A Guide To SRS Transition in B.C. – The Referral Letter

referral letter

If you are seeking HRT or SRS in British Columbia, one of the things that will help with quick approval is, what information your doctor includes when drafting the letter that will be sent to Dr. Gail Knudson.

In part two of this guide to SRS transition in B.C., is what information your doctor must include in the referral letter to help fast track the approval process.

Because I am my doctor’s first openly transgender patient, she was unsure what needed to be included in the referral letter. Because I was aware of the types of questions that will be asked during the initial assessment, I told my doctor what to write.

Sure enough, Dr. Gail Knudson praised my doctor for writing such a great letter—I allowed my doctor to take all the credit—and said that it helped greatly to get me initially approved before I even arrived for my assessment.

So, what did my letter include? In handy-dandy bullet points:

  • The fact that I’m a trans man and referenced me using masculine pronouns;
  • How many years I’ve been living full-time as a man;
  • The psychological effects not having surgery has caused—in my case, nightly dysphoria-induced night terrors that were having a huge negative impact on my mental health;
  • Why the type of surgery being requested is being requested—in my case, I already had a hysterectomy for non-SRS purposes, so that wasn’t an option and it can’t be counted as an SRS proceedure;
  • Why HRT is not an option;
  • All surgeries to date;
  • All medications and chronic health conditions;
  • History of depression;
  • Home family dynamic and support—how long I’ve been with my partner, the age of my children, the fact they are all supportive;
  • Community support—gender therapist, friends, online support;
  • Who will be supporting me and providing care at home, post-op.

Your doctor will have to modify the list as appropriate. Like, you may not have a history of migraines, TIAs, and stroke, so HRT is an option for you. If you have family support outside of your dwelling, include that.

While it is no longer necessary to have gender therapy prior to surgery, it is certainly helpful to the approval process. Demonstrating a good community support system is vital, even if it’s an online support group/system.

It is also vital that your mental health history be included. If it’s not in the letter, you will have to discuss it at greater length during the initial assessment. If your mental health conditions are being managed, they will not pose a barrier, especially since a lot of mental health conditions in transgender people are the result of their gender dysphoria: surgery is the prescription.

Armed with a great referral letter, the next step in the process—the initial assessment—will be quick and painless.

Next up in this series is: The Assessment.

As I’m still walking through this process myself, I am not sure what will come after the next post in this series. The outline will be created as I walk this road.

If you have yet to read the first post in this series, you can read the introduction here.

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I'm a trans man. My preferred pronouns are "they/them" because it forces people to treat me as a person, instead of a gender. Though, I will very happily respond to "he/him." You can read my full bio here. You may send me an email.

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