Sex Change MTF FTM SRS

January 24, 2012

 No. I have always thought about and been a lesbian just was never sure how to go about it with my family members and friends but now i realize if its what makes me happy then maybe i should look into it a little more so when they ask me about it i can explain to them a little more.   Angela

January 24, 2012

Good morning Angela,

Thank you for your interest in what we do.

There is a  difference between being a lesbian, (which is certainly an acceptable choice according to the American Psychiatric Association) and wishing to be a male.

The same for gay men.  Some just want to be gay men, and of these none need a vagina, unless they are transgendered which is an altogether different category.

Sincerely,

Harold M. Reed, M.D.
305-865-2000

January 22, 2012

Dear Dr. Reed,

was on hormones for 3 yrs 2 years ago have some breast development and feminization but no dr. here that i have found in jax to continue mt srs process  Lacey

January 22, 2012

Good afternoon Lacey,

We do hormones.  A letter of therapy clearance is required by a licensed therapist with a doctoral degree.  Our fee is 250 for consultation, and 600 per year to follow you with needed lab tests, office visits, prescriptions, counselling, numerous telephone calls, and medical records documentation. 

The 600 fee is billed 3 months after your initial visit. 

Lab tests are an out of pocket expense as is the medication.  We may recommend a laboratory, but you can have them done at a nationally recognized laboratory of your choice.

Sincerely,

Harold M. Reed, M.D.
305-865-2000

January 21, 2012

Hi  Dr. Reed,

Basically, I’m a female and my partner is a female…I don’t want to be transgendered in the speak of ‘turning to a guy’ but she does as do I, want me to have a penis so we can share that actual sexual sensation with each other. Is it possible to just get that done and me stay a female appearance wise.?  Barbara

January 21, 2012

Good morning  Barbara,

Short answer yes, can be done.

Is it advisable, affordable, or will you have remorse… another question.

I am available for phone and office consultation.
Fee 250.

Harold M. Reed, M.D.

January 20, 2012

Do u do currective work if it was done out side us and how much is it and is it worth going thru all the pain and surgery again?

Carla

January 20, 2012

Good afternoon Carla,

Yes, we do.  Consultation fee is 250.

Start to prepare a work list with photos.

Thank you for your interest in what we do.
Hope you like what you see.

Harold M. Reed, M.D.
305-865-2000

The syndrome is named after two doctors, Edvard Ehlers of Denmark, and Henri-Alexandre Danlos of France, who identified it at the turn of the 20th century.

Contents

 [hide]

• 1 Classification
  • 1.1 Other types
• 2 Signs and symptoms
• 3 Genetics
• 4 Diagnosis
  • 4.1 Differential diagnosis
• 5 Management
• 6 Prognosis
• 7 Epidemiology
• 8 Society and culture
• 9 In other animals
• 10 See also
• 11 References
• 12 External links

