Obamacare and SRS

[BellaBellucci]

We have it whether we like it or not, so should SRS be covered? I posted this on my Facebook wall and got some interesting responses. It seems that most transpeople felt that it should be, while a CD/TV and an admirer felt that it should not. The admirer compared the procedure to lipo for a 400 pound man.

Here's some of the transcript:

Steve: Point being, most people have something that you could have surgery on, but you 'could live with' at the same time, if that makes any sense. Where do we draw the line on surgeries just because we didn’t hit the genetic jackpot?

Me: ‎'Could live with?' That's the standard? Wow. And this has nothing to do with the genetic lottery. This has to do with getting corrective surgery for a chronic issue affecting both physical and mental function, that you've ALREADY lived with for a good number of years, and for which you have suffered enough.

So by your logic, let's also stop covering Viagra and birth control. Sexual health is obviously a legitimate issue to cis people, but when it comes to trans people, you say, 'well, we have ours, so who cares about yours?'

It's hypocritical, plain and simple.

And even moreover, it's pretty sad that our supposed 'allies' don't advocate for us for a procedure that at least some of us consider paramount to reconciling our bodies with our identities and mental health.

It's because Cindy doesn't want SRS and Steven wants Lipo, so the rest of us should suffer. It all seems VERY selfish.

Steve: Yes I have suffered. I’ve been single off and on for 10 years and the weight is one reason why. But Im still alive. So are you. neither is killing us. Which is the point. So where do you draw the line?

And by genetic jackpot, I mean I got a fat gene, and you were born male. Obviously neither one of us had much luck with genetics in those regards.

Me: ‎'Neither is killing us.'

You have no idea about my mental state and how I feel about life the way I'm forced to live it, and when you assume, you make an ass out of...

Also, I've done everything I can up to the point of SRS to assert my identity, physically, socially, sexually, and spiritually, and again, in contrast, there's more than one way to tackle obesity, while there is only one solution to my problem. But on the subject, I also think obesity is caused by the food. PLEASE don't even get me started on the topic of the food supply! That's a whole rant for another day.

The whole thing sort of brings me back to the rhetorical question that asks, 'if you could cheaply and easily make your brain male instead of your body female, presumably with medication, would you do it?' because the better question is, 'if such a medication existed, would it be the only treatment covered?'

I'd tell you shove that pill up your ass, and so would most transwomen. There is ONLY one fix here, and it's a matter of identity and sexual health (again, like Viagra and the pill, which IS covered), so it should most absolutely be offered, again ESPECIALLY when we're all being forced by mandate to contribute to the system.

I'm sorry Steve, and as an open-minded person I don't say this very often: you are absolutely, positively 100% wrong on this. GID is a rare disorder with unique and necessary treatment options. The only thing working against it in the public eye is the fact that every time they meet, or even see on TV, a transperson who doesn't not want surgery, it validates their uneducated opinion that it must not be necessary for the rest of us.

That said, I fail to understand how you and I could have ten mutual trans friends. Just because you sexually fetishize non-ops, that doesn't mean we should all have to exist to suit your sexual desires.

~BB~

[loveboof]

I dunno.. technically that's more in line with cosmetic surgery than anything else - and unless you're giving some breast cancer woman a new boob (or something) that shouldn't be tax payers money IMO.

(edit: I like the idea of a 'fat gene' - like stuffing his face had nothing to do with it lol)

[MdR Dave]

You were pretty nice to Steve.

Saving the "fat gene" for later?

[BellaBellucci]

I dunno.. technically that's more in line with cosmetic surgery than anything else - and unless you're giving some breast cancer woman a new boob (or something) that shouldn't be tax payers money IMO.

(edit: I like the idea of a 'fat gene' - like stuffing his face had nothing to do with it lol)

Tsk tsk. A breast on a GG or a vagina on someone with GID sounds pretty equivalent to me. A woman 'can live' without two breasts. Do you have any idea how non-compassionate you sound... on a trans porn board? Geez, with friends like you...


You were pretty nice to Steve.

Saving the "fat gene" for later?

Oh, I'm not done with him yet. He's still arguing his point that we should be miserable because he is. Medical care should not be graded on a curve if we're all going to have to contribute to it by penalty of law. If he can't be happy, then we shouldn't be?

He's also clearly a cock-bandit. I'm waiting for him to start a 'Save The Penii' campaign or something. :lol:

~BB~

[loveboof]

He's also clearly a cock-bandit. I'm waiting for him to start a 'Save The Penii' campaign or something. :lol:

More likely to be a 'save the penne' than pene from fatboy Steve lol


Tsk tsk. A breast on a GG or a vagina on someone with GID sounds pretty equivalent to me. A woman 'can live' without two breasts. Do you have any idea how non-compassionate you sound... on a trans porn board? Geez, with friends like you...

