Friday, November 30, 2007

So *that's* why...

So *that's* why...
The other day I met with the therapist who would provide the second opinion of my transsexual diagnosis and send a letter to my surgeon.

The person I met with is a well known therapist and author who specializes in gender conditions.

I was a little nervous meeting her. After all, getting the second letter gives me a green light for me to proceed with my surgery and complete my transition. Many people have said that the HBSOC, now called WPATH, is too restrictive and presents more of a gatekeeper role to the transsexual seeking GRS.

I, personally, have not felt this to be the case. The therapists I have seen have acted more as partners and have been very compassionate in aiding me in my journey.

When I met with her, she was very quick to put me at ease. We spoke for about an hour, and for the most part it was more of an interview than a therapy session. The nature of the questions and discussion will remain private. But in no way did I ever get the impression that I was being interrogated or tested to see if I was transsexual enough or had attained some sort of qualification. It was a very relaxed session.

Near the end of the session, she asked me if I had any questions for her. I did in fact have some questions.

One of the questions I had regarded why GRS, which has virtually no impact on a persons gender status in society (nobody sees what's in your pants) has such a requisite qualification (WPATH), when facial surgery, which has a huge impact on a persons gender status in society (everybody sees your face), requires virtually no qualification other than an ability to pay.

As readers of my blog may remember, this is kind of a hot button for me and I was really curious why it was this way.

Her response was very enlightening.

As you may know, surgeons are under a strict ethical guideline to not remove healthy tissue. Additionally, I found out that there are also laws regarding this as well, referred to as mayhem laws. These put additional restrictions that, among other things, specifically state that healthy reproductive tissue cannot be removed unless there is an overriding medical necessity requiring their removal.

GID is considered a medical condition as listed in the DSM-IV, and the only known solution to address the condition is surgical intervention to change the transsexual’s gender to that of the opposite gender. Thus, it makes it a medical necessity to remove or change the healthy reproductive tissue. This also covers mastectomies and hysterectomies in FTM transsexuals.

The two letter protocol is considered due diligence from a legal point of view. Basically it protects the surgeon and hospital if they are sued as a result of a person receiving GRS and then regretting the decision. It also ensures the person seeking GRS receives adequate counseling and is able to properly set expectations as to what the surgery will do and how their life will be like following surgery.

The one letter protocol for HRT has a similar purpose. But since many of the effects of feminization or masculinization can be reversed if stopped in time, there is no need for a second opinion.

Additionally, it protects the transsexuals that follow us. For example if this due diligence was not performed, and a person turned around and successfully sued, you can expect that the hospital where the operation was performed would never allow any such operations in the future. And it’s hard enough to find a surgeon in the western hemisphere as it is!

Given that I have a clearer understanding as to why things are the way they are.

-Sandy

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