Archive for the ‘orchiectomy’ Category

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Just a penectomy without vagina

Wednesday, June 30th, 2010

Hi, Harold! I am planning on scheduling a phone consultation with you in September. We had an email exchange regarding a cosmetic SRS procedure without the vaginal canal. I read your attachment, but I still have some questions regarding what I need to submit before the consultation. I am attending counseling right now and dealing with some non-gender related issues, but it has been two-and-a-half years since my last surgery and all the legal gender changes, so I already fulfilled all the necessary H.Benjamin requirements in the past. Will I need to a change in my current diagnosis from the medical one of “endocrine disorder” to the psychological one of “GID”? That would make no sense to me because I’m already a woman, legally, hormonally, and appearance-wise, and there’s nothing psychologically abnormal about a woman wanting to be like all the other women out there. It would offend me a great deal, but for this surgery I would do anything that needs to be done. Maybe I should let my counselor call you about this? I hope I’m not coming off abrasive, I just want to make sure that I have “all my ducks in a row”, and I also want to protect my psychological peace of mind (I will need it for the surgery :-)   You mentioned something about a psychological evaluation last time. Is that something you still would want me to get done? Please let me know what I need to submit, considering my individual situation, so that we can at least get this process started.

Thanks

Virginia A.
June 30, 2010

Good morning Virginia,

Presently I am in the Carolinas, but we have had on this computer alone about 8 E-mails, a few of which are posted below.

Especially for  unconventional surgery, involving penectomy to conform to a female appearance, 2 letters of therapy clearance are required, one of which has to be written by a therapist with a doctoral degree, as this is irreversible surgery.

This is not to say you need therapy.  Surely your feminine lifestyle is only that much more reassuring.  If you need help finding ualified therapist, we have a list of very experienced therapists who may elect to do the initial evaluation over the phone, to be confirmed by a face to face meeting when you are in Miami.
Sincerely,
Harold M. Reed, M.D.
305-865-2000

 Hi, Harold! My name is Virginia. I first contacted you back in 2008 regarding a possible post-orchi “cosmetic SRS” procedure, without vaginal depth. You were very helpful and accommodating, and you agreed to perform this procedure for me. However, I wasn’t ready to have it done due to financial reasons and, frankly, I wasn’t ready for it just yet. I needed some time to really figure out if it was something that was going to make me happy in the long run. I am ready now, and I would like to get this procedure done sometime in February of 2011.
       Last time, your price quote for my procedure was $10,000, and you said that you would make this a one-time procedure, with a possibility of a touch-up later, if needed. I hope that your current price is similar to the quote you gave me.
       I briefly described my situation to you before, but I don’t expect you to remember any of it :-)   I am legally female (post-orchi), and I am not seeing any counselors right now. I did get extensive counseling therapy for non-gender-related psychological issues while I was attending Boise State University. My current medical diagnosis is “endocrine disorder, unspecified”. So this SRS procedure will be purely cosmetic and it will not have any legal implications, as far as gender change, etc. You did mention last time that in my case, I would be needing a psychological evaluation and 1 counselor letter. Is that something I would still need to provide? If so, what information are you looking for in the counselor letter? My main focus of therapy was childhood trauma, so I’m not sure how that would relate to my surgery. Also, I’m not sure if any of my previous 3 counselors are still working at Boise State.

I would like to get more info on how much I will have to pay for my deposit and the whole timing thing, as well as your availability in February of 2011.
       Thanks,

Virginia

July 27, 2009

Good morning Virginia,

Understand what you would like, but the most sensual appearance will be achieved if you have cleavage between the labia. This can only be achieve by making some vaginal intrusion. You don’t need to have lots of depth.  Even a few inches will work. Of course it is easy to say if you are not planing on penetrating sex, then having hair down there is a mute point, but again, you will look better if you have electrolysis.  In natal women, there is no hair over the clitoral body.

We will attempt to make this a one stage procedure, but if you are seeking an extremely good cosmetic result, there may be a need for a touch up, which we do at no added charge as long as this is done under IV sedation and local.