That's not entirely what I meant. For cosmetic surgery - skin grafts for burn victims, boob jobs for cancer survivors.. but not vaginas for transwomen. Sorry.

I am entirely pro T rights, but that shouldn't definitely be covered by NHS or Obamacare IMO

[BellaBellucci]

More likely to be a 'save the penne' than pene from fatboy Steve lol


That's not entirely what I meant. For cosmetic surgery - skin grafts for burn victims, boob jobs for cancer survivors.. but not vaginas for transwomen. Sorry.

I am entirely pro T rights, but that shouldn't definitely be covered by NHS or Obamacare IMO

... then none of it should. Why does compassion for body image always stop at transpeople? Furthermore, why is Viagra and birth control covered? Because cis sexual health is also more important than the trans variety, and we're not even talking about cis people fornicating for purposes of reproduction. It's simply for fun and/or expression. That would make it too elective, no?

~BB~

[BellaBellucci]

Also, if there was a magic pill that could be taken to masculinize the brain as opposed to having to femininize the body, would that be covered? And what message would it send if it was, and physical treatment was still excluded?

http://www.hungangels.com/vboard/showthread.php?t=68318

~BB~

[Prospero]

It should be covered and maybe will be - once the battles are all fought and won. Obama and the Democrats have a battle royal ahead still just to keep the limited affordable care in place. The future will, one hopes, see it fine tuned and expanded once the dumb folk see the benefits they're getting . SRS is covered in the UK under the NHS.

[loveboof]

... then none of it should. Why does compassion for body image always stop at transpeople? Furthermore, why is Viagra and birth control covered? Because cis sexual health is also more important than the trans variety, and we're not even talking about cis people fornicating for purposes of reproduction. It's simply for fun and/or expression. That would make it too elective, no?

~BB~

Well that compassion for body image thing is about dealing with a significant traumatic event. While I don't know what it feels like to have body dysmorphia or Gender Identity issues - they are as you said a chronic, long time condition and not the result of sudden trauma.

This means the appropriate treatments should not automatically be the same.

Maybe I'm wrong - this is just a gut feeling response. But in that case you should convince me rather than 'straw manning' my argument...

[BellaBellucci]

It should also be noted that Steve swears up and down that he works out and eats right. I doubt this is the case, but if it was, I told him I would help him demand coverage as he has a legitimate health issue. The problem here is that he has low self esteem and doesn't want the help, so he doesn't think anyone else should get any either.

Sorry, I'm not a hypocrite Steve, but yes, if SRS should be covered, and you're not living and unhealthy lifestyle, you should have your surgery covered, and so should I.

~BB~

[BellaBellucci]

Well that compassion for body image thing is about dealing with a significant traumatic event. While I don't know what it feels like to have body dysmorphia or Gender Identity issues - they are as you said a chronic, long time condition and not the result of sudden trauma.

You don't think having a brain identity that doesn't match your body is traumatic?

The excuses people use to deny coverage for this boggle the mind... and they just keep coming at an increasingly nonsensical and desperate pace. They're just rationalizations for discrimination. :geek:

~BB~

[loveboof]

You don't think having a brain identity that doesn't match your body is traumatic?

The excuses people use to deny coverage for this boggle the mind... and they just keep coming at an increasingly nonsensical and desperate pace. They're just rationalizations for discrimination. :geek:

~BB~

Probably just as well that you ignored the second half of my comment, because I didn't find this response particularly convincing.... ;)

[lifeisfiction]

The new health care program will set of a huge debate. People are not going to care for what reasons a person needs health care. I think dental care is very important, however it doesn't mean it will be covered. I know my analogy is simple, but as the bill begins to take shape you will find people will be very critical on what should be cover. Remember, not everyone wanted the bill passed. So people will still feel sour towards any provision of the bill general.

[loveboof]

Btw, I'm sure it is traumatic - but there are different kinds of trauma (both physical & mental) and they don't all require the same treatment.

I'm talking about the rationalisation of cosmetic surgery under government subsidised healthcare.

I'm not sure this is even a trans rights issue :/

[BellaBellucci]

Btw, I'm sure it is traumatic - but there are different kinds of trauma (both physical & mental) and they don't all require the same treatment.

I'm talking about the rationalisation of cosmetic surgery under government subsidised healthcare.

I'm not sure this is even a trans rights issue :/

You're right. It's not. It's a human rights issue. Do I need to post suicide rates among transpeople? Highest of any segment... anywhere...

Ever.

~BB~

[amberskyi]

Well that compassion for body image thing is about dealing with a significant traumatic event. While I don't know what it feels like to have body dysmorphia or Gender Identity issues - they are as you said a chronic, long time condition and not the result of sudden trauma.

