Thank you letter

Hello My name is Georgette Davies and I am sending you this email in regards to your notice on your web page.  About your grant for srs surgery.  I am very interested in this grant.  I live in Milwaukee Wisconsin and I am working on buying a home in Delray, Florida soon.  I have been living full time as a woman for 15 years and on hormones the same time.  I also have followed the Harry S Benjurman plan to the tee.  I feel I would be a very good person for the srs grant.  My address is Georgette Davies,  East Juneau … ,

Thank you.
Georgette

Good morning Georgette,

Yes, the program is up and running.  “Oversubscribed” is not a word in our vocabulary.  Please write to me off line at admin@srsMiami.com   My first concern is that you are a surgical candidate and my second concern is to make it happen.

Yours faithfully,

Harold M. Reed, M.D.

305-865-2000

Yes, we do male chest reconstruction surgery.

While we will endeavor to utilize the smallest incisions possible, and strive for reasons of concealment to make those incisions along anatomical skin folds or planes if at all possible, a consultation would be required to best advise you.

We cannot do breasts larger than a C in the office, unless your breasts are pendulous and the base or pedicle (coming off the chest wall) is narrow.

Fees to include anesthesia and use of the facility range from $5,000 to $8,500.  Scheduling for surgery requires a 50% deposit which is non-refundable.

The balance is due no later than the day before surgery and must be presented in cashier’s check or currency at that time.  Credit cards and personal checks are not accepted.

Consultation is $250 and there will be some out of pocket fees for a compressive chest garment, laboratory tests (which could be done in your home town) and a letter of medical clearance (if indicated).

Any special pre-operative instructions?Do initiate a telephone consultation before surgery so we can get to know you better and answer any questions you may have. A CBC should be performed 2 months before your scheduled procedure. If your blood count is low normal or below normal values, a hematology consult may be needed. Usually patients on testosterone have normal to high blood counts.Better to learn of this well in advance.

Within 10 days before surgery, all patients are required to have these blood tests: a CBC (again), PT, PTT, and platelet count. Our lab fee is $100, but you could have this done in your home town perhaps more reasonably.

All patients over 40 and those on diabetic, neurological or cardiovascular medications require a letter of medical clearance with reference minimally to an EKG and chest X-ray to be obtained within 1 week of your scheduled procedure.

You may wish to stop testosterone a good month before surgery, as testosterone is metabolized into estrogens and may predispose to thromboses or emboli (unwanted clotting). You may resume 10 days after surgery.

No aspirin or aspirin products, no anti-inflammatory drugs such as Motrin, Advil, Alleve, or Cox 2 inhibitors such as Celebrex or Vioxx 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.

If for any reason, despite tight scheduling arrangements and eager anticipation of being converted, you have contracted an illness such as a flu like syndrome with coughing, sore throat, fever, or diarrhea, please reschedule allowing a good two weeks for recovery. These things happen and we are very sympathetic. Surely we do not want any patient with a very recent cold to have general anesthesia. If you have gained weight, please advise as we may have to postpone surgery.

If you are a smoker, you must stop completely for 2 months before surgery and please never again. Smoking causes vaso-spasm, impairs wound healing, produces excessive scarring, tissue necrosis, irritates and inflames pulmonary membranes and enhances anesthetic risk.

This goes also for any products containing nicotine or nicotine like agents including nicorette gum, nicotine patches, Nicotrol inhalers, and second hand smoke. Again not for 8 weeks before and not for 8 weeks afterward. Hopefully never again.

Obtain one pair of anti-embolism thigh high stockings. T.E.D. (by Futuro) or Jobst are common brand names. Yes, do try these on before you come here to be sure they fit comfortably. If you wash or dry them in a hot cycle, they may never fit properly again. So best not to wash them at all until after surgery.

As a courtesy to the hotel, please obtain and bring with you a bundle of “chucks” or disposable super absorbent pads with plastic liner on underside (typically 24 by 36 inches) to conserve hotel laundry and bedding.

Please keep up with a good fluid intake the day before surgery.

Nothing by mouth after midnight unless otherwise instructed. Do not shave yourself as we will do that for you.

We observe the guidelines of WPATH (World Professional Association for Transgender Health, formerly Harry Benjamin International
Gender Dysphoria Association)

Taken from the Standards of Care (SOC)
http://www.pfc.org.uk/files/medical/soc1998.pdf

1. legal age of majority in the patient’s nation
2. 12 months of continuous hormonal therapy for those without a medical contraindication
3. 12 months of successful continuous full time real-life experience. Periods of returning to the original gender may indicate ambivalence about proceeding and should not be used to fulfill this criterion
4. if required by the mental health professional, regular responsible participation in a psychotherapy throughout the real life experience at a frequency determined by the mental health professional. Psychotherapy, per se, is not an absolute eligibility criterion for surgery. In that removal of natural breast tissue is an irreversible procedure, two letters of therapy clearance, one written by a consultant with a doctoral degree (could be a psychiatrist, psychologist, or sociologist), and another with at least a master’s degree is required as mastectomy is irreversible surgery. You may already have such a letter(s).  If written in the past year this is acceptable, or simply have it updated, and co-endorsed by an independent therapist with an appropriate educational degree. For those unable to completely satisfy the SOC requirements, individual consideration may be given especially if there is a plausible explanation and concurrence of support from the therapists. Please also consider joining a very stimulating discussion group re: SRS procedures by logging in on http://groups.yahoo.com/group/MTF-SRS-FTM/.