All the best,
Harold M. Reed, M.D.
305-865-2000

Posted in Feminizing vaginoplasty, MTF, no vagina, orchiectomy | No Comments »

Orchiectomy requested

Wednesday, June 30th, 2010

hello my name is Myrna I am 22 years old, I live in Arlington Virginia, living as a woman since i was 20, I have taken female hormones from i was 20 two years now, i would love to removing the tests. out, and I would like to know the costs and all the information about it, thank you, sincerely, Myrna Lopez

June 30, 2010

Good morning Myrna,

Many thanks for you interest in what we do.

Our fees are 250 for consultation which should be initiated over the phone and also includes your first visit at the office, 2500 for orchiectomy which includes local anesthesia and IV sedation, and my post-operative care and daily visits at the Baltic Hotel.

We recommend you stay there for 2 days afterwards before returning to Virginia.  If you leave with your compression dressing on, you will be quite comfortable.   Typically after orchiectomy, you can reduce your estrogens by 1/3rd
and discontinue spironolactone if you are taking that medication now.

Two letters of therapy clearance are required (one written by a therapist with a doctoral degree) as this is irreversible surgery.  You may also wish to consider sperm banking (just a thought).

We can help with the therapy letters if needed.

Have a pleasant and productive day,

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

Posted in Feminizing vaginoplasty, MTF, orchiectomy | No Comments »

Anticipating MTF Orchiectomy with Dr. Reed

Tuesday, January 26th, 2010

I am contacting your office because of my interest in undergoing the orchiectomy procedure, however, I did have a few questions for you.

1. I know there are several places for incision, but I am curious where Dr. Reed chooses?

2. I live in St. Louis, Missouri and because of that, flying to Miami is quite costly. Will a consultation prior to surgery be necessary? I would like the Doctor to know that I have currently had another consultation in St. Louis, though I choose not to go with that doctor due to her lack of experience with MTF patients.

3. What does the $2,500 cost exactly include? If there are additional costs, could you tell me how much those additional costs usually run?

4. How long does Dr. Reed recommend the patient stay in the Miami area before flying home?

5. One of the major reasons I want to have this procedure performed is to have my gender marker on my birth certificate and subsequently my driver’s license change. In the State of Missouri, what is required for this is receipt of a certified copy of an order of a court of competent jurisdiction indicating the sex of an individual born in this state has been changed by surgical procedure and that such individual’s name has been changed, the certificate of birth of such individual shall be amended. Will the notarized documentation that Dr. Reed provides to me after the surgery use the key language “the sex of [Chloe] has been changed by surgical procedure”? I ask this because that language is key to having it amended.

6. Lastly, how many orchiectomy procedures has Dr. Reed performed on MTF transsexuals?

I have done a lot of research on Dr. Reed, and find that she would be a wonderful surgeon for me. I hope to hear from you soon, and I thank you for your cooperation.   Carla

Good afternoon Carla,

Yes, for lack of a more appropriate term, we do have to gather information before surgery about your medical history, review therapy letters of clearance, review laboratory tests, examine you and answer many questions you may have and put out information to you.  This can be initiated over the phone and with the help of Email.

We will see you the day before your orchiectomy and give you instructions to help you prepare. We recommend you stay at the Baltic Hotel so I can follow you there for 2 days, and then you are good to return home.

We are equidistant between Ft. Lauderdale and Miami airports, so take the flight that is most economical.

At Miami, you can use SuperShuttle for ground transportation, and in Ft. Lauderdale.. Go-Transportation for a significant savings.

Carla,  I can write words to that effect when we say you have had irreversible gender altering surgery. That you have been living as a female for (—) years and are recognized as a female by your psychotherapists.  We have never had a notarized letter (signed by me) of this import rejected.

I have performed about 400 or more orchiectomies on MTF patients.  We use a small 1 inch vertical scrotal incision

Your surgical fee includes: surgery, use of the facility, local anesthesia with IV sedation, my followup visits with you and of course several confirming letters.

Have a restful evening,

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

Posted in MTF, orchiectomy | 1 Comment »

Grant reactivated for limited time

Sunday, December 6th, 2009

Thank you for your interest in what we do.

GRANT SUBSIDIES AVAILABLE AGAIN

This January, 2010 the first 10 cases, will
receive Grant Subsidies.

Think “the first 10 in 2010.”