This means the appropriate treatments should not automatically be the same.

Maybe I'm wrong - this is just a gut feeling response. But in that case you should convince me rather than 'straw manning' my argument...

Do you know how many Trans woman commit suicide (including one of our former board members)I would say it's very traumatic.

[BellaBellucci]

Probably just as well that you ignored the second half of my comment, because I didn't find this response particularly convincing.... ;)

I did? You're saying that my claim that transsexuality is traumatic is a straw man? You implied that it wasn't traumatic. I'm telling you, as someone who is experiencing it, that it is. :?

What I find interesting is that you can relate to the one-breasted woman, but not to us because you're outright stated that her treatment should be covered. If transsexuals are telling you that transsexuals need SRS, it should be no different than the cancer survivor who also wants to be complete again. And in her case, she was complete once before, whereas we have never been.

If health care is to graded on a bell curve of 'need,' I'd say they're equal. Sure, the GG wants to replace something she lost, but that bears no reflection on those of us who want what we feel cheated out of EVER having. How is one more morally pressing than the other? Chromosomes. The same lame justification for those that think that SRS is unnecessary because, well, we're still men afterwards.

I'm looking at you, Kelly, you traitor.

~BB~

[flabbybody]

I don't think it's politically feasible to think that SRS will be covered by large health insurers. They'll never cover surgeries considered elective/cosmetic. I think it's more realistic to hope they will make therapy services available so those who feel they can't cope

[FreddieGomez]

post-op transwomen are useless to cock bandits lol

[BellaBellucci]

I don't think it's politically feasible to think that SRS will be covered by large health insurers. They'll never cover surgeries considered elective/cosmetic. I think it's more realistic to hope they will make therapy services available so those who feel they can't cope

A penis and a vagina (even a neo-vagina) each have a different function. I fail to see how that's strictly cosmetic. That said, if sexual health is covered for cis people, i.e. Viagra and birth control, then it should be covered for us as well.

For such a homophobic culture as ours, I find it interesting that conservatives are so obsessed with ending 'gay sex,' yet won't put their money where their mouth is. Even Iran beats us out on this, although, to be fair, it's because they hate gay people even more than Americans do. :lol:

Transsexuality in Iran - Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Transsexuality_in_Iran)

~BB~

[BluegrassCat]

Unfortunately for the trans community being turned on by tg does not translate into being an advocate for their rights. When someone says "I'm for trans rights but..." it's code for "tg are just a fetish for me and it makes my dick soft when they demand to be considered as people."

[loveboof]

Ok, well first of all - fuck you bluegrasscat...

Also, I apologise to bella for joining a discussion then fucking off and getting drunk on a Friday night + not giving it a second thought!

@ you and amber,

On reflection, I am probably being hypocritical. I don't expect any recognition for this, but I think I was wrong. Fundamentally there is not much difference - I was expressing a gut feeling to the issue without engaging my brain...

I'm happy to concede that you are more intimately involved in this topic than me, and as such I cannot hope to attain the same level of insight into it as you.

That said, Flabby could be right - would therapy offer a more complete 'treatment' than surgery? (I use that term lightly, because I don't think there's anything wrong with transwomen...

[dj4monie]

More likely to be a 'save the penne' than pene from fatboy Steve lol


That's not entirely what I meant. For cosmetic surgery - skin grafts for burn victims, boob jobs for cancer survivors.. but not vaginas for transwomen. Sorry.

I am entirely pro T rights, but that shouldn't definitely be covered by NHS or Obamacare IMO

National Health Service in the UK pays for SRS, so does the Canadian, French, German and other Universal Systems.

What's special about America? Rugged Individualism???

[ValerieNelson]

That said, Flabby could be right - would therapy offer a more complete 'treatment' than surgery? (I use that term lightly, because I don't think there's anything wrong with transwomen...

We have to have two written referrals from separate doctors that have assessed us before a Surgeon will perform SRS.

[BellaBellucci]

That said, Flabby could be right - would therapy offer a more complete 'treatment' than surgery? (I use that term lightly, because I don't think there's anything wrong with transwomen...

Thank you for your post. I appreciate your empathy. I would say though, that therapy as a treatment for transsexuality is our generation's version of the rhetorical 'man pill' (dealing with the mind). It's not a long-term solution and many women still can't handle the pressure and kill themselves, even with the help. It's far from a cure. We know what the cure is. Therefore, we should receive it and not just dismissed and told to 'toughen up.'

~BB~

[NJfan]

I think it should be covered. I don't think there is anything wrong with 'transpeople' off the bat. I've dated a couple and see them as I would see a genetic girl. The only reason why the last relationship with a transgirl ended was because she never wanted to have kids while i would eventually; even through adoption. (But that's off topic, I know!)

