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location:  Transition  >  Bottom Surgery  >  Letter 2

March 15, 2007

Miroslav Djordjevic, MD
Pikesville, MD 21208

Dear Dr. Djordjevic:

I am writing on behalf of my client Ethan F* (DOB *), whom I would like to refer for your consideration for FtM genital surgery. Mr. F* underwent an in depth gender evaluation with me for a second opinion for surgery.

By way of introduction, I am a licensed clinical social worker (LICSW) in full time private practice. I have practiced for over 27 years after obtaining my Masters in Social Work degree. Post Masters I completed specialized training to evaluate and treat patients with gender conditions and am considered an expert in the field of gender dysphoria. I am a past elected board member of the International Foundation for Gender Education (IFGE) and a full member of the Harry Benjamin International Gender Dysphoria Association (HBIGDA) as well as being a past appointed board member of that organization. I follow the HBIGDA's Standards of Care for the diagnosis and treatment of persons with gender dysphoria. I am considered an expert in the field of gender dysphoria.

Though genetically female, it is my professional opinion that Ethan is diagnosed with DSM IV Gender Identity Disorder codified as 302.85 and ICD-10 diagnosis of Transsexualism. As such, I believe the only effective treatment for him is a combination of psychotherapy and medical intervention to enable him to live as a male - the only role in which he can function comfortably and with full effectiveness.

Ethan is a highly intelligent college graduate and is currently attending * Veterinary School. He presents full time as male and has done so since January 2002, and has had excellent masculinization through hormone treatment which started May 2003. He subsequently had a hysterectomy in June 2003 and chest reconstruction in August 2003. He successfully presents himself as male both psychologically, emotionally and socially. He has expressed as strong desire to have FtM genital surgery to complete his successful adjustment to the male role.

Ethan F* has fully functioned on a superior level in society as male for at least five years. He has normal mental status without any co-morbid conditions. He has a highly accepting family and girlfriend who will accompany him to surgery. He has established a therapeutic and medical support team in his home area to help him with his recuperation after this surgery.

In treatment, we have reviewed the pros and cons of having this surgery and he appears to fully understand the benefits and risks of this surgical procedure. He appears to have realistic expectations of this transition step. He more than meets the HBIGDA's Standards of Care criteria for eligibility and readiness for FtM genital surgery. I strongly recommend that Mr. F* be considered a candidate for surgical reconstruction provided you find him medically fit. If you would like to discuss his case in more detail, you can reach me at (508) ***-**** or email me at *. Thank you.


name, LICSW
Board Certified Diplomate
in Clinical Social Work

NOTE: * = edited for privacy