The road to surgery

It is customary in Australia for a transguy to be on T for 12 months before top surgery. Firstly a definition - top surgery is removal of the breasts with a chest reconstruction into a male chest, it is not a mastectomy. Max has been on T for 6 months now, and with every passing day he is becoming more and more restless to get his “chesticles” (what he calls them) off. They (still not sure who it is that is making these decisions) believe that 12 months is a good time, as by this stage the pectoral muscles have developed into a more masculine shape making it easier for the surgeon to reconstruct into a male chest. Anyway, Max thought it would be good to start doing some research, which I am not against, but thought that it might fuel his eagerness to get them off. Surprisingly, there are only 4 surgeons in the whole of Australia that do this type of surgery. Additionally the only one in Melbourne (there is one in Perth, one in Brisbane and one in Sydney) is 70 years old and about to retire. Therefore we are limited to three. Max didn’t find any information on the one in Perth, however did find some photos of previous top surgery for the ones in Brisbane and Sydney. So Max started getting ready to organise surgery. I thought it was a little early but I was wrong. The following is in Max’s words.

So I thought I would jump the gun and book my consult for surgery this morning. I'm a little anxious about budget and what Medicare and my health fund would cover so I thought I'd get on top of things to reduce my anxiety. Clearly I haven’t learnt from my past experiences, which in relation to medical transition (booking appointments, etc) have been quite stressful. This turned out to be no different.

Research into procedures and results over the past few weeks has led me to choose Megan Hassall in Sydney for my top surgery. So I called her rooms this morning and was informed that the next available consult is in February 2011. I booked my appointment, got all the pertinent information and was told to bring both a referral and a letter from my psychiatrist. Given that I’m hoping to get my procedure done in April 2011, it feels like cutting it a bit fine. But OK.

Given that I have chosen to go with an interstate surgeon, I’m wondering what the role of the local gender clinic is for me. I am a patient of the clinic and I’m wondering why. So I called them this morning. (I called them last week to begin these discussions about surgery, but the clinic is only open on Tuesday and Wednesday so I wasn’t able to get in touch with them until today.) I explained that I am seeing their psychiatrist as a private patient at his private rooms, that I am seeing a psychologist as a private patient and that I have booked my consult for surgery in NSW as a private patient. “So I am wondering what the clinic’s role is in my patient journey?” The response was very unclear – perhaps if you needed to see a social worker or another psychologist or someone else here. Like who??? How many mental health professionals can one person see? Given the complexity of my questions (really??) the receptionist had already put me through to someone else and this was the quality of response. I’m not sure what is more shocking – the fact that no one there is able to explain things to an intelligent, engaged and enquiring person or the fact that this person didn’t even know that Megan Hassall performs top surgery for FTMs.

The medical transition process has been an incredibly frustrating and often confusing journey so far.