[edit] Classification

In the past, there were more than 10 recognized types of Ehlers?Danlos syndrome. In 1997, researchers proposed a simpler classification that reduced the number of major types to six and gave them descriptive names.^[4] These six major types are listed here. Other types of the condition may exist, but they have been reported only in single families or are not well characterized. Except for hypermobility, the specific mutations involved have been identified and they can be precisely identified by genetic testing; this is valuable due to a great deal of variation in individual presentation of symptoms which may confuse classification of individuals on purely symptomatic basis. In order of prevalence in the population, they are:
Name Number Description OMIM Gene(s)
Hypermobility type 3 Affects 1 in 10,000 to 15,000 and is caused by an autosomal dominant or autosomal recessive mechanism. Mutations in either of two separate genes (which are also involved in Vascular EDS and Tenascin-X deficiency EDS, respectively) may lead to this variant. Extreme hypermobility is the hallmark of this type. 130020 COL3A1, TNXB
Classical types 1 & 2 Affects approximately 1 in 20,000 to 50,000 people. It is caused by autosomal dominant mechanism and affects type-V collagen, as well as type I. Type 1 typically presents with severe skin involvement, and type 2 presents with mild to moderate skin involvement. 130000, 130010 COL5A1, COL5A2, COL1A1
Vascular type 4 Is an autosomal dominant defect in the type-III collagen synthesis; affecting approximately 1 in 100,000 to 250,000 people. The vascular type is considered one of the more serious forms of Ehlers?Danlos syndrome because blood vessels and organs are more prone to tearing (rupture). Many patients with EDS type 4 express a characteristic facial appearance (large eyes, small chin, thin nose and lips, lobeless ears), have a small stature with a slim build, and typically have thin, pale, translucent skin (veins can usually be seen on the chest and abdomen). About one in four people with vascular type EDS develop a significant health problem by age 20 and more than 80 percent develop life-threatening complications by age 40. 130050 COL3A1
Kyphoscoliosis type 6 Is an autosomal recessive defect due to deficiency of an enzyme called lysyl hydroxylase; it is very rare, with fewer than 60 cases reported. The kyphoscoliosis type is characterised by progressive curvature of the spine (scoliosis), fragile eyes, and severe muscle weakness. 225400, 229200 PLOD1
Arthrochalasis types 7A & B Is also very rare, with about 30 cases reported. It affects type-I collagen. The arthrochalasia type is characterised by very loose joints and dislocations involving both hips. 130060 COL1A1, COL1A2
Dermatosparaxis type 7C Also very rare, with about 10 cases reported. The dermatosparaxis type is characterised by extremely fragile and sagging skin. 225410

[edit] Other types

Although the above classifications are well defined, it is rare for a case to fit neatly in a single category, and cross-over symptoms lead to under-diagnosis or mis-diagnosis. So patients should not rely on the “fact” of having a certain type of EDS if cross-over symptoms are evident and might be life-threatening.

“The large number of distinct types of the Ehlers?Danlos syndrome that have already been identified indicates great heterogeneity, but clearly that heterogeneity is not exhausted by the present classification.” [1] Forms of EDS within this category may present with soft, mildly stretchable skin, shortened bones, chronic diarrhea, joint hypermobility and dislocation, bladder rupture, or poor wound healing. Inheritance patterns within this group include X-linked recessive, autosomal dominant, and autosomal recessive. Examples of types of related syndromes other than those above reported in the medical literature include:

• 305200 ? Type 5
• 130080 ? Type 8 – unspecified gene, locus 12p13
• 225310 ? Type 10 – unspecified gene, locus 2q34
• 608763 ? Beasley-Cohen type
• 130070 ? Progeroid form – B4GALT7
• 606408 ? Due to Tenascin-X deficiency – TNXB
• 130090 ? Type unspecified

[edit] Signs and symptoms

 
Individual with EDS displaying hypermobile joints.
 

Individual with EDS displaying skin hyperelasticity

Signs vary widely based on which type of EDS the patient has. In each case, however, the signs are ultimately due to faulty or reduced amounts of collagen. EDS most typically affects the joints, skin, and blood vessels, the major signs and symptoms include:

• Loose, unstable joints that are prone to: sprain, dislocation, subluxation (partial dislocation) and hyperextension (double jointedness) ^[5]
• Early onset of osteoarthritis
• Easy bruising
• Dysautonomia typically accompanied by Valvular heart disease (such as mitral valve prolapse, which creates an increased risk for infective endocarditis during surgery, as well as possibly progressing to a life-threatening degree of severity of the prognosis of mitral valve prolapse) ^[6]
• Chronic fatigue
• Flat feet
• High and narrow palate, resulting in dental crowding
• Vulnerability to chest and sinus infections
• Fragile blood vessels resulting from cystic medial necrosis with tendency towards aneurysm (even abdominal aortic aneurysm)
• Velvety-smooth skin which may be stretchy, is often translucent, and can contribute to underestimations of chronological age
• Abnormal wound healing and scar formation
• Low muscle tone and muscle weakness
• Myalgia and arthralgia^[7]