What I want to say is that mental conditions are paid for. Like lithium pills for people that are bipolar. People can live being bipolar, right? That's covered though. Why not cover SRS? If someone really feels that he or she is in need of gender surgery because it would better his or her life, by all means, cover it.

Tax dollars are spent to cover the unemployed and underemployed. Tax dollars are wasted to fix roads that don't need fixing. So much money is wasted by the government so why not afford money to be allocated to help 'transpeople?' I actually don't like the term 'transpeople' or any other terms like that. I view people as the genders that they want to be.

If a girl is born with a tumor, it is covered and removed? Ok, that makes sense. So why not remove the penis and replace it as a vagina?

I'll admit that I have dated and been with genetic girls, pre-op girls, and post-op girls. I find pre-op girls to be a little more exciting with their genitals but I'm fine with whatever parts are there as long as she has an amazing personality, looks sexy in heels, and can cuddle. If I was dating a pre-op girl who wanted to go through with becoming post-op, it is her body and her right. And I would want it to be covered.

I also think that by covering the SRS, some girls won't have to life the risky lifestyles they do to have the surgery. One girl I dated told me she had to escort for a while so she can afford her body. I felt for her.

[Stavros]

The issue is not in fact about the availability of SRS on our NHS, it is the definition of gender dysmoprhia as an illness that separates it from cosmetic surgery. And this, again should be examined because many -most?- transexuals resent the idea that they are 'sick' as if they had cancer. On the other hand, the psychological distress and its consequences are viewed as the medical justification for all those except the marginal cases where a baby emerges from the womb with no clearly defined sexual organs (the decision on surgery to emphasise male or female is usually taken quickly th parental advice and does not fall in the same category as gender dysmoprhia). For this reason, the hormone treatment is not considered as important as the psychological counselling during which the 'patient' must prove that 'he' is really a 'she' [or vice versa] and not hi-jacking transexuality for some other unhappiness. I know it used to be two years of counselling before the NHS would consider surgery (and for hormone treatment to be effective), not sure if that is still the case. I believe some men who have been refused treatment on the NHS have gone to Thailand for the operation; but the research that was published in The Guardian in 2004 does raise some profound questions about gender dysmorphia, its diagnosis, and its treatment -and negative as well as positive consequences, the original article and a commentary are here:
http://www.transgenderzone.com/library/st/fulltext/62.htm

Once you deal with the justifications, you then have the more difficult question -is the NHS surgical procedure better than, worse than or equivalent to the procedures carried out in, say Thailand?

[onmyknees]

It should be covered and maybe will be - once the battles are all fought and won. Obama and the Democrats have a battle royal ahead still just to keep the limited affordable care in place. The future will, one hopes, see it fine tuned and expanded once the dumb folk see the benefits they're getting . SRS is covered in the UK under the NHS.


You're amazing. You "ass"ume because some folks don't want this particular health care act, they're dumb. Do you realize how pampas and arrogant that sounds ? They're just too dumb, (unlike you of course who no doubt has studied each of the 2200 pages) to see what wonder lies ahead for them with a government managed health care system written so broadly and vaguely that most of it will be administered by HHS bureaucrats, and was front loaded with bennies until the hammer drops in 2014( that's when we get to start paying for all this) I guarantee you, most folks in Congress who voted for it didn't have a clue what was in it...they didn't even know it was a tax and not a fee ( wink, wink) and we're the dumb ones? It's one thing to say you favor a single payer system, or a quasi government run health care system...or that America can do better, it's another to infer that the 55-60% who are not in favor of this are dumb. Frankly that makes you sound dumb. I have a "healthy" dose of skepticism when it comes to the government, For example.....everyone wants to keep student loans affordable...and at rates between 2-4%, but the question was...how to pay for that. So what did Congress do behind closed doors...they told big companies they could no longer write off some of the corporate deductions for pension contributions. Big companies will in turn begin contributing less to employees pensions causing workers to stay working longer preventing those young college grads from filling the vacancies of retired workers. So although they may have a degree....they won't have a job. More unintended consequences. Only in Washington could they call this a victory and hold a press conference. That's the same type of back room deals those dumb folks you refer to, will be entrusting thier health care to now. You fancy calling people you don't agree with politically, dumb and ignorant, and you seem to know what's best for us here in the States. You never pass up an opportunity to school and enlighten us with your wisdom. Those dumb folks are probably a lot like those dumb folks back in 1775, who just didn't know how good they had it.

[Prospero]

Oh I should take lessons from a convicted felon should I? You are so crass and twisted OMK. By dumb, OMK, I was referring to the arrant manipulation of so many perhaps good hearted, but naive tea party supporters and their kind by cynical big business. The key elements of the affordable health care reforms extend good health care to many people presently excluded. As to remarks going back to 1775 - plain absurd.

