Can this happen? SRS without hormones? SRS without transition?

[Drea]

So are these pre-requisites really needed.

For purposes of the question, one should consider it applying to mainstream surgeons such as Marci, Brassard, meltzer, McGinn, etc. Not one of those surgeons on the margins or overseas that are liable to take money to do anything.

With regards to the first question I am referring to people who choose not to have HRT and was not intending to mean those who can't have HRT for medical reasons.

[Guest KimberlyF]

A friend had her surgery the same time as a girl who never had HRT prior to her SRS.

You can find a surgeon who'll do anything for the money. I'm sure some won't.

[Guest Donna Jean]

.

Would a surgeon perform MTF SRS without the person having any intention of transitioning?

Isn't SRS transitioning in itself?

Or do you mean SRS without living in role?

Dee Jay

[Drea]

.

Would a surgeon perform MTF SRS without the person having any intention of transitioning?

Isn't SRS transitioning in itself?

Or do you mean SRS without living in role?

Dee Jay

Transition would be a change in in public gender role.. Just going on hormones or having surgery would not be transition by my definition. I understand some people tend to lump any level of treatment, even just some therapy as "transition" but I don't subscribe to that as it is pointless to have a term that covers such a wide range as to become meaningless.

But if you consider "transitioned" to include a MTF living as a guy full time post SRS, that is your perogrative. It certainly would raise questions as to exactly what transition means.

[Guest Donna Jean]

.

Would a surgeon perform MTF SRS without the person having any intention of transitioning?

Isn't SRS transitioning in itself?

Or do you mean SRS without living in role?

Dee Jay

Transition would be a change in in public gender role.. Just going on hormones or having surgery would not be transition by my definition. I understand some people tend to lump any level of treatment, even just some therapy as "transition" but I don't subscribe to that as it is pointless to have a term that covers such a wide range as to become meaningless.

So, by that definition, someone living in role (even if they have no HRT, surgery and have a beard) are in transition...

And someone in therapy, doing hormones and and having surgery aren't necessarily in transition?

Yeah....that makes sense to me....

Dee Jay

[Carolyn Marie]

Drea, I think the question shouldn't be "would they," but "should they?" We've all seen a couple example at least of people who got SRS because they were rich and could pay a surgeon whatever they wanted without all the rest of the hoopla. If someone can convince a doctor that they know what they're doing and signs an ironclad release of liability document, then I think more than one doctor would do it.

Should they, though? Depends on whether one would consider doing so, "doing no harm," and whether asking for SRS under condition #2 would indicate someone not in full possession of their faculties. What conceivable reason would a rational person have for removing their reproductive organs if not to transition, barring some weird medical necessity?

Concerning the first question, I can see how someone might not be able to take hormones and still desire SRS. There are many medical conditions that make hormone treatments risky or inadvisable, but where SRS is still feasible.

HUGS

Carolyn Marie

[Guest kelly_aus]

The SoC's require a year of RLE before a surgical referral can be given..

That said, I'm sure you could find a surgeon that would perform SRS regardless.. As to whether it was a surgeon you would actually want to use is another matter..

[Drea]

Should they, though? Depends on whether one would consider doing so, "doing no harm," and whether asking for SRS under condition #2 would indicate someone not in full possession of their faculties. What conceivable reason would a rational person have for removing their reproductive organs if not to transition, barring some weird medical necessity?

Perhaps their strongest need is just to be comfortable with their body?

Concerning the first question, I can see how someone might not be able to take hormones and still desire SRS

That is true however the question was really intended to refer to those who decide they don't want hormones as compared to those who can't medically take hormones.

[Guest Sascha]

I voted both question as NO.

However, it might be technically possible. The reason I said no, is because the preferred way or method in my personal opinion should be the intention to transition and experience in the use of hormones that will replace the testosterone. Ergo, the human body needs either estrogen or testosterone. So even if someone obtains an SRS and no estrogen, (S)he still needs testosterone.

[Guest ~Brenda~]

One can always find unscrupulous surgeons, or those that that claimthat they are to be. The anwser is yes, one can always find someone to perform surgeries outside of the established WPATH recommendations. This is a very serious problem. Please do not fall for this temptation. SRS is very serious and demands consultation both before and after. Additionally, one must work with good therapists and doctors to achieve the best the results with the least risk possible. Far too many people have died cutting corners.

Brenda

[Drea]

One can always find unscrupulous surgeons

For purposes of the question, one should consider it applying to mainstream surgeons such as Marci, Brassard, meltzer, McGinn, etc. Certainly there are those surgeons on the margins or overseas that are liable to take money to do anything.

