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Bottom Surgery Dilemma - Need Advice Please


Charleigh Dakota

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Okay, so I have the resources to finally get my bottom surgery…..and I can have it as early as July...but it will all have to be out of pocket as my insurance wont pay any of it since I will have not met all their requirements by then... and I also wont have anyone to help me during the early stages of recovery, plus nobody to drive me the hour and a half home from the surgery or even be there for the surgery....and I would use up all my paid time off at work before going on long term disability for two months...and then have no time off available for follow up appts over the next year....at least not until Jan 1st 2025...then I will have plenty again. BUT.....if I wait til like December....my insurance will pay for almost all of it and none of that other stuff will be an issue....I just have to hope I dont get fired, laid off, sick, injured, outlawed or something happen to the doctor between now and then!!.......Then I would lose my chance to finally become me....on every level!!

 

I don’t know what to do!!!! Anyone got any good advice??

 

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  • Forum Moderator

Good afternoon Charlie,

 

I love your signature at the bottom of your posts. I'm a conservative when it comes to money, and an optimist when it comes to long term employment. While no business is promised a tomorrow. I would look at the your company history, your employment record with them, and hope that for the most part you'll be employed there for years to come. That being said, I know the trouble we all have waiting for lifetime needs. If you have the means to pay out of pocket? I'm only guessing that you're raiding your 401K or IRA. These are savings that you really don't want to tap into. Especially if you're under the age of 59 1/2, because you'll have to pay taxes and penalties for taking money out early. If your over 59 1/2 you'll still have to pay taxes on the withdraws. In real life you'll never be able to pay yourself back for those withdraws. We're already in the second quarter of the year, and you're saying that waiting until December keeps your money in place, you have time to find someone to drive you around, and your paid time off isn't a problem.

 

So I'm for waiting. I hope you understand my views are from a retired person living off my 401K and IRAs. I will be following this to read other's opinions.

 

Hugs,

 

Mindy🌈🐛🏳️‍⚧️🦋

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Hi @Charleigh Dakota

hugs and clarity to you 

 

breathe (sometimes hate it when people tell me that)

 

I agree with @Mmindy100.01%

(although I can’t see any signature at the bottom of your posts)

 

I’ve been through alot dealing with similar things.  Two bottom surgeries (yeah!!) .  Insurance dilemmas.  I was terminated just prior to last surgery.  All kinds of stuff. 
 

I cannot know every possible way your train can derail.  But rushing things out of fear can be destructive also.  
 

-  things start to move real fast and there’s a lot to prepare with this life changing surgery

 

Sorry if you’ve posted your story already and I’m not remembering it now.  


Questions for you:

 

- what specific “requirements for your insurance” will you not have covered by July?

- how long have you been actively transitioning (this time around, if it’s not your first rodeo)? 


 

 


 

 

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5 hours ago, Charleigh Dakota said:

Okay, so I have the resources to finally get my bottom surgery…..and I can have it as early as July...but it will all have to be out of pocket as my insurance wont pay any of it since I will have not met all their requirements by then... and I also wont have anyone to help me during the early stages of recovery, plus nobody to drive me the hour and a half home from the surgery or even be there for the surgery....and I would use up all my paid time off at work before going on long term disability for two months...and then have no time off available for follow up appts over the next year....at least not until Jan 1st 2025...then I will have plenty again. BUT.....if I wait til like December....my insurance will pay for almost all of it and none of that other stuff will be an issue....I just have to hope I dont get fired, laid off, sick, injured, outlawed or something happen to the doctor between now and then!!.......Then I would lose my chance to finally become me....on every level!!

 

I don’t know what to do!!!! Anyone got any good advice??

 

Charleigh,

 

Make sure your insurance company will reimburse you the amount you are going to pay the surgeon. I learned that even with pre-approval, they may only pay what they feel like paying, and that may be much lower than what you are paying the surgeon out-of-pocket. Is the surgeon keeping you in the hospital for some time post-operatively? Has your surgeon outlined your post-operative care? It sounds like you have some planning and some issues to work out prior to the surgery. Make no mistake, this is a major abdominopelvic surgery. You need adequate time to heal post-operatively. Also check into your short-term disability. That can help taster than the long-term disability. 

 

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6 hours ago, Mmindy said:

Good afternoon Charlie,

 

I love your signature at the bottom of your posts. I'm a conservative when it comes to money, and an optimist when it comes to long term employment. While no business is promised a tomorrow. I would look at the your company history, your employment record with them, and hope that for the most part you'll be employed there for years to come. That being said, I know the trouble we all have waiting for lifetime needs. If you have the means to pay out of pocket? I'm only guessing that you're raiding your 401K or IRA. These are savings that you really don't want to tap into. Especially if you're under the age of 59 1/2, because you'll have to pay taxes and penalties for taking money out early. If your over 59 1/2 you'll still have to pay taxes on the withdraws. In real life you'll never be able to pay yourself back for those withdraws. We're already in the second quarter of the year, and you're saying that waiting until December keeps your money in place, you have time to find someone to drive you around, and your paid time off isn't a problem.

 

So I'm for waiting. I hope you understand my views are from a retired person living off my 401K and IRAs. I will be following this to read other's opinions.

 

Hugs,

 

Mindy🌈🐛🏳️‍⚧️🦋

My funds are from a HELOC...Id never touch my retirement!! Great advice though!! 

