TfTM Blog: Searching for the Right Top Surgeon by MKPosted: August 13, 2012
Deciding Top Surgery Was My Top Priority
Top surgery actually wasn’t one of my immediate goals — maybe something I would do within the next few years. But then something exciting pushed it to the forefront of my reality: I learned that my university explicitly covers “GRS” (gender reassignment surgeries) under its’ students health plan. I’ve been on-leave from school for the past 3 years, and apparently it’s only within the past 3 years that they’ve been covering…what a thing for me to almost miss!
Once I learned that I could get top surgery covered, I figured I might as well go for it if it was something I wanted to do anyway; I could save the thousands I would use on surgery and build something else exciting for my future. And maybe I could help some other guys along the way by documenting the process. (Unfortunately, I think universities covering top surgery are an exception rather than a rule at this point, but I’d recommend everyone read their health insurance plans front-to-back. I will cover more insurance details in a future post).
As listed in my Summary of Benefits (aka Evidence of Care)
Setting Up My Search Criteria
So, I began my search for the right top surgeon with a few parameters already described for me: a time limit (1 year before graduation!) and a set of surgeons to choose from (the ones who accept my health insurance!). I also held, in the back of my mind, the hope that location could be a criteria for me. I knew that if the right surgeon came up who was across the country, I would definitely travel out to them, especially considering that the surgery costs would already be covered.
The more I searched, the more I came to believe that it’s really legit to want to go to a surgeon close to you — I was at least holding out for the East Coast by the time I settled on my first consultation. I think there are a few names that get a lot of buzz, and the logic does follow: 1) more guys mention this surgeon, 2) more guys go to this surgeon, 3) surgeon gets more practice, 4) surgeon performs surgery better.
Top names I’ve heard are Beverly Fischer (Baltimore, MD), Charles Garramone (Sunrise, FL), Daniel Medalie (Cleveland, OH), Michael Brownstein (San Francisco, CA — ending practice soon, training a predecessor), and Melissa Johnson (Springfield, MA). However, there are plenty of talented plastic surgeons who, for whatever reason, aren’t flocked to in great numbers. I wouldn’t tell a guy considering a surgeon closer to him to count them out — but I would ask the surgeon for a book displaying their results, as I would any surgeon.
Trolling the Interwebs
Anyway, the first thing I did was what any guy probably does: I jumped on the internet. I can’t say enough about how the internet is such an important tool for community-building among FTMs. One thing I like most about our community is our dedication to sharing our experiences in the hopes of educating and helping one another; I think it really is something unique to the generation of trans* guys living in the 2000s, and has helped us be visible and connected in huge ways.
I entered the search that’s been done a million times over: give me a list of every surgeon performing top surgeries (in America). I immediately came up with a long list that I was able to find repeated on many different websites. I guess that someone(s) several years ago compiled this list to be the extremely useful resource that it is…but beware. Some websites update this list and others don’t.
I soon found that there are other surgeons NOT commonly listed who perform top surgery. It’s worth digging further to find more names to give yourself options, especially if location is one of your defining criteria. I say this especially because the doctor I eventually decided to have my first consultation with is a name that barely hits the trans*man blogosphere register at this time.
After cross-referencing the surgeon list with my health insurance, I came up with about 15 plastic surgeons who accept my insurance. I decided my next step, before I started calling offices, was to see what, if anything, I could find out there about each surgeon. Usually a plastic surgeon will have some kind of self-made web presence, but I felt luckiest if even one trans* guy offered a testimonial on any of the less commonly mentioned names on my list.
I made detailed notes about each surgeon — what their website says, what other guys have to say, consultation costs, etc.
To name a few: Paul Costas (Concord, MA), Kathy Rumer (Bala Cynwyd, PA), Perry Johnson (Omaha, Nebraska), Richard Bartlett (Brookline, MA), Marci Bowers (San Mateo, CA)…and a couple I considered who don’t take my insurance include Christine McGinn (New Hope, PA), Sherman Leis (Philadelphia, PA) and Gary Alter (Beverly Hills, CA).
I’m not advocating yes or no for any of these surgeons, just listing names I looked into who didn’t have an “AVOID” warning label attached somewhere! (e.g. Renee O’Sullivan, Alan Neal Wilson). All of these surgeons perform top surgery, but some probably get more brownie points for bedside manner than others. In other words, do your research!
A Website Is Worth a Thousand Words
The more I looked into surgeons but wasn’t coming up with much word-of-mouth, the more the surgeons’ own websites began shaping my perception of them. It almost developed into another criteria for me. Are trans* people mentioned on the front page of their website? Or do they compartmentalize their trans* clientele into a separate website? If we (or trans* women) are mentioned, is it somehow buried or coded? What language does the surgeon use in talking about trans* bodies and procedures?
For instance, a few websites (e.g. Costas, Bartlett) referred to the condition of having breasts as “gynocomastia” (male breast enlargement), or at least interchanged this term with “sex reassignment surgery”. While this is a true medical term, it generally refers to cisgender males with over-active mammary glands, and isn’t a key word FTMs use in our community to describe ourselves.
At the very least a surgeon listing top surgery as correcting gynocomastia in trans* men is not in touch with how our community talks about our bodies; at the very worst, they are trying to soft peddle the fact that they perform trans* surgeries to the “general” (read: cisgendered, heterosexual, “normal”) public. That instinctively turned me off.
Some surgeon websites make trans* surgeries visible to anyone who visits — others require some digging [Dr. Christine McGinn vs. Dr. Paul Costas]
The “I” Word
Finally I tried to find elusive information on the surgeons’ stance towards insurance. Even though most of the names I looked at do accept my insurance plan, it became clear that not everyone accepted it for trans* surgeries or were at least wary of it being possible to actually have top surgery covered. I can only attribute this cautiousness to probable past experiences where a surgeon was burned by an insurance company….accepted insurance ahead-of-time as payment, submitted a claim, got it rejected, etc. After that experience, the attitude of the surgeon may be “you do all the work and good luck on getting it covered, as long as I’m still compensated in the end.”
While that attitude might be logical from a surgeon’s standpoint, I found myself definitely more attracted to any surgeon who seemed open to working with me to get my top surgery covered. I accept that what may ultimately happen is that I pay out-of-pocket and attempt to get reimbursed from my insurance. But I really want a surgeon who sees it as part of their care for me to be concerned with how I’m paying and its affect on my life — I’d want that for any guy.
Refining My Search
Ultimately, I was able to set up my first top surgery consultation with a doctor (Kathy Rumer) who met my evolving criteria: 1) accepts my insurance, 2) has been open to working with other clients in the past on getting their insurance to cover surgeries, 3) is on the East Coast, 4) proudly states in website/promotional material that she works with the trans* community.
While this may not be the last consultation I have, the process helped me define what was important to me about the right top surgeon. I may, in the end, have to choose a surgeon who only meets some of my criteria, and wouldn’t blame any guy for getting what they need in any way they can. But I’m at least glad I can say I know what would work for me in an ideal situation, and that I truly don’t think it’s out of reach.