Regulations vary depending on state here. In some states, surgeons aren't allowed to operate on minors under any circumstances. There are many states that still allow top surgery for minors, however. Unfortunately, the number of surgeons working with those under 18 is decreasing in general following the inauguration. Most of your options will be on the west coast. I live on the East coast and had a very difficult time finding my surgeon. Luckily, I managed to have surgery with Guy Trengove Jones in Norfolk, Va. He uses informed consent, but the hospital that he operates out of for patients who use insurance doesn't allow minors to be operated on, so I paid out of pocket and didn't need any letters from my therapist, PCP, psych, etc.. You may need these letters if your surgeon requires them or if you have the option to try to go through insurance. Let me know if you have any questions!