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Top Surgery Eligibility FAQ

• What should I do to prepare if I have a history of anxiety or depression?

• Although everyone expects to be ecstatic after surgery, it is not uncommon to go through a period of post-operative depression following surgery. If you already know you are prone to anxiety or depression, it might be a good idea to establish a relationship with a therapist to help with emotional support before and after surgery.  We recommend scheduling a visit with your therapist 10-14 days after surgery, so that you are prepared with a support system in the event that you experience post-operative depression. If you are unable to or do not want to pursue therapy, having a robust support system of family, friends, and other community can be helpful. Easy access to things that make you happy (music, video games, TV shows/movies, short walks or sitting out in the sun, etc.) can be helpful during the short-term period of post-operative depression. It is important to remember that these feelings are normal and will dissipate throughout and after your recovery.
  

• Can I get top surgery even if I identify as nonbinary or genderqueer?

• YES! Gender confirming surgery is a highly individualized process. We welcome patients of any gender identity, and  we believe in every person’s right to feel comfortable in their own body. .

• Can I get top surgery even if I am not on hormones?

• Absolutely. Our surgeons do not require any of his patients to currently be or have been on hormones. 

• Can I get top surgery if I am a minor (under 18 years old)?

• Yes, but there are a few more requirements. We will need consent from all legal guardians, which most often means both parents (unless only one parent has been awarded legal custody), as well as two letters from mental health professionals in order to assist with insurance coverage.  A GCC clinician  will also speak with your therapist via phone prior to your surgical procedure, in order for everyone on your healthcare team to be as interconnected as possible. It may be a bit more difficult to have your health insurance cover your surgery as a minor, but it is not impossible, and we can help you through the appeals process if you are rejected.

• Can I get surgery even if I have other medical and/or mental health diagnoses?

• The best candidates for top surgery are physically and emotionally healthy, and have their mental health conditions optimized.  Surgery is overall a very positive experience, but as with all life changes, can be a bit stressful.  Therefore, having as much emotional reserve as possible to manage this short-term stress is important. However, this does not mean if you are not the perfect surgical candidate, you cannot have surgery.  You should ensure you discuss your health history with your surgeon so your conditions can be managed around surgery. 

• Are there body weight requirements or other restrictions for surgery?

• Dr. Mosser does not have a body mass index (BMI) requirement for chest reconstruction surgery, and has performed top surgery on patients with BMIs as high as 65, after a thorough medical clearance in partnership with the patient’s primary care physician.

  It is a good idea to not attempt any drastic weight changes close to surgery or afterward, and to be close to the weight range that your body normally stays in. Losing or gaining a significant amount of weight following surgery can impact your final outcome. 
  
  BMI Criteria for Surgery

• Do I need a letter from a therapist?

• Our practice  follows the Informed Consent model and does not require a letter from a therapist or mental health professional for adult patients under most circumstances.  We very much value therapists as part of the process of a gender transition, but a letter is not a requirement. It is important to note though, that if you are pursuing insurance coverage of your surgery, you will need to get at least one letter from a mental health provider if your health insurance provider follows the WPATH Standards of Care for coverage of surgery.

• Which insurance plans does Dr Mosser accept?

• Our office is actively working to negotiate contracts with a number of insurance companies. Please contact our Insurance Concierge to find out if we accept your insurance. 

• Does insurance require a letter from a therapist?

• Yes. We recognize this is an outdated requirement, and while Dr Mosser does not require a letter from a mental health professional, it is necessary for insurance approval.

• Can I get top surgery with Dr Mosser even if I don’t live in San Francisco or the US?

• Definitely! Many of our patients travel from across the US or abroad to see our surgeons. We have had patients from Japan, England, Italy, and many other countries.  Our office can help provide recommendations for travel arrangements and accommodations.

• If I’m traveling to San Francisco, how long do I need to stay in the area?

• We recommend at least 6-7 days following your surgery.  After that, you will be touching base routinely with your surgeon through our secure online system.