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Kathleen Weber's avatar

Awais, thank you for providing a platform for this interesting post.

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Michael Sikorav MD's avatar

In France you need a psychiatrist's opinion for gender affirming surgery

Even though psychiatrists have basically 0 training in doing so

The psychiatrist's opinion itself is mandatory, but the surgery can happen regardless of what the psychiatrist said

The whole process feels a bit odd

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The One Percent's avatar

That is more or less how things work in Canada and the US. Insurance policies require a referral letter from a mental health provider or physician for surgery but the letters are fairly formulaic. I am not aware of any studies that look at % seeking surgery who receive a letter, but I have never heard of anyone being determined ineligible. I've been in trans community and in the trans care research space for 10+ years. With trans people determined to be more mentally or medically complex, sometimes there will be delays or more mental health supports put in place, though. BMI cutoffs for surgery would be the biggest barrier to surgery in cases in which weight is an issue. BMI cutoff is generating a lot of debate and division within the field now amongst some surgeons and patient advocates. There was a rather tense panel on this topic at a recent trans care conference in the US.

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