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FTM Top Surgery Requirements And Eligibility

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The World Professional Association for Transgender Health is a global organization whose purpose is to provide guidance and support to health professionals to help them provide safe and effective options for transsexual, transgender, and gender nonconforming people.

They aim to maximize the overall health, psychological well-being and self-fulfillment of these patients while providing resources for primary care, gynecologic and urologic care, reproductive options, and voice and communication therapy. The WPATH has set out a list of criteria to be used to identify patients who would benefit from top surgery procedures. This list includes:

  • Well-documented and persistent gender dysphoria in the patient
  • Proof of the patient’s capacity to make informed decisions and consent to treatment
  • The patient must be over the age of majority in the country in which they wish to undergo surgery
  • Any significant mental or medical health concerns must be properly controlled at the time of surgery

While we at the McLean Clinic use “Informed Consent”, many other surgeons will require a support letter from a qualified mental health professional attesting to the above and recommending top surgery. This letter should also include the following information:

  • The general identifying characteristics of the patient
  • The results of any psychological assessments that have been performed, as well as any diagnoses
  • The duration of their relationship with the patient in question including the type of evaluation performed, any forms of therapy undergone, and counselling sessions to date
  • A brief explanation of how the above criteria have been met, along with a rationale for supporting the patient’s request for top surgery
  • A statement of informed consent from the patient
  • Proof that they are available to help coordinate care

Although it’s a requirement that patients be over the age of majority, in some cases adolescents have undergone this procedure with the permission of their parents. In these cases it’s generally recommended that the patient has spent a significant amount of time adjusting to their new gender role before the procedure is performed. Some insurance plans may include coverage for top surgery under certain circumstances. In many cases this requires at least 1 year of hormone treatments prior to surgery. While this is often recommended for top surgery patients, it is typically not a requirement for the surgery itself. Many patients find that this hormone therapy can be quite beneficial in that it helps them develop larger chest muscles prior to the surgery. These muscles can also be developed through exercise if preferred. Speak to your surgeon about their requirements for FTM top surgery. Although these are a general guideline, many surgeons have requirements specific to their practice.