I’ve wanted top surgery for a long time, but with the recent (medication-induced??) weight gain, it’s become even more critical.  I managed to get support from my spouse, and I have a consult with a surgeon scheduled in mid-April.  I’m extremely excited, and I get a smile on my face just thinking about it.

I know it won’t be an easy surgery, but I think the results will be worth it.

As part of the process, however, I have to get a letter from a therapist who is knowledgeable about gender and about these surgeries, saying that it’s medically necessary.  I met with the therapist yesterday, and we had a good talk.  He should have my letter ready soon.

Unfortunately, he also mentioned that I would have better results if I were closer to my “ideal body weight”. It really threw me for a loop.  I don’t feel like the concept of “ideal body weight” is a good one, and I certainly don’t like the name.  It makes me feel bad for being above what society/doctors/this particular therapist deems “ideal”.  It makes me wonder how much weight I’d need to lose to have an easier surgery and easier recovery.  Maybe I should try losing weight now.  I don’t want to delay my surgery, so clearly I should lose as much weight as possible, as quickly as possible…

And yet I know that for my body to recover well, it needs to be well-nourished.  Giving in to the eating disorder is not the answer.  But… why would a therapist of all people not understand the harm that his comments would cause?  I feel like he must have known it would be harmful and thought it was worth it anyway, in order to convey his message.  In that case, I must be much heavier than I “should” be.

The ironic thing is that this is all happening during a pandemic; we had a Zoom call and he could only see my head and shoulders.  He’s assuming my weight is too high based on my own opinion—which I think is correct, but I also recognize that I’m still struggling with anorexia.  Even at a “high” weight, I’m still restricting and having trouble with those thoughts.

I’m being transparent and open about all this with my usual therapist, who works at an ED center, and I plan to talk to the new therapist about his comments next week.  Until then, though… well, it’s hard.

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