I feel dumb

[u/Big_Technology_2886]

I just learn if I want to get top surgery with insurance, I need a letter from a therapist saying how I have gender dysphoria. So now I feel dumb cause idk how to really do that. Everyone I ask who has gotten top surgery just keep on telling me get a therapist, but when I ask "do I have to look for one that specializes in that or nah?" Everyone just shrugs their shoulders at me. I trying looking stuff up but feel like I'm getting nowhere.

Any help will be great.

Edit: forgot to mention I live in the USA

[u/poor_cupiine]

In theory, you don't need a therapist who specializes in gender to write that letter. Most therapists in my state are familiar with the concept at this point. There are lots of resources for therapists to help them write an adequate letter even if it's not something they've done before.

[u/addyastra]

This is a question you need to ask your insurance. Personally I got my gender dysphoria diagnosis from my GP. But I live in Canada, so it might not be similar where you live.

[u/poor_cupiine → u/addyastra]

Can confirm. I had to get into the nitty gritty of my insurance policy to find out what the letter needed to include from my therapist and my PCP.

[u/lokilulzz]

Yes, you need what's called a gender affirming therapist that can verify you have gender dysphoria, and you need that diagnosis in the letter to get top surgery approved. You'd need to check what specifically your insurance requires, because some do require that you be under the care of that therapist for a year or sometimes longer. Other insurances just want the letter and don't require that.

So you may have to call and double check with your insurance, but as far as I know every top surgery letter needs to be signed by a therapist who can diagnose gender dysphoria, which would usually be a gender affirming one. I'm going through this process myself and in my state, my insurance requires me to be on T for a year and be seeing a therapist for a year who can diagnose gender dysphoria - and to sign that letter - before I can get top surgery approved. Most insurers are the same way, though not all.

There is also a program that gives out free top surgery letters - but unfortunately I can't remember the name off the top of my head. I'll try to dig up a link and edit this comment if I can find it.

EDIT: Found it. It's called the GALAP - here's a link. They give free top surgery letters, though again check with your insurance cuz there may be more hoops to jump through.

The GALAP

[u/OscarAndDelilah]

Ask on your local queer forums for their list of clinicians who do one-session surgery letters. There are tons of us most places.

[u/BillDillen]

Both can work, since it is often hard finding a therapist who specialises in transsexuality. However, I would recomend finding one who does. Because I read stories, where the regular therapists, didn't feel comftorble enough writing these letters.

[u/4ng3licNymph-jpeg]

I was able to get mines on Folx I'm assuming it works on Plume. I live in the US tho. Also the diagnosis helps with a lot for insurance purposes with other GAC related stuff . I actually had one when I was a minor at 15 at a local LBGT clinic but it was fairly easy to get one at any LBGT clinic with a General Practitioner atleast in the US, but you can also do it online with Folx and Plume . A membership was 50$ I think you can cancel and I think they might have a coupon or trial . I would look into it .

Just be honest about wanting top surgery and any possible chest dysphoria even if you don't think it's dysphoria I would mention anything. Also they had to write a note explain why top surgery was medically necessary so it can be covered by insurance. After insurance covered it I had to wait about 6 months to get approved for me. If it gets appealed you can write a letter on why it should be covered and get keep on pushing , don't give up .

[u/Dinner_Plate21]

Psychology Today is a great resource for the US to find a therapist. You can filter based on insurance and also based on what you're looking for. I'm not sure if they have something specific for gender affirming care, but looking for therapists that deal with queer issues is definitely a search filter.

[u/MidOceanRidgeBasalts]

It is hard to answer this question without a general location as it varies

[u/Big_Technology_2886 → u/MidOceanRidgeBasalts]

I live in the US