We hope you’ll join us!

With kindest regards,

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

To bad there isn’t any money for those of us who would like to FtM.
I  have been suffering my entire life in the wrong body. I do have my  PCP and other doctor behind me for what I want only my insurance  won’t let it happen [all I want at the moment is my top done].

guardianmax

Re: Grant Program, up and running, by popular demand

Hi “Max”,

Please write to our office and provide some background information.
If I personally cannot help you, I will refer you to doctors who know
what they are doing and whose surgery I have personally watched.

These very same doctors are mentioned in our letter to prospective
patients, as you should have many choices when it comes to selecting
your surgeon.

Have a restful Sunday and if it is not Max, don’t be shy,

All the best,

Harold Reed, M.D.
admin@srsMiami.com

This coming month we will offer an additional 5.  This past month all 5 were quickly taken by needy patients who are really caught in this recession crunch.

What’s included:  surgery, use of facility, private duty RN nursing care, anesthesia, any followup care provided by Dr. Reed, including touch ups under local. 

What’s not included:  consultation, stents, travel, out of pocket expenses,  some medications (the small stuff).  We do have Cipro samples enough for 10 more cases.

This means you may have feminizing vaginoplasty for as little as $5,000 and for no more than $8,500 if we can secure an allotment for you.   It all starts with an E-mail letter admin@srsMiami.com

Harold M. Reed, M.D.

305-865-2000

Dear SueEllen,

Yes, quite agree.  Scrotal grafting is the key to depth.  Please see our photographic examples, panels 6/1-5 for scrotal graft preparation and on lay.

Hope this is of help,

Harold M. Reed, M.D.

Re: Depth  (from http://groups.yahoo.com/group/MTF-SRS-FTM/message/40720)

The discussion started out by a patient saying her doctor was not able to make a depth of over 4 1/2 inches and  blamed it on her perineum which is short.

Reply from another…

The perineal flap is not that long regardless and does not play into depth but very important to provide a proper entree into the vaginal introitus or opening and of course provides girth at the opening or outer portion of the vagina. Girth not depth. It is sewn into the back wall of the vagina to funnelize the vagina. For depth, the scrotal graft with rare exception is unsurpassed as this skin when properly thinned stretches quite easily.

SueEllen, RN

I am looking into nullification with urethra displacement. How much am I looking at? Also, how much extra is a neo-clitoris. Since, I am already legally female and not seeing a psychiatrist, do I still need letters? P.S. I have my letter from the doctor that did my orchiectomy.   Valerie

Hi Valerie,

Thank you for your well put together letter.  There is a saying among transgender professionals, “you can get on a train going from LA to New York, but you are allowed to get off in Chicago.”

What you desire, we can do.  However, there are some thoughts that need to be mentioned.

If you are having nullification because you are asexual or only anticipate female companionship, please be sure this is a long term goal as the best opportunity to make a vagina is when you are having your penectomy done.

Also the making of a vagina even if only a modest depth, will provide some degree of labial cleavage, so in the event, someone looks at you for whatever reason, they will not do a double take.

However, if after all is said and done, this is what you want, yes we can do this.

Two letters of therapy clearance are required, one from a licensed therapist with a doctoral degree and the other, a letter of concurrence from a therapist with at least a masters degree.  We have therapists in the greater Miami area, who could initiate teletherapy with you to be confirmed by a personal visit when you see us.  We can provide you with several names.  You interview them over the phone and choose whomever you find most suitable.

The longer your time in grade (as a female) with good social integration and lack of personal ambivalency,  the more convincing and reasonable your desire for surgical confirmation becomes.

Please remember the incidence of remorse with below the waist surgery is 3%,
although every patient at the time of  surgery swears this would not apply to them.

By the way, thanks for visiting our web-site http://srsMiami.com regarding your male to female transition.

Harold M. Reed, M.D.

admin@srsMiami.com

(feminizing vaginoplasty, nullification, smoothie, MTF)

1. Camilla F. | pinko@pallino.it | srsmiami.com | IP: 87.18.47.195 Dearest Dr. Reed, First of all, I will d?like to say THANK YOU VERY MUCH for your wonderful revision labiaplasty you did on me. I?M VERY HAPPY! Let me say hello and thanks to you secretary Anne, as well, such kindly and lovely. I had all of kind of attentions and care about the staff, and lots of care from you. I consider to advice all the folks need procedures about any kind of ?sexual gender problems? to go to Dr. Reed. He?s definetelly, is the best of surgeon and as good person. Thank you forever. Camilla

1. Gishelle Diva Gish | gishellegish@yahoo.com | mtf-srs-ftm@yahoo.com | IP: 70.147.131.192 Just read todays group e-mail and read the post about Grant assistance for MTF SRS at the Clinic in Miami. PLEASE let me know as soon as possible what I need to do to be considered for one of the grants. I have completed all necessary steps to have surgery, and can have my two letters by next week if needed. Thank You!!!!!!! Gishelle