"Diving into contexts"
Brownstein & Crane Surgical Services
Curtis Crane, M.D.
208 Pennsylvania Avenue
San Francisco, Ca 94107
To Whom It May Concern:
Mr. Guy has been living in the male gender since June 2010, although his gender dysphoria dates to childhood. He is a female to male transsexual. He has been diagnosed with transsexualism, severe, 302.50 ICD 9 and Gender Identity Disorder 302.85 DSM IVr. He has legally changed his name to reflect his male identity and has been taking the male hormone testosterone since October 2010. Mr. Guy had a hysterectomy and bilateral oopherectomy In June 2011. He had a chest reconstructive surgery to reflect his male identity a year ago and is now ready to proceed with his final gender confirmation surgery, phalloplasty.
Gender reassignment surgery is considered medically necessary as outlined in this excerpt from the standards of care of the World Professional Association of Transgender Health (WPATH):
Sex Reassignment is Effective and Medically Indicated in Severe GID. In persons diagnosed with transsexualism or profound GID, sex reassignment surgery, along with hormone therapy and real-life experience, is a treatment that has proven to be effective. Such a therapeutic regimen, when prescribed or recommended by qualified practitioners, is medically indicated and medically necessary. Sex reassignment is not “experimental”, “investigational, “elective”, “cosmetic”, or optional in any meaningful sense. It constitutes very effective and appropriate treatment for transsexualism or profound GID.
Mr. Guy meets the criteria of the WPATH Standards of Care for genital altering surgery, which can be viewed at www.wpath.org Standards of Care, version 7. Mr. Guy's mental health professionals indicate that he is ready for genital surgery and can provide additional documentation of this if needed. I have spoken with Mr. Guy many times over email and do agree he would make a very good candidate for gender confirmation surgery. I am meeting him in consultation early in 2013 to discuss the final surgical stage to relieve his dysphoria.
Curtis Crane, MD
CC: Andrew Guy