Some people want to get vaginoplasty right away. That is fine, but for many people it does not have a big effect on your life each day. If you don’t have a lot of money, it may be better to do other things before or instead of vaginoplasty. Your surgical status has nothing to do with keeping a job or personal safety.
I had vaginoplasty four months after going full-time. Here’s how I did it.
The myth of waiting lists
I believe waiting lists are not applicable if you have everything they require. Many surgeons have long waiting lists. Some people hold surgery dates, then find they are not ready as the date gets close. That means there are often cancellations and reschedules. These same people who reschedule rarely cancel altogether, but “postpone” instead, with no guarantee they’ll make their new date. And so the list keeps getting longer.
You won’t get preferential treatment if you pay up front, nor do other surgeons. You don’t get moved up the list because of bribery. You get moved up because you are prepared. If they know you have the money and letters in hand and are ready at a moment’s notice, they will very likely be able to move you up into a spot held by some postponer. There are no guarantees, though. Being prepared only increases the likelihood you’ll be moved up. Don’t go in and tell a surgeon you have only been full-time a few months. Don’t go in and demand you be moved up because you heard you can get moved up. Go in, say you’re available to move up (but only if you really are), and then hope for the best.
Is a pie-in-the-sky surgery date right for you?
Some people seem to find that having a hypothetical date set up is reassuring or validating. Some women even send you “welcome to the club” notes once you announce a set date. These sorts of rewards for setting a date make it tempting for some to set a date just to look like they really are serious about this. For some, it can also be incentive to get everything together by that date. After all, it’s hard to hit a target that doesn’t exist.
However, you risk major disappointment and embarrassment if you are unable to make the date. This puts a lot of unnecessary stress on some people and may not be the best way for you. Some people are devastated when they have to postpone, and fall into a deep depression. Do you want to risk that?
I recommend having everything together before scheduling. At the very least, you should have a realistic budget in place if you’re saving for a specific date. If you’re too ambitious or not brutally honest about how much you can save, you may find yourself forced to reschedule.
For those interested, I have included my presurgical timeline with my surgery journal.
Getting documentation
For surgeons who follow the WPATH STandards of Care, many require “documentation of persistent gender dysphoria by a qualified mental health professional.”
To get this, you’ll need to find a supportive therapist. This is best done via a long-term relationship with a therapist, but some people will document your state of mind after a few sessions. Much depends on how high functioning you are.
If your therapist won’t give you what you need, start looking elsewhere. Don’t walk out in a huff, but explore other avenues. Too many people just accept “no” as an answer.
Therapists are providing a service for which you are paying. If you are not pleased with the service, go elsewhere.
Things you’ll need to get therapist letters early:
- Being able to present as a functioning member of society
- Being mentally well-adjusted and self-accepting
- Being employed
- Being organized
- Being out to all friends, family, and coworkers
- Showing that you’ve thought everything through carefully
- Not being belligerent, suicidal, etc. if they say “Not yet”
- Being able to negotiate and convince them that you are really ready
Things that can’t hurt:
- Being accepted as female at work and outside of work
- Being done with other transition needs (electrolysis, etc.)
- Being in good physical condition
- Being pleasant to your therapist
Getting the money
Things you’ll need to get money
- A pre-transition job (no excuses!)
- A post-transition job (no excuses!)
- A very clear spending plan
- A realistic savings plan
- A realistic timeframe
See my section on how to pay for transition. Basically, there’s always a way if you’re willing to make certain sacrifices. If that sounds like self-help bullshit to you, and you think, “Well, my situation is hopeless,” then I didn’t write any of this for you. I write this to enable those who would rather achieve their goals than come up with excuses for failure. I know people from ages 22 to 64 who were able to get the money, with all sorts of different financial impediments. This isn’t some rich white conservative pull-yourself-up-by-the bootstraps speech. I’m not saying it’s easy to get the money. I’m just saying it’s definitely possible if you really, really want it.
How to move your surgery date up
Things you’ll need
- Any required letters
- ALL the money
- Flexible schedule
Things that may help
- Being employed
- Being in good physical condition
- Meeting the surgeon in person at their office
- Asking thoughtful questions
- Having genital hair removal done
- Mentioning friends who went to the surgeon
- Being nice to schedulers and the surgeon