Male to Female (MTF) Surgical FAQ and Checklist

Male to Female (MTF) Surgical FAQ and Checklist – Part 1

This is a male-to-female (MTF) surgical FAQ by Dr. Harold Reed. The piece is the first of a four-part series on the procedure.

See also: Male to Female (MTF) Surgical FAQ and Checklist – Part 2

See also: Male to Female (MTF) Surgical FAQ and Checklist – Part 3
See also: Male to Female (MTF) Surgical FAQ and Checklist – Part 4

1. Where to start?

In every major city in the USA there are therapists and physicians who will assist you. The best places to start are the web-sites of

a. Dr. Anne Lawrence http://www.annelawrence.com/links.html

b. Dr. Becky Allison http://www.drbecky.com/therapists.html

c. Mrs. DaleLynn Sims http://www.intersexualite.org/English-Index.html

d. Andrea's http://tsroadmap.com

2. How do I obtain hormones?

Hormones are helpful to assist in the real life test. If being passable is an important consideration in your decision to undergo transition, then your first stop is to see a therapist.

Ethical and responsible medical practice would suggest that hormones should only be prescribed by a knowledgeable doctor such as an endocrinologist, who will request a letter of therapy clearance.

Hormone changes may be irreversible and some very adverse effects may occur with improper use. Do-it-yourselfers, beware!

You will need to have a few baseline blood tests performed and be followed every so often to be sure you are achieving safe and effective levels.

For those in the South Florida area, this service is provided by our office.

3. What are the therapy requirements for transsexual surgery?

Once you made your selections and accept continuous cross-dressing for at least 1 year and have fulfilled the standards of care of the World Professional Association for Transgender Health (WPATH) or http://www.wpath.org/site_page.cfm?pk_association_webpage_menu=1351&pk_association_webpage=4655, or http://www.wpath.org/documents/IJT%20SOC,%20V7.pdf - you are psychologically all set for below the waist surgery. Two therapy letters are required, one from a therapist with a doctoral degree, could be a psychiatrist, psychologist, sexologist, nurse, or sociologist. The other letter can be written by another therapist who may not necessarily have a doctoral degree, but at least a master's degree or its equivalent in a clinical behavioral science field. The therapist must be a graduate of an institution accredited by a recognized national or regional accrediting board and have an active license. One of these 2 therapists has to know you for an extended period of time.

4. What are your fees for MTF Surgery?

Our affordable surgical fees are posted on our web-site. These are comprehensive fees which include surgery at our facility, anesthesia, and 24 hours of observation (phase one) at our facility and of course any followup care that I provide. Again, consultation, lab fees, out of pocket expenses for oral medications and the like are not included.

With the new technique, we are endeavoring to do everything in one stage and our fee is now $14,500, to keep pace with our expenses. In the event your need a scrotal extension for added depth, there is no additional charge. In the event you require a revision or touch up, after 3 months of complete wound healing, there is no additional charge as long as this is done under local with IV sedation (about 85% of our patients). In the event you require the services of an anesthetist the fee is an additional $600.

In the unlikely event you require transfer to a local hospital, I will continue to follow you there at no charge and orchestrate any needed consultative care. However you are responsible for all hospital bills and consultant fees. If you are approaching surgery without any reserve to cover this contingency, please wait until you are financially more secure or have a line of credit.

We invite you to compare and contrast our fees with other centers.

MTF fees are related to a myriad of procedures which may include breast implants, tracheal shave, and other feminizing facial cosmetic procedures. We also do breast augmentation.

Submission of medical records or letters must be accompanied by a check for $250 annotated "for initiation of consultation and review of medical records."

In the event you wish to bring medical records and letters with you or simply request a consultation, anticipate a consultation fee of $250 during your initial visit.

This fee is not applied to surgery, but remains an independent charge.

While our initial intention has been to spare any profit and welcome aboard new patients, certainly these fees will be adjusted upwardly within a few months. Still they will be well below what others may charge in the USA or Canada.

Candidates who wish to secure their reservations with our facilities are required to have minimally letters of clearance and a phone consultation with a favorable response to questions of concern. Assuming this, you will be given the nod to send in a 50% deposit which is non-refundable.

But of course you can watch and wait as there should not be any dramatic increases for the next few months.

Please do not undergo surgery without contingency funds to cover unexpected complications, hospitalization, the costs of other consultants, and return visits to your doctor. People who are just marginally getting by should postpone surgery until their resources are more plentiful.

While deposits can be made with a personal check, the balance of payment has to be made either in cash or with a certified bank check such as a cashiers check brought into the office a day or two before surgery by the patient or your surgery will be postponed.

We are not set up to handle credit cards.

We need to meet with you at least the day before surgery about 9 AM (by appointment), ideally 2 days before surgery, to review all your pre-op letters, lab work, exam you, and answer questions. The day before surgery you will be starting your bowel prep, so traveling on that date is ill-advised.

5. Where is surgery performed and age qualification?

If you are below 60 and in tip-top medical shape (not overweight, exercise regularly, (not on insulin) you can be done as an outpatient at our facility with a 24 hour hold for observation. Both an RN and I will be in attendance during this time. Most likely you would then be transferred to a nearby motel. There are a few on our preferred list.

We recommend that patients over 65 be done in a hospital setting by others. We have done a few patients in their early sixties with a sterling letter of medical clearance, a perfect thallium stress EKG, and good height-weight conformation. If you have any reservations that you may not qualify, please ask before initiating a consultation.

Well controlled diabetics on oral medications can be done at our facility, however, diabetics on insulin need to be done in a hospital environment in other locales, unless as in rare instances there is no evidence of systemic disease and a glycosylated hemoglobin A1C shows excellent control.

For the only 2 motels on our preferred list (where rounds are made daily) we recommend Daddy O Hotel, 3 star. Daddy O is located at 9660 E. Bay Harbor Dr, Bay Harbor Islands, FL 33154, one block from our office (305-868-4141). Ask for Courtney. Please make reservations as soon as you obtain a surgical date and specify a room on the ground floor. Some discount is usually given to our patients.

Less expensive is the Beach Place Miami at 8601 Harding Avenue, Miami Beach, FL 33141 (305 866-3313). These hotels are the exception to the concept that doctors don’t make house calls anymore.

For example, if you have surgery on April 4, you will minimally need to have the room available on April 5th at 7 AM, and stay there until April 11th (6 days). Room rates typically provide for 2 guests. So please bring a female friend or relative to stay with you. Please do clarify "two for the price of one" when making the reservation.

While you are there, I will see you every day and do dressing changes and whatever is needed to keep you comfortable and happy. A catheter will drain your urine. At least you won't have to get out of bed to void. On the 7th post-operative day (1 week later) you will have vaginal packing removed, your first douche, suspension sutures removed, and introduced to dilating with stents.. Your may shower. Your catheter will remain indwelling for 5 more days.

This is a male-to-female (MTF) surgical FAQ provided by Dr. Harold Reed. The piece is the first of a four-part series on the procedure.

See also: Male to Female (MTF) Surgical FAQ and Checklist – Part 2

See also: Male to Female (MTF) Surgical FAQ and Checklist – Part 3

See also: Male to Female (MTF) Surgical FAQ and Checklist – Part 4

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