After reading the attached (our letter to prospective patiuents available by writing admin@srsMiami.com) , if you believe I am the doctor for you, please initiate a consultation over the phone with our office by sending us your name, address, and telephone number in an envelope along with a check for 250. We’ll get started ASAP. We’ll have a lot to talk about.

The grant should reduce your fees by about 1/3 from our typically affordable price when you agree to donate your testes to a non-reproductive research project. Certain restrictions regarding age and communicable disease may apply.

Happy Holidays,

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

Posted in Feminizing vaginoplasty, MTF, MTF Grants, Vaginoplasty, orchiectomy, sex change | No Comments »

FTM needs some advice before male chest reconstruction and metoidioplasty/

Thursday, August 27th, 2009

possible phalloplasty.

Dr. Reed,

 I have been on T since Jan 2008. I am looking into having a hestorectomy, but also want to have both top and bottom surgery as well.
Specific_Questions: I am on psychratric medications. Seroquel, Methylphenidate ER, Methylphenidate, and Lexapro. Would these medications be a complication?

 Armando

 Hi Armando, 

Thank you for your interest in what we do.

Hysterectomy is performed by others, but if you have this done, please go for a laparoscopically assisted vaginal hysterectomy and simultaneous oophorectomy (removal of ovaries) as well.  2 letters of therapy clearance should be obtained prior to this irreversible surgery.

We operate on patients taking your medications all the time, and this is not a contraindication.  A letter of clearance from your psychiatrist will be requested, and also we do advise your taking any AM medication on the morning of surgery with a sip of water. 

A word about methylphenidate…

Methylphenidate is the most commonly prescribed psychostimulant and is indicated in the treatment of attention-deficit hyperactivity disorder

Contraindications:

Methylphenidate should not be prescribed concomitantly with tricyclic antidepressants, such as desipramine, or monoamine oxidase inhibitors, such as phenelzine or tranylcypromine, as methylphenidate may dangerously increase plasma concentrations, leading to potential toxic reactions (mainly, cardiovascular effects). Methylphenidate should not be prescribed to patients who suffer from severe arrhythmia, hypertension or liver damage. It shouldn’t be prescribed to patients who demonstrate drug-seeking behaviour, pronounced agitation or nervousness. Care should be taken while prescribing methylphenidate to children with a family history of Paroxysmal Supraventricular Tachycardia (PSVT).

Special precautions:

Special precaution is recommended in individuals with epilepsy with additional caution in individuals with uncontrolled epilepsy due to the potential for methylphenidate to lower the seizure threshold.

All the best,

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

Posted in Electrolysis, FTM, FTM chest, male chest reconstruction, metoidioplasty, orchiectomy, phalloplasty, sex change, subcutaneous mastectomy | 1 Comment »

MTF patient wants simultaneous orchiectomy and breast augmentation

Sunday, August 23rd, 2009

with cohesive gel  implants. 

Dear Dr. Reed,

Male
BECOME: Female – MTF
Hormones/Conversion: Yes, I have been taking hormones for about 3 and half years.
Specific_Questions: i am interested in having castration and also Cohesive gel breast augmentation, do you have a price package for that?    Sarah

Good morning Sarah, 

Thank you for your interest in what we do.

While our fee for orchiectomy is 2500 and for cohesive gel breasts 6000 (saline 5000), we can put a package together for you for 7000 if both procedures are done simultaneously.

Please understand that with cohesive gels the recommendation is to have MRI scans every 2 years or so
to detect rupture.  Very shortly this will be quite expensive for you.

The US-FDA has recommended that MRIs be considered to screen for silent rupture starting at three years after implantation and then every two years thereafter.

Most likely, you will have a retro-pectoral implantation, in which case salines or gels will be covered with a fair amount of muscle and the palpable result may turn out to be quite similar.  Also keep in mind your present breast masses may not be exactly similar and although cohesives come in various sizes it is possible to tweak fine difference with salines on the table when we sit you up under anesthesia, than with gels.  Although there are sizers, once a gel is in it cannot be augmented.

Incidentally, when you are sat up, at least 4 people, usually 2 women and 2 men (associated with the case) give
their opinions for final adjustments.

