seeking guidance on bottom surgery - eviltoast

Hi, I’m the total mess known as Emma, and I’m currently a little overwhelmed with things.

So, long story short:

  • I started HRT January 2023

  • I desperately need bottom surgery as soon as possible

  • I’m worried that I should have been doing electrolysis instead of laser

  • I’m worried about wait lists for surgery

  • I’m worried about the costs of surgery

  • I need to find a surgeon

  • I’m interested in evacuating to a safe state on the west coast

  • I feel overwhelmed with everything that I need to do

There’s so much going on for me right now, and I’m seeking input from everyone here with something to say about any of my struggles.

Thanks ❤️

  • femtech@midwest.social
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    6 months ago

    I only got Lazer, but I had 12 sessions. My Dr said either was good but laser takes longer. I’m not sure where you are for Drs but if in America Rush medical center is great and where I had mine done. Cost wise will depend on insurance. Mine has paid a lot, I paid co pays which was a few hundred dollars after everything. My account still says I “owe” 90k but that’s because Blue Cross is being stubborn. All the good surgeons have a long wait list. Was 4 months for the consultation and almost a year for the surgery.

    • Ada@lemmy.blahaj.zoneM
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      6 months ago

      Laser is MUCH MUCH faster than electrolysis. The issue is that it’s not 100% effective. A small amount of hairs will always grow back.

      • -Emma-@fedia.ioOP
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        6 months ago

        A small amount of hairs will always grow back.

        Yeah, that’s what I was saying on matrix is what concerns me. Like, I’m thinking I just want the most permanent removal possible. I’m such a perfectionist, and it causes bad thoughts to consider flaws and stuff. I really need to find a surgeon and go over this stuff. Also a therapist would probably help a lot right now…

        • Ada@lemmy.blahaj.zoneM
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          6 months ago

          The majority of surgeons do pore scraping to remove any hairs left over. As my surgeon said to me, he can do hair removal during the surgery, but he doesn’t want to be doing hours and hours of hair removal, so he wanted me to get rid of as much as possible before hand.

          • -Emma-@fedia.ioOP
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            6 months ago

            omg that is so good to know! thank you thank you! that is like the missing puzzle piece that actually calmed my mind about it. i should still get a therapist tho.

          • -Emma-@fedia.ioOP
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            6 months ago

            damn, two therapists? this gate-keeping of healthcare is really exhausting and frustrating. exhaustingly frustrating. frustratingly exhausting. grrrrrrrrrrrrrr

            • femtech@midwest.social
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              6 months ago

              Yep, that’s for insurance and the Dr. They both require it. Also one had to have their PhD but the hospital had one on staff that validated my letters with the therapists.

        • lady_scarecrow (she/her)@lemmy.blahaj.zone
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          6 months ago

          I haven’t done electrolysis myself, only laser, but as far as I know, with electrolysis you have to run a needle through each hair individually, while laser can cover a large area at once. I’ve heard many people do laser first to massively reduce the amount of hair per area, then electrolysis to kill off the few remaining hairs.

          • -Emma-@fedia.ioOP
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            6 months ago

            yeah i’ve been doing the laser first just like you said. my doctor that prescribes my hrt is the one who does the laser, and she said i may need the electrolysis after laser is done. well at least for the remaining light-colored hairs. buy yeah, i can kinda work myself into mild panic and stress out enough to doubt myself. like a lot. lol

    • -Emma-@fedia.ioOP
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      6 months ago

      I’m not sure where you are

      I’m in southeast Louisiana. I’ve been doing laser for my whole body since I started HRT, but I’ve only done three sessions on my…delicate region. I’m just concerned about the permanence of laser and the wait for surgery. One of the reasons I’m considering evacuating to a safe state on the west coast is that I could hopefully have the surgery covered by my insurrance.

      Was 4 months for the consultation and almost a year for the surgery.

      I’ve heard some people suggesting that some surgeons have a wait list of three to five years, and I absolutely cannot wait that long. One year is already long enough to consider.

      Thank you for your comment ❤️

      • nadiaraven@lemmy.world
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        6 months ago

        In Oregon the wait list is not very long for surgery, but the problem is getting electrolysis by someone who takes insurance. Currently as far as I’m aware, OHSU is the only place doing bottom surgeries. You can get OHP to cover everything, and you get the insurance immediately after moving if you are low income. Side note, you can get a vulvaplasty done very quickly, but if you want the full vaginoplasty, it requires electrolysis. Dr Dy at OHSU said I could get the vulva first and if I wanted the vagina later, I could have a second surgery, but I think the skin would have to come from my side.

        • -Emma-@fedia.ioOP
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          6 months ago

          and you get the insurance immediately after moving if you are low income

          I would guess that I’d need to actually have a residence there right? So like, if I can manage to rent a room, I’m good, but if I can’t find a stable living situation it wouldn’t count as having moved there?

          I currently have Medicare, so I think everything should be covered if I can just manage to secure a residence.

          • nadiaraven@lemmy.world
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            6 months ago

            Medicare might be different, what I was talking about is Oregon’s medicaid program, OHP. For OHP I don’t think you need a permanent address, you can be homeless and list your address as “general delivery” at the local post office. But Medicare is an entirely different program, and I can’t tell you whether you can have both Medicare and OHP, the rules get very complex

      • fadingembers@lemmy.blahaj.zone
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        6 months ago

        If you have insurance now, it might cover bottom surgery. This site has a pretty comprehensive list, but if it’s not listed there it’s worth googling “<your insurance> trans healthcare” and seeing what comes up. You’ll likely need two letters of support in order to receive coverage: one from your hrt provider and one from a mental health provider.