[maddygirl]

Of course crossdressers are going to think it's a cosmetic surgery... they're men who like to play dress up, they can't possibly begin to understand how women like us feel... I hope it does get covered by obamacare... that would be a huge step.

[danifan]

This is a very interesting thread. As it's covered by the NHS here in the UK, I'd instinctively assume it would come under the US helathcare system too.

Wjile I've read on some threads here that a minority of tgirls are gay men who transition to earn more money (mainly in poorer areas such as Brazil, I believe?), this isn't the case for most transwomen.

It's not cosmetic surgey in the vain, chosen way (ie wanting bigger boobs or getting a tattoo removed) but it is similar to cosmetic corrective surgery (eg rebuilding post-masectomy tissues, facial scarring, etc) in that is is altering the body to allow that individual to act in society with less confrontation, self esteem or personal distress issues. For all the things I've read about kids being put on puberty blockers until they are old enough to decide whether to transition permanently (which makes sense), I haven't read much about people outgrowing their gender issues (there are a few people who have detransitioned but I belive they are the minority, most people dropping out before transitioning if they are unsure about it?).

While essentially a mental condition, the distress of living in the wrong body and not being able to present your core self is obviously acute, hence the suicide/drug stories. While it may be more logical to tackle the mental problems, as someone with lifeliong problems leading to pretty serious mental health issues myself, I know that not all such problems can be solved with medication or therapy/counselling, etc.

Because of that, sometimes medical procedures are a better, more effective route for some individuals and i believe most trans people would sooner transition than "flip the gender switch internally". It may be more costly but it will be the preferred, better route for alot of trans people.

The older the person transitioning (certainlt MTF), the more cosmetic work will be required (eg, chin shaves, eyebrow lifts, etc, which probably wouldn't be covered and would need to be privately funded) so the more understanding medical services and society are of these issues, the better for youngsters. Of course, dealing with kids in making life-altering decisions will always be a tricky process but that's a different argument :)

So, long ramble short: yes, SRS
should be covered...

[dakota87]

Do you really want the gov't involved in your transition decisions? They (or their agents as Doctors will become) will tell you how much therapy you need before you are allowed to start. How you take your hormones. Where you get your hormones. (No overseas pharmacies btw) What doctor you go to. Maybe you want to go to Dr. So and so for SRS, but they have assigned you someone else. Maybe you want certain procedures for FFS, but might they say you don't need it or aren't qualified? How about your timetable. Maybe you're ready for SRS or augmentation now but they say take a number instead. Beware of what you ask for because you might get it.

[Jericho]

Do you really want the gov't involved in your transition decisions? They (or their agents as Doctors will become) will tell you how much therapy you need before you are allowed to start. How you take your hormones. Where you get your hormones. (No overseas pharmacies btw) What doctor you go to. Maybe you want to go to Dr. So and so for SRS, but they have assigned you someone else. How about your timetable. MMaybe you want certain procedures for FFS, but might they say you don't need it or aren't qualified? maybe you're ready for SRS or augmentation now but they say take a number instead. Beware of what you ask for because you might get it.

I don't see how anything you've mentioned is a problem.


They (or their agents as Doctors will become) will tell you how much therapy you need before you are allowed to start.

Could anyone in their right mind have a problem with that?



Where you get your hormones. (No overseas pharmacies btw)

No more pills with chalk fillers


What doctor you go to. Maybe you want to go to Dr. So and so for SRS, but they have assigned you someone else.

Then go on the other doctors 'waiting list'.



Maybe you want certain procedures for FFS, but might they say you don't need it or aren't qualified?

Then you go private...It's not a dictatorship.

[dakota87]

I don't see how anything you've mentioned is a problem.



Could anyone in their right mind have a problem with that?



No more pills with chalk fillers



Then go on the other doctors 'waiting list'.



Then you go private...It's not a dictatorship.

I do have a problem with gatekeepers and a gatekeeper system. I have a problem with people having to wrestle with the gov't to get what they want. Do you think the gov't knows best or believe they always act in your best interest? Maybe some trans girls don't want to go through with the RLE and other bullshit hoops as mandated by the standards of care some doctors and gov'ts follow just to get hormones. Chalk fillers? Wrong. Familiarize yourself with the Yahoo DIY group to learn more. There's already a bill pending that will make it illegal to buy drugs from overseas pharmacies. Ask girls in other countries where this is already illegal how they feel about that. Without the overseas pharmacies the black market will take over. You worry about chalk fillers? Wait for that to happen. Waiting list? Unacceptable. Not a dictatorship? What do you call it when the gov't has this much control of your life. For those who have not experienced tyranny, it's hard to imagine. This history of mankind has been fraught with tyranny and control of the individual. It's only the last few hundred years that so many have been able to live a life of liberty and freedom. Let's not cede our liberty back to those who are more than willing to take it.