Please look at photographic examples and we hope you like what you see.   http://www.srsmiami.com/photography-breast.html

Orchiectomy is a procedure we understand quite well and you certainly do not want a tootsie roll effect (retained spermatic cord), that goes too.   Orchiectomy is a procedure we understand quite well and you certainly do not want a tootsie roll effect (retained spermatic cord), that goes too.  Additionally when you are ready to have a feminizing vaginoplasty we will give you a 1000 credit to our already low prices, which are 6000 below what others charge in North America, in that we own our surgical facility.

With every best wish for a peaceful Sunday,

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

Posted in breast implants, orchiectomy, sex change | No Comments »

Orchiectomy as first surgical step for MTF patient

Sunday, August 2nd, 2009

orchiectomy

Good morning Joni,

Thank you for your interest in what we do.   For orchiectomy, our fee is 2500, and two letters of therapy clearance are needed written by licensed therapists, one of whom has to have a doctoral degree, as this is an irrversible procedure. The same letters will probably work for feminizing vaginoplasty, if you have this within a year or two. 

A 1000 credit will be issued to you for your vaginoplasty when you have that done at our facility.

Please check out photos of some of our work. Hope you are pleased with what you see.

Anticipate we will show you every courtesy.

All the best,  

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

Posted in MTF, orchiectomy, sex change | No Comments »

Dr. Reed’s MTF Grants

Sunday, January 4th, 2009

Having an MTF vaginoplasty with reduced fees.

Last year (2008) and the year before (2007) we were very fortunate to have been a research resource for orchiectomy specimens.  Regretfully this relationship was concluded last year.   This was the sole basis of funds for our Grant project with one exception.  A very nice prospective MTF patient made a sizeable donation to help another have an operation.  She herself is on the schedule to be done soon.

What next then.  Well with Dr. Reed, there is always individual consideration.  This does not mean we can work for free, and surgery is a team approach and members of the team such as nurses and anesthetists expect a pay check at the end of their shift. 

However, we have always offered compassionate discounts to those who have enough reserves to cover contingencies and out of pocket expenses.  We do recommend a friend, loved one, or relative stay with the patient for at least 2 to 3 days.  That’s an added expense although we have the availability of attendants, but they bill at about $12 an hour.

Hotel and food for a week adds up to about $650, medications, ring pillow, anti-embolism hose, about $100, stents $350.

As is, our fees are easily about $5,000 below what most  are charging in the US and Canada, and we are busy.

Harold M. Reed, M.D.

Posted in Feminizing vaginoplasty, MTF, MTF Grants, Vaginoplasty, orchiectomy, sex change | No Comments »

Orchiectomy and hormones

Sunday, January 4th, 2009

As a rule of thumb, you can reduce female hormones by one third after orchiectomy.  My bias is to keep estradiol ranges betwen 125 and 150 to avoid thrombo-embolic phenomena, such as strokes and coronary events.  

An MTF oriented patient wrote yesterday: can he have orchiectomy even if not on hormones.  My reply was yes, but two letters of therapy clearance are needed, one from a licensed therapist with a doctoral degree and another from a therapist with at least a masters degree.   

We can all relate that this is irreversible surgery and all patients should be advised to consider sperm banking just in case there is a change of heart, especally before the real life test.   This individual cannot dress en femme at work and keep his job .

 Harold M. Reed, M.D.

Posted in MTF, orchiectomy | No Comments »

Grant program goes off the air

Thursday, December 25th, 2008

Dear Friends and prospective patients.  This year we gave out 15 grants with a combined savings of about $50,000.   These funds were made possible by a testicular research program who paid for the specimens.   All gone.

However, however, we may still offer compassionate professional courtesy discounts to those who need feminizing vaginoplasty (MTF procedures) such as augmentation mammoplasty or FTM procedures such as male chest reconstruction and metoidioplasty and testicular implants.

Anne, our office coordinator, is the maker of deals and the brains behind Pa.

Please call her at 305-865-2000.

Merry Christmas and Happy Holidays to All,

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

Posted in FTM chest, Feminizing vaginoplasty, MTF, MTF Grants, male chest reconstruction, metoidioplasty, orchiectomy | No Comments »

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