It's been a while since I've been on the site, but I've gotten some really wonderful and supportive advice on this site before so here I am My first question is about top surgery (well, questions I suppose): like, how do you find a gender therapist? And how long does it take to get a letter for top surgery? What kind of questions do they ask you? I need the letter because I want my surgery covered by insurance (we have good insurance through my dad's job, my dad spoke to someone on the phone saying they'd cover 80% I think), but like what's the process of going through insurance like? How long does it take for them to get back to you, stuff like that? And how long is the process of getting the surgery from start to finish, like from first visit with a gender therapist to date of surgery? I've been paralyzed by fear for years, wanting to die from tremendous dysphoria and I'm tired of crying my eyes out. I want to take action but I have no f***ing clue what I'm doing. My second question(s) are about coming out. As I posted in another thread, I am beyond tired of being referred to with feminine pronouns. My immediate family (my mom in particular) does so out of ignorance/being unwilling to accept that I'm trans yet, but some other people (you know, people that my mom hasn't already told without my permission yet) just do it because they have no idea I'm trans. Well, anyway I'm 1,000,000% DONE with it so I wanna start coming out to people. But like... should I wait until I get top surgery? Should I wait til I quit my job at the deli (which will be in just two months, and my *very Christian pastor* boss would potentially be able to see the Facebook post if my mom ends up commenting on it, since we both work for him there and they stay connected on Facebook)? Should I come out on Facebook and get it all done in one fell swoop? Some of the people I was friends with on Facebook (before I paused my account) I don't see very often in person anymore, but I think I still would want them to know in case I ever run into them again. I'm just so tired of my mom telling people I "think I'm a man in a woman's body," casting it in a light like I'm a mental patient instead of letting me do it myself with my own words, she's already told my aunt and at least one or two other people, and I'd really just like to do it myself and maybe, FINALLY have some other humans see me as a damn man! Y'know what I mean? Sorry for all these questions and sorry it's a little crazy. I'm just feeling so overwhelmed with all the steps here to get to where I wanna be, and suicide is completely off the table for me now which I guess is a positive but now I have to do the hard work to get myself outta this hole somehow. And I guess I'm scared and tired of looking at other people's post-op photos wishing it was me. Thank you for your time
First, top surgery. Getting rid of "the girls" is a major step. For some that means waiting a while and binding, for others that means doing it right away. Immediately getting rid of them surgically helps prevent binding injuries and the other parts of hell that is binding. The moment I realized I wanted to transition, I totally skipped the binding thing and made an appointment for surgery. I saw no point at all to waiting. From the time I had my surgery consult to the actual surgery was about 3 months. That included about two weeks of waiting for insurance to pre-approve my surgery, and a delay due to the surgeon having to reschedule because of a family emergency. I only had two visits to a therapist (2 weeks total) for a letter and a second letter from my primary care doctor (my insurance required two letters). Each doctor/insurance company has different requirements. WPATH used to also require testosterone as a prerequisite, but that's no longer true. Some doctors aren't aware of the change to WPATH, or aren't comfortable without the prior evidence of commitment to transition. To find a therapist, look for an LGBT counseling center. If there isn't one in your area, go to https://www.psychologytoday.com/us/therapists and use the keyword transgender. It should point you to therapists in your area. Be aware though, the listing is self-selected, and it may include those who are transphobes trying to get trans people into conversion therapy, or are simply clueless but think they can add trans folks to their income mix. If you don't like the first therapist you don't have to go back. It took us two tries to get a good one.
