Looking for a doctor who will perform BA on M2F w/o Therapist letter?
Doctor Answers 1
M-F Transgender Breast Augmentation does not always require letter from Therapist.
Not every transgender patient sees or requires a therapist or psychiatrist, and of course would not require a therapist letter in order to undergo elective breast augmentation surgery. If you are seeking insurance reimbursement/coverage for this surgery (may not be received), WPATH guidelines would require a letter of referral from a treating psychotherapist. However, if surgery is being paid-for personally as an elective "cosmetic" procedure, then no letter is "necessary," just appropriate consultation and informed consent with your chosen plastic surgeon.
That being said, any M-F transgender patient undergoing hormone therapy is well-advised to wait for at least 18 months (after starting HRT) to see the full/final degree of breast growth as a result of hormone stimulation before adding implants.
On some occasions with specific patients (for example, one who has been on HRT for one year and is seeing no breast growth or change whatsoever), proceeding with elective implant placement prior to 18 months would seem reasonable and appropriate, and I have done this in my work with transgender patients for nearly 3 decades. Please see an ABPS-certified plastic surgeon with transgender experience, not just someone who places breast implants. Best wishes! Dr. Tholen