How long does it usually take to get a letter for bottom surgery

Hi Xav! Thank you for reaching out. As a professional, it is difficult to answer these questions directly as each state has different requirements. I am more than willing to provide letters for transgender clients that are in my practice. In my experience, the letters must be dated within a year of submitting them for bottom or top surgery (mastectomy, chest masculinization or augmentation mammoplasty). I am willing to provide these letters after one month of therapy sessions.  To be diagnosed with gender dysphoria you must have experienced significant distress for at least six months due to at least two of the following: marked incongruence between your experienced and expressed gender and your primary or secondary sex characteristics. It sounds like you are already past that six-month mark. I have worked with the trans community personally as well as professionally. I understand the numerous issues that stem from living in a society that is plagued with stigma and misinformation. I always try to present my clients with solutions and tactics to confront their mental health challenges that can include depression, anxiety, shame, guilt, and loneliness. I also treat co-occurring disorders such as substance abuse, sexual health issues, high-risk behaviors, self-mutilation, and social support or network issues. Feeling disconnected when you are transgender can easily turn into chronic depression and anxiety disorders. All of these things should be worked on as you go through your full transition. A small percentage of transgender people get the therapy they need. There is a huge gap in therapy services and the LGBTQIA+ community. I suggest that if you are willing to go through therapy to get your letter, to also remember that therapy is a place to learn tools to help combat those systems that cause disparities. Thankfully, most therapists are allies but that is not the case every time. It would be best to let your therapist know your intentions quickly so that you may head on your journey to living YO BEST LIFE! I hope this answer helped you and you may reach out anytime you need any information. Good luck on your journey and you are safe here! 

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