How do I get a letter for top surgery as a genderqueer (or neutral) woman, not wanting to identify as male?

Answer 1

The latest WPATH SOC make this easier in theory for you to achieve, as they no longer state hormones as a pre-requist for surgery, however getting a psych and a surgeon who feel comfortable doing this may be harder than expected. The easiest way aroundd the gender patient hullabaloo process, may be to seek out an independant cosmetic surgeon and pay them. This would be an expensive option, but may turn out to be the only way. Are you currently seeing a pysch? If yes, are they comfortable writing a letter for top surgery? If not, that may be your first port of call. Find someone who is comfortable with gender nuetral/ gender queer, who doesn't subscribe to the gender binary etc. You will need to do your research on surgeons who would be comfortable operating on you under these circumstances, so start contacing them, and then make some appts for consults, and ask them exactly what paperwork is required for them to operate. Depending on what state you live in and what state you have surgery in will differ in the levels of paperwork/letters/approvals you need for surgery. I wish you luck in your journey.

Answer 2

I asked my psychologist this question a couple months ago and she suggested just that - seek out a cosmetic surgeon that would be happy to perform a breast reduction (enough to have a flatter chest),

I identify as genderqueer and at present am not wanting to go through the typical transgender top-surgery route. It would be easier to have a psychologist/psychiatrists letter and there are a few of them around depending on where you live. Basically instead of getting the top-surgery which includes removal of all the breast tissue and glads you may need to have a breast reduction - this may either make binding easier, give you the look you want or be enough to have a flatter more masculine chest.

Answer 3

I spent 18 months working with the Brisbane Gender Clnic, educating them about genderqueer. The problem with a standard GID diagnosis is that one of the criteria is 'persistent cross-gender identification' which doesn't necessarily apply to genderqueer people. Also, hormone treatment is usually a prerequisite before surgery, but I didn't want hormone treatment at all.  Finally I was given a diagnosis of 'gender identity disorder, otherwise not specified', which is enough for most surgeons.  I did however find a surgeon who was prepared to do surgery without a letter from a psychiatrist. 

I also found a private psychiatrist who was prepared to approve surgery after the end of one consultation.  Which was nice, but I'm sure part of the reason is that I'm in my 50s and have had a couple of kids.  I doubt a young genderqueer person would get the same response.  Private psychiatrists are also very expensive, and many genderqueer people just don't have the resources to use that option.

The psychiatrist at the gender clinic, who's employed by Qld Health and thus bound by their policies, said that the difficuly for him is that there is no existing evidence base to justify top surgery for genderqueer people.  And of course there won't be, while genderqueer people feel they have to give the conventional 'boy-in-girl's-body' story in order to get surgery.  This really worries me, because it means a lot of people, especially young genderqueers, are taking hormones they don't want in order to get the surgeries they do want.

Anyway, I was able to give him enough academic journal articles about genderqueer (including my own unpublished stuff) to finally persuade him.  But this is definitely an area that needs properly funded research to provide an evidence base for the treatment of genderqueer people.

Sorry if this answer is too technical :-) happy to provide more info if required.

Sujay Kentlyn  dryad@internode.on.net

 

Answer 4

Any healthcare professional who is working in the field should follow the international standards of care published by WPATH. Fortunately the latest version of the standards of care is very genderqueer friendly. The first criteria for chest surgery is a persistent history of gender dysphoria. Gender dysphoria is defined as persistent distress caused by a discrepancy between a person's gender identity and the person's sex assigned at birth. Your gender identity is defined as your intrinsic sense of being male, female or an alternative gender (eg genderqueer etc). You don't need a diagnosis of Gender Identity Disorder where there was a need for "cross gender" identification.

Some cosmetic surgeons may encourage testosterone prior to surgery because larger chest muscles help give a better cosmetic result but this is not a requirement in the standards of care. 

Answer 5

Goodluck...let us know if after WPATH has changed if in Australia people are able to go through with top surgery if Genderqueer