The Legal Documents Checklist for GRS Surgery: What You Need to Know with Dr. Richie Gupta

GRS surgery needs not only medical transitions but also a considerable number of legal documents. Dr. Richie Gupta, who has close to 30 years of experience, will shed light on the necessary documents for us.

What documents do you require to get surgery from Dr Richie Gupta?

If you are worried by the extensive and overwhelming appearance of these procedures, don’t be. In the beginning, it might seem like a lot, but it’s not as challenging as it appears.

Why is it important to ask about the documents? So that you receive the proper care. The documents ensure a long-lasting relationship with the doctor, where you feel confident to express your desires, and that your decision is well thought-out. The doctors aim to provide the best care to help you feel your best.

According to Dr. Gupta, a thorough understanding of the patient is necessary before undergoing surgery. He warns that conditions like body dysmorphic disorder can cause harm if not properly addressed. The World Association of Mental Health and Indian Association for Mental Health have created a protocol as a result. The WPATH Standards of Care, with its latest version released in September 2022, provides guidelines. The seven standards of care dictate that an initial consultation with two mental health professionals is necessary.

What is the job of a mental health professional in Transgender surgery?

According to Dr. Gupta and other mental health professionals, the individual is evaluated to check for psychopathology. The consultation aims to identify any mental health problems and ensure they are properly controlled. If the patient struggles with disorders like Multiple Personality Disorders, the mental health professional will rule them out to confirm genuine gender incongruence. It is a job that only a certified mental health professional can do. They are also instrumental in counselling the family and finding out what is bothering the patients and settling all the issues that are bothering them before surgery. They also ensure that the patients understand what is going to happen if they move ahead with the surgery or when they start with hormone therapy. After all assessments are complete, the mental health professional provides a letter confirming their contact with the patient and verification of the patient’s understanding of the necessary requirements. This allows the patient to proceed with the transition process..

Dr Gupta explains the need for objectivity by recommending the use of two mental health professionals from different institutes, not part of the same team. “Even if the patient wants to receive services at Fortis, we have mental health professionals here, but we suggest only one from Fortis and the other from another institute. To avoid any potential biases, it is essential that we follow this approach. By having evaluations from two separate professionals, we can eliminate incidents involving bias,” says Dr Gupta.

Living as your desired gender for a year

“Additionally, it’s crucial for the patient to experience life in their preferred gender role for a full year. This includes dressing in line with the seasons, such as wearing appropriate winter attire for a transwoman in a work, academic, or social setting. This 12-month period is crucial in giving the patient a realistic understanding of what their life will be like after transitioning.”

Hormone therapy

“Taking hormone therapy is optional. It may bring about benefits such as preventing male pattern baldness for MTF individuals, stimulating hair growth, and producing smoother and more radiant skin. There’s a 22% chance of a more feminine outcome, as well as breast growth. These developments can reduce the patient’s discomfort and aid in a greater sense of adjustment to their desired gender role.”

“That’s why we recommend that patients undergo hormone therapy for 12 months. However, if the patient has medical issues, cannot take hormone therapy, or chooses not to, this requirement can be waived as it’s not compulsory.”

What are the requirements for breast augmentation?

“According to Dr. Gupta, only one consultation with a mental health professional is required for breast augmentation or top surgery. But, to ensure a more in-depth evaluation and to give the patient a chance to discuss their decision at length, speaking with two mental health professionals is recommended. This will complete the patient’s file and eliminate the need for additional visits in the future.”.

Waiver of Liability Certificate

A waiver of liability certificate on a notarized stamp paper is required. According to ethical standards, surgeons are not permitted to remove healthy organs. In the case of a transwoman undergoing testes removal, it is considered causing harm, thus a document including the patient’s identification details is necessary. The notarized stamp paper waiver of liability certificate mentions your body parts and a long history of gender incongruence, and confirms that you have received medical guidance before the surgery. It certifies your diagnosis of gender incongruence and gives the surgeon the power to carry out the procedure. It states your consent to the change in your sexual functions and demonstrates that you have opted to undergo the surgery.”

What documents are required for ancillary surgery?

The waiver of liability certificate and other related documents are not a requirement for Facial Feminisation surgery (FFS) and accompanying procedures such as rhinoplasty, hair transplant, and others.”


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