Other, less common signs and complications may include:

• Headaches caused by an acquired Arnold-Chiari malformation (brain disorder)^[8]
• Osteopenia (low bone density)
• Talipes equinovarus (club foot), especially in the Vascular type
• Deformities of the spine, such as: Scoliosis (curvature of the spine), Kyphosis (a thoracic hump), Tethered spinal cord syndrome, Occipitoatlantoaxial hypermobility^[9]
• Functional bowel disorders (functional gastritis, irritable bowel syndrome)
• Gastroparesis
• Dental issues, including early-onset periodontitis
• Nerve compression disorders (carpal tunnel syndrome, acroparesthesia, neuropathy) ^[10]
• Vascular skin conditions: Raynaud’s phenomenon, Livedo reticularis
• Blue sclera
• Swan neck deformity of the fingers ^[11]
• Insensitivity to local anesthetics.^[12]
• Premature rupture of membranes during pregnancy ^[13]
• Platelet aggregation failure (platelets do not clump together properly) ^[14]
• Weak muscle tone (hypotonia) in infancy, which can delay the development of motor skills such as sitting, standing, and walking
• Arterial/intestinal/uterine fragility or rupture

 
Because it is often undiagnosed or misdiagnosed in childhood, some instances of Ehlers?Danlos syndrome have been mischaracterized as child abuse.

[edit] Genetics

Mutations in the following can cause Ehlers?Danlos syndrome:

• Fibrous proteins: COL1A1, COL1A2, COL3A1, COL5A1, COL5A2, and TNXB
• Enzymes: ADAMTS2, PLOD1

Mutations in these genes usually alter the structure, production, or processing of collagen or proteins that interact with collagen. Collagen provides structure and strength to connective tissue throughout the body. A defect in collagen can weaken connective tissue in the skin, bones, blood vessels, and organs, resulting in the features of the disorder.

Inheritance patterns depend on the type of Ehlers?Danlos syndrome. Most forms of the condition are inherited in an autosomal dominant pattern, which means only one of the two copies of the gene in question must be altered to cause the disorder. The minority are inherited in an autosomal recessive pattern, which means both copies of the gene must be altered for a person to be affected by the condition. It can also be an individual (de novo or “sporadic”) mutation. Please refer to the summary for each type of Ehlers?Danlos syndrome for a discussion of its inheritance pattern.

[edit] Diagnosis

A diagnosis can be made by clinical observation. Both DNA and biochemical studies can be used to help identify affected individuals. In some cases, a skin biopsy has been found to be useful in confirming a diagnosis. Unfortunately, these tests are not sensitive enough to identify all individuals with EDS. If there are multiple affected individuals in a family, it may be possible to perform prenatal diagnosis using a DNA information technique known as a linkage study.

[edit] Differential diagnosis

[edit] Management

There is no cure for Ehlers Danlos Syndrome. The treatment is supportive. Close monitoring of the cardiovascular system, physical therapy, occupational therapy, and orthopedic instruments (e.g., wheelchairs, bracing) may be helpful. One should avoid activities that cause the joint to lock or overextend.

A physician may prescribe bracing to stabilize joints. Surgical repair of joints may be necessary at some time. Physicians may also consult a physical and/or occupational therapist to help strengthen muscles and to teach people how to properly use and preserve their joints. To decrease bruising and improve wound healing, some patients have responded to ascorbic acid (vitamin C).

[edit] Prognosis

The outlook for individuals with EDS depends on the type of EDS with which they have been diagnosed. Symptoms vary in severity, even within one sub-type, and the frequency of complications changes on an individual basis. Some individuals have negligible symptoms while others are severely restricted in their daily life. Extreme joint instability, pain, and spinal deformities may limit a person’s mobility. Most individuals will have a normal lifespan. However, those with blood vessel involvement have an increased risk of fatal complications.

