One Small Step, One Big Step

Got my official “referral for sexual reassignment surgery” letter from my physican today. It was a much more emotional moment than I would thought be.
 
Let me explain… This letter is simply to try to get insurance to cover the surgery.*
 
The letter that actually matters is the “gatekeeping” letter** I’ll be getting from my therapist shortly, saying that SRS is appropriate treatment for my gender dysphoria, that I’m not mentally ill or mentally impaired, and that I’m able to give informed consent. I can’t get surgery without it.
 
But still, even if it’s just “insurance paperwork,” this is a definite milestone. Shit’s getting real, real fast.
 
*Technically, California law requires insurers to cover SRS. But I’ll be having mine done in Thailand, which means paying upfront and then trying to get reimbursed your insurance company. Who usually do their best to avoid paying if you go overseas (which is ironic because the surgeons there are often better, and usually are less expensive).
 
I’m not that optimistic, but I’ve heard that the odds improve slightly if you get an referral from an in-network doctor, and seek pre-authorization. We’ll see…
 
**Surgeons typically require two therapists/psychologists to sign off your SRS, however, my surgeon has his own psychologist do the second evaluation, so I only need to get one letter myself.
 
I understand why surgeon’s want that sort of CYA, given that it’s an irreversible surgery. And certainly you’d be foolish to do without having done The Work about why you want it. (Which is true of any other plastic surgery). But yeah, it definitely poses issues around patients’ having autonomy over their bodies.