The AGP video is just Nyk doing a public dress-rehearsal of the revised story he is going to tell the psychiatrist when he gets his bottom GRS referral. Dr Suporn Watanyusakul's clinic in Thailand is popular right now with trannies who want to have neovaginas dug into them (Stef Sanjiati is going to get a pussy from Dr. Suporn) and he only demands one letter from one "therapist", not even an actual psychiatrist, confirming dysphoria and having lived one year as a transwoman (in Nyk's case, living mostly locked up in his room doing videos, having Sabrina order food for him over the internet because he's too drunk to feed himself):
ALL patients undergoing SRS MUST provide an original, signed document from a qualified psychiatrist or psychosexual specialist, confirming as a minimum that:
They have been diagnosed with Gender Identity Dysphoria.
SRS is indicated in their case, and is the recommended treatment.
Ideally, the referral should also confirm that:
They have been living full time as a woman for at least 12 months prior to surgery or - if not - gives an explanation as to why that has not been possible in their case. It is accepted that RLT is not a practical possibility in some countries.
They have been undertaking a course of female hormone replacement therapy (HRT) unless there are medical reasons (to be indicated) that such a course is not advised in their case.
The letter must show the name, address and telephone number of the signee, for possible verification
SRS Referral Letter
There is no specific format for a SRS Referral letter. Dr Suporn does not expect a long report or detailed diagnosis, but he does expect it to contain certain minimum criteria. We would expect the doctor to mention how many times he has seen the patient, and since when. The doctor or practitioner does not have to specifically recommend that the patient should undergo SRS, nor do they have to specifically refer the patient to Dr Suporn ( a qualifying referral previously addressed to another surgeon is acceptable ). However, we would expect to see that the doctor or therapist considers that the patient:
has been diagnosed with gender dysphoria as the conclusion of a number of personal communication sessions. Confirmation of diagnosis in accordance to DSM IV Code 302.85 and/or ICD10 code F64.0 (or as otherwise appropriate) must be mentioned.
shows no evidence of co-morbidity or substance abuse. (Nyk would normally never meet this requirement given his public history of continuous drug abuse and alcoholism and his refusal to quit drinking and using during his HRT, but these therapist doing the referrals just don't care.)
is demonstrably living full time as a woman for at least 12 months, or shows evidence of commitment to do so, or has satisfactory reasons as to why she is not yet doing so. There might, for example, be legal reasons in any particular country preventing this.
is not suffering from any psychological or psychiatric disorders (****) that might be adversely influencing her decision or desire to undergo SRS. (Nyk suffers from multiple comorbid psychiatric disorders, but he now has revised his psychiatric history to claim he was "only once diagnosed with OCD" as opposed to the plethora of diagnoses he listed in the Psychiatry video, including bipolar.)
has been taking female hormones (for a specified period - usually a minimum of 6 months), unless it is considered medically unsafe to do so.
is fully adjusted to living in society as a woman or – if not yet living as a woman – must have a satisfactory explanation as to why this is the case.
is fully aware of the consequences, cost, details, complications and surgical and non-surgical options available to treat her gender dysphoria.
is aware that SRS is irreversible.
is considered suitable by him / her to undergo SRS insofar as he/she offers no reason why you should NOT undergo SRS and that SRS is necessary for the patient’s long-term well-being.
If the letter has all (or most of) those "ingredients", and the doctor is competent to write and sign it by virtue of his / her qualifications and credentials, Dr Suporn will accept that as suitable referral.
http://www.supornclinic.com/restricted/Scheduling/protocol.aspx
The letter from the "therapist" is just a formality. It doesn't really matter under the informed consent regime, in the US any therapist will just sign off on any ole thing that comes in through the door asking for permission to have bottom surgery, but Nyk had to try his revised erotic history before his fans on Youtube to see if it would stick, and of course it stuck because none of these braindead morons noticed that Nyk had left out all of the diagnoses he had listed in the Psychiatry video from the erotic history he told in the AGP video. It's a revised narrative Nyk prepared for his therapist but no one noticed it and if they did no one had the nerve to say anything about it. Nyk got away with covering up (in plain view) of a large part of his psychiatric record, and he now feels confident about getting away with the same thing before the therapist who is going to prepare his referral, no questions asked - who doesn't care and would approve it anyway because they approve even exceptional people and people suffering from multiple personality disorder for GRS.
Here is a public Livestream Nyk did with lolcow colleague Milo Stewart with the whole story about ordering drugs from the internet and then going to
Chase Brexton ("Our goal is not to treat you “regardless of” who you are, but to affirm and help you become who you are!") where he received drugs on demand without ever being asked to see a psychiatrist to get a proper diagnosis before being given drugs. Note also that Chase Brexton made him wait for two months, but even that was too long for a drug addict like Nyk who wants his fix right here right now.
Nyk: I have avoided going to the doctor apart from the informed consent clinic I go to which is really good.
MS : Oh! Later I would be interested in knowing how you feel about informed consent.
Nyk:Well, Chase Brexton is a place I go to in Baltimore and it's actually kind of amazing in terms of... they like sorta know what trans people are like, and any time you have to fill in your legal name on a form they also ask you your preferred name, they ask what your pronouns are, it just makes a big difference in terms of the comfort of your experience there you know, that they have some basic knowledge about this stuff. So, I have had basically a really good experience there.
...
MS: What was the process of getting on informed consent like for you?
Nyk: It was really easy for me. And a lot of people have asked me: "How the fuck did you do that?". Well, I always have to put a disclaimer before this, but, this is not medical advice. But, I originally started with black market hormones. I was getting them on the internet. I mean, they worked or whatever, I did that for, like, a month and a half before I even showed up to the clinic. Because the clinic, I called them, and they made me wait for, like, three months or something. Or, it wasn't that bad, it was, like, two months, two and a half months to get an appointment. And at the time I was like, my dysphoria was at its max and I was like, no, I am not, I can't wait that long. (Look at that smug look on his face in this part of the video. He knows he is just delivering a script and getting away with it because Milo doesn't have the wit to question it. His narrative about being unable to wait for 2 months to go the clinic and just having to get internet drugs is such BS on the face of it, because he now has to wait a whole year before he can go to dr. Suporn in Thailand, so what is he going to do in the mean time, self-castrate?)
So I started [inaudible] and then when I came in, as femme as possible, and I told them I was a transwoman, she/her pronouns, my preferred name is Natalie, I am already on black market hormones and just trying to get a prescription here. And they were like, alright - what they said was, we don't usually give you a prescription the first day but since you are gonna do it anyway...
MS: It's safer, so we might as well to give it to you.
Nyk: It's safer, it's really better that you do this with a prescription, so I will give you a prescription. And I just walked in and walked out with a fucking prescription.
MS: That was what it was like for me, except I wasn't on black market hormones.
Nyk never mentions Chase Brexton asking him to go and see a psychiatrist first and receive a referral for HRT because of having actually been diagnosed with gender dysphoria before getting drugs or anything else. Chase Brexton just affirms everything in the name of informed consent.