EDS is a lifelong condition. Affected individuals may face social obstacles related to their disease on a daily basis. Some people with EDS have reported living with fears of significant and painful ruptures, their condition worsening, becoming unemployed due to physical and emotional burdens, and social stigmatization in general.

[edit] Epidemiology

Ehlers?Danlos syndrome is an inherited disorder estimated to occur in about 1 in 5000 births worldwide. Initially, prevalence estimates ranged from 1 in 250,000 to 1 in 500,000 people, but these estimates were soon found to be vastly inaccurate as the disorder received further study and medical professionals became more adept at accurately diagnosing EDS. In fact, many experts now believe that Ehlers?Danlos syndrome may be far more common than the currently accepted estimate due to the wide range of severities in which the disorder presents.^[18] However, the prevalence of the six types differs dramatically. The most commonly occurring type is the hypermobility type, followed by the classical type. The other types of Ehlers?Danlos syndrome are very rare. For example, fewer than 10 infants and children with the dermatosparaxis type have been described worldwide. Ehlers?Danlos affects both males and females of all racial and ethnic backgrounds, although some types are more common among certain groups than others.

January 8, 2012

Yes have been on hormones for 7 1/2 years and hace been living full time as a woman fr 7 years now. I have natural grown breast.
Specific_Questions: On December 21 2010 I had a heart attack and althoe I am doing real good i was told that I may never be able to have my SRS. Now I ask is it still posable to have my SRS and if not is there a sugery that will remove the testies and shorten the penis to where I will apear more female down there with no buldge. If so can you give a ball park priceon what it would cost for me to have my SRS or other feminizing sugeries to be able to fit in and feel a bit more normal in apearance.  Carla

Good afternoon Carla,

If you have a letter of medical clearance with reference to a stress EKG, we can do an orchiectomy under local with IV sedation, also perhaps scrotal removal.  We cannot do any surgery that requires general or spinal anesthesia in your case because the Ameican Society of Anesthesiologist’s physical status classification places you in a class 3 risk.    Please be sure your estrogen levels are carefully monitored to keep you in a safe range, as they are coagulopathic.  Can produce blood clots.

Cordially,

Harold M. Reed, M.D,.
305-865-2000

January 5, 2012

Dear Dr. Reed,

No, I only wish to have breast surgury. I do not want a full conversion. I want a mastectomy with nipple replacement. I viewed the photos on your web page and they look great. It is exactly what I would like for surgery.
Specific_Questions: I was wondering the cost of this type of surgery and what finance options are out there. I do not want a conversion only the breast surgery. I have seen a local surgeon but he did not appear to understand the consept of what I want. I want a mastectomy to look like a mans chest.

Madison

Good morning Madison,

Understood.  In that this is not conventional surgery, and irreversible and possibly could lead to remorse later on 2 letters of psychiatric clearance will be required

Sincerely,

Harold M. Reed, M.D.
305-865-2000

January 4, 2012

Dear Dr. Reed,

I am seeking full hysterectomy with vaginectomy and closure. Do you perform this procedure, or is there another surgeon that performs those procedures? I am also interested in a consultation regarding meta and phalloplasty.  Marlon

Good afternoon Marlon,

We do vaginal closure (colpocleisis) and metoidioplasty.  The other procedures are done elsewhere.

Sincerely,

Harold M. Reed, M.D.
305-865-2000

December 29, 2011

Dear Dr. Reed,

I am wanting a castration.  I am bound by the scripture found in Matthew 5: 27-30.  This procedure is not listed as one of your services but I think that you might be able to perform this.  Please contact me to discuss this. 

Thank you,

Aaron

December 29, 2011

Good afternoon Aaron,

Read the scripture.  It talks about adultery and lust.

Yes, we will consider doing orchiectomy for men such as yourself, but there are a few advisories we need to put out first.