        Though not completely up to date, this site can help you find GRS surgeons that take insurance by area

        • -Emma-@fedia.ioOP
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          6 months ago

          If you have insurance now, it might cover bottom surgery.

          I currently have Medicare, so it looks like I am covered. 😊

          You’ll likely need two letters of support in order to receive coverage: one from your hrt provider and one from a mental health provider.

          Well I do currently have a GP that prescribes my HRT and should be able to write me a letter, and I have a Psychiatrist who knows that the only reason I’m talking to him is to get the letter. So maybe I’m all set and don’t need to rope a third person into this to get consent to alter my own body? (I cannot begin to articulate the level of rage that I feel about my lack of bodily autonmy)

  • LadyAutumn@lemmy.blahaj.zoneM
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    6 months ago

    This is subjective but I did no laser or electrolysis before my bottom surgery. My surgeon did electro as part of the operation and I have had no problems over a year out with hair.

    As for how to find one, it depends on: how you’re paying, if you have insurance coverage, how far you’re willing to travel, what your cost limits are, what surgical technique interests you, and what you think about each individual surgeon. Read lots of reviews and email the surgical clinics you’re interested in. Ask for costs and information booklets, they have them in abundance I assure you.

    For me I didn’t pick my surgeon, I just went with the only option I could have covered. And I am very happy with my results. Your insurance company, if you’re insured, can give you information about what procedures and what surgeons are covered. There are options for essentially making your insurance cover it, but that’s longer than I can go into in this short comment. You also will need two recommendation letters from WPATH certified clinicians, good place to start on getting the surgery is getting those. They also can help with getting some of the costs covered.

    Long and short of it, do your research. Read up on forums where trans women talk about their experiences with certain surgeons. Investigate coverage options. And consider your individual needs and finances most of all. Once you’re past the initial stage and into the full planning stage, you’ll have lots of other work to do. For now I’d focus on making some more concrete plans.

    • -Emma-@fedia.ioOP
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      6 months ago

      My surgeon did electro as part of the operation and I have had no problems over a year out with hair.

      Wow, I had no idea this was even possible. I’m learning quite a lot recently.

      what surgical technique interests you

      I think you’ve already seen my messages about that in one of the Matrix chat rooms. If not, I can elaborate here or there.

      how you’re paying

      I usually pay for things using cash that I withdraw from my checking/savings.

      if you have insurance coverage

      I currently have Medicare coverage.

      how far you’re willing to travel

      If I need to flee the country, I’ll do it.

      what your cost limits are

      I’m willing to empty my savings and, if necessary, sell access to my body. I need the surgery.

      what you think about each individual surgeon

      What I think I really need is to actually talk to one or more surgeons in-person so that I can know what to expect, and as I said before, I really don’t wanna be on a waiting list for more than a year. That and the cost are the main reasons I’m considering evacuating to the west coast.

      I’m hoping that I can get letters from my GP (who prescribes my HRT) and my Psychiatrist (who knows I’m only interested in the letter), and I figure that the letters do not expire and can be taken out of state if I evacuate. Is this correct?

      Thank you for all of the help to start me off in my research. ❤️

      • Skydancer@pawb.social
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        6 months ago

        On the “how far you’re willing to travel” front, the reality is it’s much harder and more expensive to get the surgery in the US. One of the consequences of this is that most US surgeons aren’t 100% specialised on SRS so they may not have the level of experience of someone elsewhere.

        You didn’t request specific surgeon references, but my partner used Dr. Chettawut Tulayphanich and has never regretted the choice. There’s a level of competence that only comes with repeated practice, and if there’s a US surgeon with over 3,000 of these surgeries behind them I’d be beyond shocked.

  • LainTrain@lemmy.dbzer0.com
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    6 months ago

    Hey 👋

    I started HRT Nov of 2015 at 17 and just got my SRS a month ago.

    As soon as possible

    Unless you have fuck loads of cash I’d say settle in for the long haul and cope, I’ve never heard of SRS costing less than £20k and that’s for basic old school PI in the UK.

    Even with a full time job for years at software dev with an MSc I never managed to save anywhere close to that with the pandemic hitting as I entered the workforce, unless you’re like some boomer with a house? I take it you’re in the US? Is there insurance that covers it maybe?

    As for surgeons check out the /r/Transgender_surgeries wiki.

    Laser, you mean on face or genitalia? For face do Laser for now while you’re early in transition and try to zap away as much as possible. I stopped because I thought it’d be good enough and was broke, big mistake as years later my hair came back but now it was blonde and required electro, which takes forever, just some stubborn bits on neck have taken me over 2 years for now and it still doesn’t feel gone, just more sparse.

    For genitalia you need electrolysis as laser is not permanent, but I wouldn’t rush into that as most people don’t need any hair removal prior to SRS, I had totally normal amount of pubes even well along the shaft and the follicle scrape took care of everything and I got no hairs inside, I woke up with most of my pubes intact to my shock even, I’m in the UK and I wasn’t circumsized so YMMV.

    • -Emma-@fedia.ioOP
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      6 months ago

      Unless you have fuck loads of cash I’d say settle in for the long haul and cope,

      😢

      unless you’re like some boomer with a house?

      😢

      I take it you’re in the US?

      yeah, in the deep south 😢

      Is there insurance that covers it maybe?

      😢

      Laser, you mean on face or genitalia?

      everywhere. i’m pretty much done with face now and have been focusing on genital region. i’ll be doing electro of remaining light facial hairs soon.

      i’ve learned some good info from this thread, that laser isn’t technically necessary, that electro is also not technicaly necessary, and idk. i’ve already paid for several sessions, so i’m gonna get 'em done and take it from there.

      i wish this were easier. i wish that i could just push the button. i wish it didn’t have to be this way.

      thank you for your reply ❤️