[Guest ~Brenda~]

One can always find unscrupulous surgeons

For purposes of the question, one should consider it applying to mainstream surgeons such as Marci, Brassard, meltzer, McGinn, etc. Certainly there are those surgeons on the margins or overseas that are liable to take money to do anything.

I would recommend that what I quoted is made clear in the poll. What is the motivation for this poll?

I am expressing a warning to all who have contemplated "alternatives".

Brenda

[Guest KimberlyF]

One can always find unscrupulous surgeons

For purposes of the question, one should consider it applying to mainstream surgeons such as Marci, Brassard, meltzer, McGinn, etc. Certainly there are those surgeons on the margins or overseas that are liable to take money to do anything.

My friend was with Bowers when the person w/her didn't have any prior HRT, and I know of a few people who had their surgeries at about the 6 month mark w/Brassard. How early into FT I don't know.

[Guest Leah1026]

Under Version 6 I would have said NO. But Version 7 is slightly more liberal. That said I still think it will be very difficult to get the 2 letters of recommendation AND a surgeon willing to help. In my mind the person would have to have a documented medical reason for not being on HRT, for example clotting problems/previous pulmonary embolism.

I simply cannot fathom a transsexual person not wanting HRT. And almost anyone that's ever gone full-time will tell you they will NEVER go back to living as they did before. So I'm don't understand the motivation for this question at all.

This question highlights something that is a fear of mine. Namely people who are not transsexual getting surgery willy-nilly and then regretting it. And then a bunch of bad press erupting and resulting in us going back to more draconian measons like Version 5 (or worse).

[Guest Edu]

After a moment of hesitation, I voted "yes" on both questions: as many people has already stated, you could always find some surgeon who would do it.

Had the questions been worded with "should" instead of "would", I would have immediately answered "no". Sure, there may be some extreme corner cases where it would be justified, just like sometimes doctors have to perform limb amputations on some patients; but in the general case, performing SRS on someone who neither needs it nor is prepared for it is just insane.

Hugs,

Ethain

[Guest Fionnuala]

What is the point of this poll?? It doesn't make any sense. And besides, no one here can answer this question

If someone doesn't want HRT for any other reason than a pre-existing condition which precludes them from taking hormones, they don't have the medical condition known as transsexuality; SRS would be a disaster for such a person. I can't imagine that Dr. Brassard, McGinn, et al., would perform SRS on such a person.

[Paula ult]

So are these pre-requisites really needed.

For purposes of the question, one should consider it applying to mainstream surgeons such as Marci, Brassard, meltzer, McGinn, etc. Not one of those surgeons on the margins or overseas that are liable to take money to do anything.

With regards to the first question I am referring to people who choose not to have HRT and was not intending to mean those who can't have HRT for medical reasons.

Having had a consult and Surgery with Dr. Mcginn, i can say without a doubt that she would not preform srs/gcs/grs on someone that had no intention of transitioning, taking hormones or doing the RLT, i seriously doubt any reputable therapist/ psychologist/psychiatrist would write surgical letters for a person not intending to fully transition because they would not consider that person to have gid.

Maybe someone that wants srs without the rest just wants to feel comfortable in their body without further changing it, without the coming out, losing friends, family, job etc, i do not see how someone could do this but i guess anything is possible.

Paula

[Guest Donna Jean]

I simply cannot fathom a transsexual person not wanting HRT. And almost anyone that's ever gone full-time will tell you they will NEVER go back to living as they did before. So I'm don't understand the motivation for this question at all.

This question highlights something that is a fear of mine. Namely people who are not transsexual getting surgery willy-nilly and then regretting it. And then a bunch of bad press erupting and resulting in us going back to more draconian reasons like Version 5 (or worse).

You said it, Girl!

How can a Transsexual (by definition) NOT want HRT or other measures?

Dee Jay

[Guest KimberlyF]

There have been transsexuals throughout history. They didn't come about with the manufacture of the first premarin Pill. Some just lived as the sex they IDed as. Without therapists, without SRS and even without HRT.

Now there are cases of people on these boards of kids in HS going FT w/o HRT. If they do it long enough, they can have SRS without HRT. Totally legal. Meets SOC criteria and makes question one a yes. Or, someone could just not have money for a therapist or HRT and start living FT. Not all TSs need to be treated with HRT. You can start after SRS.

[Drea]

To be clear, I exclude those from this discussion who have gone overseas to avoid standards, have forged papers, have decived their doctors or even bribed their doctors to have SRS.

I posed to question see what the understanding was about the true situation when it comes to how the professionals deal with things compared to what the community beliefs are.

I know for a fact that answers to both these questions ae yes though none of the surgeons would seem to allow for this according to their published requirements..