[BellaBellucci]

It's only the last few hundred years that so many have been able to live a life of liberty and freedom.

That's just what they want you to think.

~BB~

[dakota87]

That's just what they want you to think.

~BB~

Well, I'll amend that to say live a life of relative freedom and liberty.

[robertlouis]

I do have a problem with gatekeepers and a gatekeeper system. I have a problem with people having to wrestle with the gov't to get what they want. Do you think the gov't knows best or believe they always act in your best interest? Maybe some trans girls don't want to go through with the RLE and other bullshit hoops as mandated by the standards of care some doctors and gov'ts follow just to get hormones. Chalk fillers? Wrong. Familiarize yourself with the Yahoo DIY group to learn more. There's already a bill pending that will make it illegal to buy drugs from overseas pharmacies. Ask girls in other countries where this is already illegal how they feel about that. Without the overseas pharmacies the black market will take over. You worry about chalk fillers? Wait for that to happen. Waiting list? Unacceptable. Not a dictatorship? What do you call it when the gov't has this much control of your life. For those who have not experienced tyranny, it's hard to imagine. This history of mankind has been fraught with tyranny and control of the individual. It's only the last few hundred years that so many have been able to live a life of liberty and freedom. Let's not cede our liberty back to those who are more than willing to take it.

Jericho is messing with you - just one of his many skills. Consider this though. Both he and I live in a country that has had what you choose to call "socialised" medicine for over 60 years. It provides healthcare free at the point of demand in return for a contribution to the general tax burden and through the "job tax" of national insurance. Every other developed economy except the USA plays comparable variations on the same healthcare tune. And the NHS, despite its faults, is the most universally loved institution in the UK, up there with the BBC, both founded on the principle of providing excellent publicly-funded service.

Your fear that "the government" will make decisions about the quality and timing of care is essentially groundless. Here, all key decisions are made by clinicians and locally by general practitioners. The "government", other than setting the overall budget, plays no part in that. If you study the general response to the current Tory - right-wing - government's proposals to make fundamental changes to healthcare organisation and spending by essentially privatising key aspects of the system, you'll discover suspicion, fear and loss, and the recognition that they are attempting to dismantle what has come to be embraced as one of the most admirable things about being British.

The NHS is far from perfect, but rather that than the US version of social Darwinism red in tooth and claw. Is the principle of rugged individualism worth defending when it allows the poor to suffer and die? I hope that your answer to that question will be no.

Oh, and SRS is available on the NHS. Women seeking the surgery have to go through rigorous and searching (sometimes brutally so) processes before they can move to the final procedure. I know - several ts friends of mine have gone through it, so any suggestion that the NHS is knowingly underwriting "cosmetic" surgery in such cases is simply untrue.

Add the fact that the procedure is carried out under the cleanest and most stringent of conditions by the best expert surgeons that the NHS can provide and a girl has little to fear, unlike in the US where the prohibitive costs of self-funding often drive them abroad to places where standards are less scrupulous, to say the least, and the results, as already pointed out in this thread, are unsatisfactory or worse.

[dakota87]

Jericho is messing with you - just one of his many skills. Consider this though. Both he and I live in a country that has had what you choose to call "socialised" medicine for over 60 years. It provides healthcare free at the point of demand in return for a contribution to the general tax burden and through the "job tax" of national insurance. Every other developed economy except the USA plays comparable variations on the same healthcare tune. And the NHS, despite its faults, is the most universally loved institution in the UK, up there with the BBC, both founded on the principle of providing excellent publicly-funded service.

Your fear that "the government" will make decisions about the quality and timing of care is essentially groundless. Here, all key decisions are made by clinicians and locally by general practitioners. The "government", other than setting the overall budget, plays no part in that. If you study the general response to the current Tory - right-wing - government's proposals to make fundamental changes to healthcare organisation and spending by essentially privatising key aspects of the system, you'll discover suspicion, fear and loss, and the recognition that they are attempting to dismantle what has come to be embraced as one of the most admirable things about being British.

The NHS is far from perfect, but rather that than the US version of social Darwinism red in tooth and claw. Is the principle of rugged individualism worth defending when it allows the poor to suffer and die? I hope that your answer to that question will be no.

Oh, and SRS is available on the NHS. Women seeking the surgery have to go through rigorous and searching (sometimes brutally so) processes before they can move to the final procedure. I know - several ts friends of mine have gone through it, so any suggestion that the NHS is knowingly underwriting "cosmetic" surgery in such cases is simply untrue.

Add the fact that the procedure is carried out under the cleanest and most stringent of conditions by the best expert surgeons that the NHS can provide and a girl has little to fear, unlike in the US where the prohibitive costs of self-funding often drive them abroad to places where standards are less scrupulous, to say the least, and the results, as already pointed out in this thread, are unsatisfactory or worse.