Assuming you are not a transgendered patient, yes, we will consider doing an orchiectomy with or without scrotal removal for men such as yourself.  As this is not conventional urological surgery, a letter of psychiatric clearance from an American Boarded psychiatrist is required. We want  to be sure you are mentally stable, will be a happy and more productive person after your orchiectomy, and most importantly that you will have no remorse.  The letter should state if correct, that you have had no emotional problems or suicidal ideation.  One resource would be to look
up psychiatrists under Physicians and Surgeons in your yellow pages or any neighboring
large city.

If you are a transgendered patient, seeking to be a female or wish feminization, then you can approach 2 therapists (a list of South Florida therapists is appended below) who work with transgendered patients.

Mention should be made that there are medical (non-surgical) ways to achieve the same effect.  At least you may wish to have a clinical trial with these methods to see if this is really for you.

Next, if you are married we will need a release from your wife.  Remember this is an irreversible procedure and unless you sperm bank, you are forfeiting your right to pass  on your excellent genetic potential to the next generation.

If there is further interest, we are available for consultation.   Our fee is 250 for consultation and 2500 for the orchiectomy.  For scrotal surgery, add an additional 1500.

If you are over 40 or on medications, a letter of medical clearance with reference to an EKG  is required.  Routine lab work for all patients includes a CBC, platelet count, PT and PTT.

Typical scenario, day one consultation, day two orchiectomy, You will need to stay for two additional days with a generous amount of bed rest, and be seen before departure.

We recommend the Baltic Hotel in Miami Beach at 7643 Harding Avenue (phone 877-622-5842), where Christina the owner-manager takes a special interest in our patients.

Please no aspirin or aspirin products, no anti-inflammatory drugs such as Motrin, Advil, Alleve, or Cox 2 inhibitors such as Celebrex or Vioxx (withdrawn from the market for safety concerns) for a week before surgery. No Vitamin E or excessive alcohol or spices for a week before surgery as this may promote bruising.

Bruising can be reduced (many believe) with Bromelain 500 mg 1 twice a day, Arnica montana (Boiron brand) dose 30C (take 4 small tablets sublingually, 4 times a day), vitamin C 500 mg (3 times a day) starting 1 week before surgery. Do take these medications unless there are specific reasons why you choose not to and let’s discuss it beforehand.

Boiron brand is available at Whole Foods and on the web at http://www.vitaminshoppe.com for “pennies” and we do notice a difference.  You will need 2 vials.

We hope to have the pleasure of serving you whenever your travel plans include the South Florida area.

Sincerely,

Harold M. Reed, M.D. FICS
Senior Member of the American Urological Association
Member Society of Genito-Urinary Reconstructive Surgeons
Founding Member and Treasurer of American Academy of Phalloplasty Surgeons
Founding Member Sexual Society of North America

305-865-2000

— In MTF-SRS-FTM@yahoogroups.com, “meljo51″ <mellanie462004@…> wrote:

I would like to be considered for the 12 in 2012 grant program. I have been transitioning now for over eight years. I’ve also been trying to loose weight.
Current weight is 230 right now. However, things are changing and I should be down to about 140 by spring.

Let me know the particulars and what I have to do on this end.

Thank You

Mellanie

Hi Mellanie,

Thank you for your interest in what we do. 

This year we are re-vitalizing our Grant with a slogan similar to one a few years ago (“the first 10 in 2010″), now it is “the first 12 in 2012.”

So far 5 positions have been filled this month.

Call the office and speak with Anne our amiable office manager for details. We re-open on Tuesday, January 3rd.

Be assured I will send you more information and a reprint of a very comprehensive article that was published a few months ago in Seminars in Plastic Surgery.

Happy and Healthy New Year to you and your loved ones,

Harold M. Reed
1111 Kane Concourse, Suite # 311
Bay Harbor Islands, Florida 33154
305-865-2000