I know for a fact that Marci Bowers has performed surgery on someone who has never been on HRT because she didn't want HRT.

I know for a fact that both Dr Menard and Dr Brassard have performed surgery on people who had no intention of transitioning.

I know for a fact that Dr McGinn has performed surgery without the requisite referrals.

In all these cases, they were people who did not engage in any sort of deception in order to get surgery. These were fully documented exceptions as allowed by the standards and the instances I know of all occured before the current SOC which seems even more permissive. One was at least 7 years ago.

Such exceptions aren't common, but neither are they especially rare. They may represent 5% (1 of 20) surgeries performed. The professionals (therapist and surgeons) that grant such exceptions (and I can't speak entirely to the rationale they may have) usually won't speak of such as suddently a significant portion of their clients wish to be such exceptions.

I used these very extremene examples for purposes of illustration. What I wished to illustrate is that the "community speak" the "online experts" tend to parrot the standards whereas the professionals for whom the standards were written often interpret them somewhat differently.

There is a great deal of "community speak" that suggests transition is the only cure, that without transition someone trans can never be happy. When in reality, of the many folks that seek professional help there are all sorts of treatment combinations that they may avail themselves of. For some therapy provides sufficient relief. For another maybe hormones alone. For a third maybe part time living. Others may find, like in the extremee surgery example, surgery without transition works for them. In still other cases public gender role change is needed or even both public role change and surgery.

The point is that there are no hard absolutes. There is nothing wrong with transition, but that is not the only treatment option available. That depending on one's individual circumstances there may be options that work better than that one word "transition".

[Drea]

I should add. Such decisions are for the professionals to make.

If the professionals, well respected ones in fact, make these decisions who are we to judge that they are making wrong decisions?

I don't consider professionals perfect, but if there is anyone who understands there is not just a one fits all solution and when an exception is warrented, they are the ones to make that decision.

[Guest ~Brenda~]

Most trannsexuals do not "transition". There many, many good reasons why these people decided not to transition. Each person is allowed and encouraged to find their balance.

This is the most fundamental reason why we are here. We exist to help people find peace and balance. It is interesting to compare specific instances of SRS that happened outside of the normal expectations. However, one should follow up and consider if the people in these circumstances are happy in their lives now. I surely hope that they are happy.

Noone's path is the same as another's. Safe practices is what is necessary to advocate here. Indeed, there may be occurrences of SRS without HRT or even those who do not desire to transition. Well.....OK. What is missing is the history and all dynamics for those that are mentioned. The real importance here is that each and every person finds their peace and themselves. Anecdotal information, although interesting, does not change my views nor the mission of Laura's.

Brenda

[Guest Leah1026]

I posed to question see what the understanding was about the true situation when it comes to how the professionals deal with things compared to what the community beliefs are.

Such exceptions aren't common, but neither are they especially rare. They may represent 5% (1 of 20) surgeries performed.

I think the numbers are way lower than that.

I used these very extremene examples for purposes of illustration. What I wished to illustrate is that the "community speak" the "online experts" tend to parrot the standards whereas the professionals for whom the standards were written often interpret them somewhat differently.

I see your purpose somewhat differently. Namely to cause controversy. I mean arguments like this are pointless, the fact remains that transition IS a highly successful treatment and has been for hundreds of thousands of people.

There is a great deal of "community speak" that suggests transition is the only cure, that without transition someone trans can never be happy. When in reality, of the many folks that seek professional help there are all sorts of treatment combinations that they may avail themselves of. For some therapy provides sufficient relief. For another maybe hormones alone. For a third maybe part time living. Others may find, like in the extreme surgery example, surgery without transition works for them. In still other cases public gender role change is needed or even both public role change and surgery.

The point is that there are no hard absolutes. There is nothing wrong with transition, but that is not the only treatment option available. That depending on one's individual circumstances there may be options that work better than that one word "transition".

It's not "community speak". The kind of people you're talking about JUST AREN'T HERE. If they were "community speak" would reflect that and be different. You seem to be blaming us because they don't participate. I am aware that many people don't transition for various reasons, but I also see problems with the scenarios presented.

1. The possibility for abuse of the system if anyone can simply skip all treatment and go straight to SRS. Will this allow non-trans people to get SRS?

2. And if so I see lots of bad things happening. Things like patients commiting suicide, suing doctors and maybe government intervention.

3. And I also worry that those same problems could happen with some of these rare trans people you speak of. IMO hormone replacement therapy and the RLT help prepare people for SRS. Without those building experiences I think some of these people are in for a shock.