Here's an anecdote about the NHS I just came across.
MTF Transition: The NHS: Be Prepared! - YouTube (http://www.youtube.com/watch?v=V8uNicUIwgI&feature=g-u-u)
In a nutshell, very bureaucratic and unresponsive. However well meaning universal health care is, people deserve better imo.

[Prospero]

The NHS is very far from perfect... and this in part due to chronic underfunding and a clear desire by the present UK Government to privatise parts of it.

[Stavros]

Prospero although most of what you say is true, it may just be that the NHS has not had the time or resources -or the clinicians interested in SRS to give it a better reputation. As well as the variation in quality across the UK in, for example, specific forms of cancer, there are some disciplines the NHS has never excelled at, Psychiatry being another. In recent years the cost of SRS world-wide has come down and I think this and the speed with which it can be arranged in Thailand make the NHS a second choice for many people. On the other hand, maybe the NHS, by making it harder and longer to get SRS begs the question of the patient who may insist on SRS when in fact they need treatment of some other kind...

[Murderous-marge]

Move to Europe it's covered there.

[Fancy fancy]

The NHS is not chronically under-funded, it's the way the money is used that makes it appear that way



The NHS is very far from perfect... and this in part due to chronic underfunding and a clear desire by the present UK Government to privatise parts of it.

[fred41]

Prospero although most of what you say is true, it may just be that the NHS has not had the time or resources -or the clinicians interested in SRS to give it a better reputation. As well as the variation in quality across the UK in, for example, specific forms of cancer, there are some disciplines the NHS has never excelled at, Psychiatry being another. In recent years the cost of SRS world-wide has come down and I think this and the speed with which it can be arranged in Thailand make the NHS a second choice for many people. On the other hand, maybe the NHS, by making it harder and longer to get SRS begs the question of the patient who may insist on SRS when in fact they need treatment of some other kind...

Can the process be sped up by, for instance, paying out of pocket for the hormones... to be able to start the regimen earlier...and then going through the NHS for SRS?

[fred41]

Add the fact that the procedure is carried out under the cleanest and most stringent of conditions by the best expert surgeons that the NHS can provide and a girl has little to fear, unlike in the US where the prohibitive costs of self-funding often drive them abroad to places where standards are less scrupulous, to say the least, and the results, as already pointed out in this thread, are unsatisfactory or worse.

Is there a difference between NHS covered SRS surgery...and SRS that can be attained only from a private surgeon..from a cosmetic (artistic) point of view?

[Stavros]

Can the process be sped up by, for instance, paying out of pocket for the hormones... to be able to start the regimen earlier...and then going through the NHS for SRS?

There are private doctors and clinics in the UK as well as the NHS, and there is nothing to stop an individual buying preferential treatment privately if the NHS can't do it soon enough or if it does not sanction certain types of treatment. Hormones are avalilable online, I believe; I knew one Asian girl who had her friends send them from the East. The problem with girls registering with the NHS is that they monitor development and it would be obvious if the pace of change was too rapid for the amount of hormones being taken; I don't know how this would affect the timetable but it would cause problems, I assume. Frustration at the pace of change is what I believe has motivated some girls to abandon the NHS course and go straight to Thailand.

[Stavros]

Is there a difference between NHS covered SRS surgery...and SRS that can be attained only from a private surgeon..from a cosmetic (artistic) point of view?

I mentioned this in an earlier post; I really don't know what the quality of the surgery is compared to others, and it would be difficult to find out as the available research on comparisons is not good; there is the added problem that some post-ops lie about their satisfaction, while most tend not to be available for follow-up responses. I don't know if there is a theory that anything provided by the state is always inferior to the private sector, as there are some surgeons out there who maybe graduated from a butcher's shop first...I know of one ts who had problems with minor surgery after visiting one of the most reputed clinics in Thailand. There are no guarantees, and no two bodies are the same, which to me makes SRS something that girls should avoid for as long as possible.

[robertlouis]

I mentioned the NHS provision in the first place and my evidence, such as it is, comes from friends - not sexual partners - who have undergone SRS under the auspices of the NHS, so there's no reason for them to tell me anything other than the truth. Bear in mind that individual circumstances have an impact on the relative success of the procedure too, in that the best results tend in the main to come for those who are younger and less hormone-impacted in terms of their penis length and therefore the surgeon's ability to provide them with suitable vaginal length and that essential ingredient, clitoral sensitivity.

And as I said, the NHS' criteria for providing the treatment are primarily about the individual's gender dysphoria and not about their cosmetic desire - for a publicly-funded service that is entirely appropriate. The only opposition or negativity that my friends experienced was at the initial GP consultation level. Once in the specialist area they usually met with understanding and empathy.

