About Benjamin's Syndrome
General Resources
Resources for Men
Resources for Women
Resources for New Zealanders
Mailing List
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Miscellaneous Advice
The Internet
Never, ever use your real name when discussing Benjamin's Syndrome on the internet, or an email address associated with your real name. You might not be concerned about people knowing you have Benjamin's Syndrome now, but how about in ten years' time? In my experience people tend to become increasingly uncomfortable with their medical history being known by other people as it becomes less relevant to their current lives. Anything done on the internet is potentially recorded permanently for anyone to look up and read. Don't take the risk of doing something you might regret later when it's too late to do anything about it. Web pages may be stored in whole or in part in search engines. Posts made to usenet are archieved at groups.google.com and other places, and while it may be possible to delete your posts from the archive you cannot delete posts made by other people who have quoted you. You can ask the poster to delete them for you and hope that they're willing to do so, if they're still around, but it's a long shot. And there's no way to know who else is subscribed to mailing lists. On the other hand, the internet is the best source of information on Benjamin's Syndrome there is, albeit with no guarantee of accuracy. Read as widely as possible, and make your own judgements from the various sources out there.
The Standards of Care
The Standards of Care (SOC) is a widely recognised set of guidelines issued by the Harry Benjamin International Gender Dysphoria Association (HBIGDA) regarding the appropriate handling of Benjamin's Syndrome. The most notable elements of the SOC are that they require three months of psychiatric assessment before hormones can be prescribed (they don't specify how frequently you must see a psychiatrist within that period), and one year of living full time in the appropriate gender role before GRS can be carried out. This is intended to make sure that treatment is only given to those for whom it is really appropriate - it would be somewhat unpleasant to have surgery straight away and then realise you were really a woman and not a man suffering from Benjamin's Syndrome after all. I personally haven't had any problems with the SOC, and think they are mostly fairly sensible, but a lot of people object to having such strict regulations placed on their treatment. Though they are generally followed by most reputatble medical professionals, the SOC are just guidelines, not rules that have to be followed no matter what. If you can convince your medical practitioners that the SOC isn't appropriate in your case, that's fine.
Psychiatrists and Counsellors
It's pretty much impossibly to avoid contact with them altogether, since at the very least all the reputable (and skilled) surgeons will require a reference letter from a psychiatrist before carrying out GRS. However, I personally don't feel any need for counselling and haven't found them to be particularly helpful, so have kept my contact with them to a minimum. Some people do apparently get a lot out of if, though. If you do feel that you might benefit from counselling, make sure that the person you see has experience in dealing with people who suffer from Benjamin's Syndrome (they'll probably only know of it by the name "transsexuality") and has a reasonable attitude, or if that really isn't possible someone who admits their inexperience and shows a willingness to learn. Read up as much as you can on Benjamin's Syndrome so you can tell if the therapist knows what they're talking about. And always remember, they're just human, they can't read your mind, and they can make mistakes. I was referred to my psychiatrist and counsellor by my endocrinologist; the best way to find one is usually to ask other women in your area.
Doctors and Endocrinologists
Don't trust them. It's quite possible that they don't know what they're talking about. Do listen to them - they do know a lot about the human body and what can go wrong with it - but don't assume everything they say is right, and be aware that they make mistakes. No single person is capable of being an expert in the entire field of medicine, and there's a huge amount about the human body that we still don't understand anyway. And there is a lot of variation between individuals, so what the text books say is normal might not be right for you. I recommend finding out as much as possible about any medical problems you may have (including but not limited to Benjamin's Syndrome), so you can understand what your doctor tells you and evaluate whether they're doing a good job. Often they are, and most should be willing to learn from someone who has a much stronger motivation to study one particular condition than they do. It's often helpful to talk to other people (that's people plural, it's important to get a wide range of opinions rather than accepting what one person says) with your condition - the internet is again your best resource. But don't trust them either. Trust no-one. The truth is out there :-)
Medical Insurance
If you have medical insurance before you are diagnosed with Benjamin's Syndrome, then you may be able to get a certain amount of assistance with your medical expenses. Unfortunately, most companies exclude pre-existing conditions from coverage, if they are willing to insure you at all, so if you don't have insurance already you're unlikely to be able to get any. Group policies such as company employee schemes have more chance of including coverage of existing conditions than individual policies. Some insurance companies may extend coverage to pre-existing conditions after you've held a policy with them for an extended period. Other companies specifically exclude coverage for any treatment associated with Benjamin's Syndrome.
Getting HRT covered isn't difficult, though it helps to report it as treatment for a hormonal imbalance rather than Benjamin's Syndrome specifically. GRS is another matter. If your insurance policy doesn't specifically exclude GRS or Benjamin's Syndrome, then you have a good case for demaning that they pay up, but they are likely to fight. There have been court cases determining that GRS cannot be considered a cosmetic or unnecessary operation, which is the main reason many US companies have the specific exclusions in the first place; they know they can't get away with refusing coverage on any other grounds. Insurance companies generally only pay for surgery carried within their own country, and there may be additional restrictions on which surgeons can be used. Psychiatrists etc may be covered, and some men have managed to get breast reduction paid for (eg by citing back problems), but electrolysis and other cosmetic expenses are your own responsibility.
Overall it's probably best not to hope for too much assistance from medical insurance.
External Links
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