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FYI...I can easily afford the payment on my HELOC...even after taking a $12/hr pay cut to go from the field to the home office so that how I can afford my surgeries...thanks again for your great tip though...I fully agree with you on that!! :-) 

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1 hour ago, Maddee said:

Hi @Charleigh Dakota

hugs and clarity to you 

 

breathe (sometimes hate it when people tell me that)

 

I agree with @Mmindy100.01%

(although I can’t see any signature at the bottom of your posts)

 

I’ve been through alot dealing with similar things.  Two bottom surgeries (yeah!!) .  Insurance dilemmas.  I was terminated just prior to last surgery.  All kinds of stuff. 
 

I cannot know every possible way your train can derail.  But rushing things out of fear can be destructive also.  
 

-  things start to move real fast and there’s a lot to prepare with this life changing surgery

 

Sorry if you’ve posted your story already and I’m not remembering it now.  


Questions for you:

 

- what specific “requirements for your insurance” will you not have covered by July?

- how long have you been actively transitioning (this time around, if it’s not your first rodeo)? 

 

 

Hi Maddee, no worries. I appreciate everyones input cause I need some friends to talk sense to my head cause my heart is pretty strong atm with this wonderful opportunity finally in its grasp..thats why I am here!! As far as your specific questions....my insurance requires 12 months HRT and 12 months living full time as a female (concurrently)...and support letters from my PCP and my psychotherapist. November is that 12 month point...the letters are easy and they already agreed to provide them.

 

I have been medically transitioning since Oct 1st 2023 and this is my first...and my last rodeo with this. I promise.

 

Theres my signature Mmindy was referring to....Thank you for that btw @Mmindy
 

SIgnature.png

"To Thine Ownself Be True" - William Shakespeare


 

 

 

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1 hour ago, KatieSC said:

Charleigh,

 

Make sure your insurance company will reimburse you the amount you are going to pay the surgeon. I learned that even with pre-approval, they may only pay what they feel like paying, and that may be much lower than what you are paying the surgeon out-of-pocket. Is the surgeon keeping you in the hospital for some time post-operatively? Has your surgeon outlined your post-operative care? It sounds like you have some planning and some issues to work out prior to the surgery. Make no mistake, this is a major abdominopelvic surgery. You need adequate time to heal post-operatively. Also check into your short-term disability. That can help taster than the long-term disability. 

 

Hi KatieSC. Yes...I am in heavy discussion with the insurance on that topic and ask lots and lots of questions of both the surgeon and the insurance...while I can pay for it 100% out of pocket...who would want to if they didnt have to...right? (I think I just answered my own question...SMH). It is only supposed to be 1-2 nights in the hospital (trach shave and vaginoplasty at the same time) and yes she has provided very detail pre and post op instructions, including my dilation schedule and which dilator to use when, etc as well as an extensive list of items I will need for post op care, etc...I am also in talks with my employer about FMLA and STD/LTD processes... I am in good hands with my employer, my surgeon and with my wife...if I am a patient girl and stop being so rushy rushy...its just OMG soooo hard since I am finally THIS CLOSE!!! 

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27 minutes ago, Charleigh Dakota said:

 

@Charleigh Dakota

Thanks for answering sister. 
 

I hold no necessary standards or beliefs that apply to anyone 100%.

 

My advice is my opinion.  And your thread is asking for advice.

 

I think you should take your time.  
The 12 month requirements isn’t that long.  This is going to change your future. 

Transitioning totally is a long term thing.  

There are a lot of other  changes and work in transition you can do also that are not surgical.  In addition to surgeries.  
 

Everybody’s different.

I don’t know how long it should take you.


But I think it’s wise to look at this as a longer term thing and brace yourself for let’s say a SEVEN year process (and then beyond) 

 

Do not  spend your savings IF your insurance will cover it in the near future.

 

DO be careful.  You are correct in that you could get hurt, or lose your insurance  etc.  You COULD lose your chance by not acting now.  Accidents  illness, etc.

Short of things like that, If your conviction is real, than no amount of time will stop you.  And very few obstacles will be able to block you.  I’ve been blocked many times.  If it’s real nothing will stop you.  

 

But unless you have a strong gut feeling (listen to those) that you absolutely, positively, no doubt, need to do this DONE IN THE NEXT THREE MONTHS, then PLEASE settle in and focus on your plans for December or beyond.  Do not rush this, but also never stop moving forward.  There is always some way to keep going forward each day in transition.  Focus on what you CAN  do today.
 

I’m rooting for you to do the right thing by you. 
 

🌈🌈

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There is one statement I need to restate:

 

I said if this is a real thing then nothing can stop you.  I guess more accurately I mean that if you are meant to transition, many obstacles can and will be overcome.  
 

There are many sisters and brothers that are blocked from surgical transitions for various reasons beyond their control.  This does not dictate their REALITY of living their best life if they can transition in other ways.  I myself am extensively medically and socially transitioned.  But there are NON OP trans women who are more feminine than me.  Maybe more “trans” than me.  
 

Thanks for putting up with my rants. 
 

Bless your path

🌈🌈

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@Maddee Good morning my sister! Thank you so much for your great post. I truly appreciate everyone's input and I am certainly listening to those whom are in a better place to more clearly evaluate my situation. I am in total agreeance with waiting until my insurance will cover the procedure etc....There are many reasons why waiting would be the best choice and only one reason why not waiting would be....so after reading everyone's comments...it is much easier now to settle in on the longer haul to my surgery. Thank you being so awesome!! **MuchLove**

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