My girlfriend, who is from Singapore and is with me right now (hooray!), is post-op and had her SRS in Singapore. She is professional - a high-flying accountant in a big four firm - and has never escorted, so her surgery was self-funded, and she, and I, for what it's worth, are more than satisfied with the results. I've asked her if I can post about her experience, and she's agreed.

She always knew she was a girl in a boy's body and had to fight hard against a very traditional Malaysian-Chinese background, but began living as a girl from her early teens, was on hormones from age 17 and completed her transition at age 24 via the best available surgeon in Singapore. We met some years ago while we were working the opposite ends of a merger between a UK and a Singapore business. She didn't tell me about her status until the first time we slept together; by that time it didn't matter, I was smitten. The sex was, and is, great. Being with a girl who has wanted all her life to be the woman she knows herself to be makes the sex mutually pretty wonderful. The fact that I'm not enormously endowed probably helps too. Our lives had to be mutually exclusive for a while but we stayed in touch and rekindled the relationship when I stopped over in Singapore on my Australian trip earlier this year. Bit of a risk, but it's worked out even better than I could have dreamed. Where we'll end up is anyone's guess - Singapore, the UK, Australia, possibly the US, but it doesn't matter. We're all loved up lol.

She's busy in the kitchen while I type this, she loves my cat (phew!) and we're packing for a trip over to Brittany where I've got a number of gigs. I'm a lucky, and very happy, guy.

So, if that helps anyone wondering about the mechanics and also the aesthetics of post-operational sex and relationships, we're very happy to share it with you.

[Prospero]

RL is a lucky guy. Sounds like he has found a little piece of paradise... and a nice cat too.

[GroobySteven]

Nice going Robert L - proving nice guys can finish first (even those that "aren't enormously endowed")!

[Token Williams-Black]

Excellent, RL!

[robertlouis]

Thanks guys. Life is very good right now.

[robertlouis]

Nice going Robert L - proving nice guys can finish first (even those that "aren't enormously endowed")!

I've never had any complaints, Seanchai. ;)

[Dino Velvet]

I mentioned the NHS provision in the first place and my evidence, such as it is, comes from friends - not sexual partners - who have undergone SRS under the auspices of the NHS, so there's no reason for them to tell me anything other than the truth. Bear in mind that individual circumstances have an impact on the relative success of the procedure too, in that the best results tend in the main to come for those who are younger and less hormone-impacted in terms of their penis length and therefore the surgeon's ability to provide them with suitable vaginal length and that essential ingredient, clitoral sensitivity.

And as I said, the NHS' criteria for providing the treatment are primarily about the individual's gender dysphoria and not about their cosmetic desire - for a publicly-funded service that is entirely appropriate. The only opposition or negativity that my friends experienced was at the initial GP consultation level. Once in the specialist area they usually met with understanding and empathy.

My girlfriend, who is from Singapore and is with me right now (hooray!), is post-op and had her SRS in Singapore. She is professional - a high-flying accountant in a big four firm - and has never escorted, so her surgery was self-funded, and she, and I, for what it's worth, are more than satisfied with the results. I've asked her if I can post about her experience, and she's agreed.

She always knew she was a girl in a boy's body and had to fight hard against a very traditional Malaysian-Chinese background, but began living as a girl from her early teens, was on hormones from age 17 and completed her transition at age 24 via the best available surgeon in Singapore. We met some years ago while we were working the opposite ends of a merger between a UK and a Singapore business. She didn't tell me about her status until the first time we slept together; by that time it didn't matter, I was smitten. The sex was, and is, great. Being with a girl who has wanted all her life to be the woman she knows herself to be makes the sex mutually pretty wonderful. The fact that I'm not enormously endowed probably helps too. Our lives had to be mutually exclusive for a while but we stayed in touch and rekindled the relationship when I stopped over in Singapore on my Australian trip earlier this year. Bit of a risk, but it's worked out even better than I could have dreamed. Where we'll end up is anyone's guess - Singapore, the UK, Australia, possibly the US, but it doesn't matter. We're all loved up lol.

She's busy in the kitchen while I type this, she loves my cat (phew!) and we're packing for a trip over to Brittany where I've got a number of gigs. I'm a lucky, and very happy, guy.

So, if that helps anyone wondering about the mechanics and also the aesthetics of post-operational sex and relationships, we're very happy to share it with you.

Thanks for sharing that. As previously mentioned, you're a lucky fella. Glad she likes the cat too. She cooks too.

[Angel/Faced]

i just had to jump in here and say that srs is completely tax deductable including flight and hotel if you go overseas. why ? because the ssa has confirmed that it is MEDICALLY NECESSARY. insurance should be forced to cover srs. its not an argument.