I look pretty cute, even if I look like a lesbian. Think I'm coming to terms with my face.