4. Also after SRS they are going to have almost no hormones in their body. As a result to remain fully healthy they are going to have to start HRT.

5. You seem focused on the physical effects of HRT. HRT also has tremendous metal effects as well. There is a lot to be said for having a hormone balance that matches your gender.

6. Although people may opt for surgery only I still believe that full transition offers the best chance for fulfillment. Surgery may bring them some measure of peace, but they won't know the happiness many of us have found. It may help their physical dysphoria, but they will still suffer from social dysphoria.

I know I may be slammed for what I've written, but I just don't see the point of this question. This is a support forum for the people that are here, not for the ones who aren't.

[Guest KimberlyF]

This below is from page 9 bottom of my current SOC 7.  It says any combo and any order based on the individual.  It allows for ethical doctors to make exceptions for people.  They should always be concerned with the health of their patient overall which is where the consult comes in. A lot of people made the automatic jump that no HRT prior to SRS meant no SRS after. The patient w/my friend took her first estrogen in Bower's hospital.

***

Options (NOT REQUIREMENTS )) for Psychological and Medical Treatment of Gender Dysphoria

-Changes in gender expression and role (which may involve living part time or full time in

another gender role, consistent with one’s gender identity)

-Hormone therapy to feminize or masculinize the body

-Surgery to change primary and/or secondary sex characteristics (e.g., breasts/chest, external

and/or internal genitalia, facial features, body contouring)

- Psychotherapy (individual, couple, family, or group) for purposes such as exploring gender

identity, role, and expression; addressing the negative impact of gender dysphoria and stigma

on mental health; alleviating internalized transphobia; enhancing social and peer support;

improving body image; or promoting resilience.

****

[Drea]

This seems unlikely as the extreme examples I provided are cases were not some people off the street who went to a therapist and said "this exemption applies to me" and after 3 sessions had provided a surgery letter. In the cases I know of these were instances where after extensive therapy the therapist felt an exception (as allowed for in the standards) was warranted and it was agreed upon by the surgeon. That the therapist and surgeon were putting their licenses at risk. As such this isn't likely to be abused.

If one is worried about abuse of the system, look at the do it yourself transitioners who use the standards as a guide, get info and then find a therapist to sign off on hormones after a visit or two. Or the ones that go overseas for surgery or use other nefarious means

2. And if so I see lots of bad things happening. Things like patients commiting suicide, suing doctors and maybe government intervention.

It is the professionals who have put their licenses on the line in these instances which I am sure in such cases it is because that is what they felt was best for the client.

Your concerns are valid however and is equally applicable to those who could find some way to manage their dysphoria short of full transition but end up hearing transition is the only option. There is also some concern that as the lines between transsexual and trangender have become blurred that and there are transitioning now who don't fit what would have been considerd a good candidate for transition in past.

3. And I also worry that those same problems could happen with some of these rare trans people you speak of. IMO hormone replacement therapy and the RLT help prepare people for SRS. Without those building experiences I think some of these people are in for a shock.

As mentioned, these folks don't just end up having surgery after a couple casual therapy visits. I am not going to argue with professionals who have worked with hundreds of trans patients to tell them they don't know what they are doing.

4. Also after SRS they are going to have almost no hormones in their body. As a result to remain fully healthy they are going to have to start HRT.

Good point, I don't know what the docs had planned for the one who didnt' want to go on hormones.

5. You seem focused on the physical effects of HRT. HRT also has tremendous metal effects as well. There is a lot to be said for having a hormone balance that matches your gender.

I don't know where you draw this conclusion from. I been on the stuff over a decade and if it were just physical changes I could have stoped taking it long ago.

6. Although people may opt for surgery only I still believe that full transition offers the best chance for fulfillment. Surgery may bring them some measure of peace, but they won't know the happiness many of us have found. It may help their physical dysphoria, but they will still suffer from social dysphoria.

Perhaps those folks didn't suffer significant social dysphoria? I do however agree with you that the varied treaments under what we call transition do address many more different aspects of the condition. The decisiions about exceptions is one of professional judgement.

The topic however was less about those extreme examples but more understanding how narrow the focus can be. That we are all individuals with individual needs and we shouldn't be judgemental. That we shouldn't push just one option. That people should be encouraged to get therapy first and from there determine where that leads rather than put the blinders on that "transition is it" before even starting therapy.

There are folks who definitly know they want to transition for which this really is not relevent. It is the folks who are questioning, it is the folks who feel they fit but fit at the same timet, it is the folks that are conflicted because of personal circumstances, that could benefit from understanding there isn't just one option. That the standards of care allows for a mixture of treatment options and that the place to start is by seeking out a therapist.

These are my opionions of course.