i am a 44 year old woman who is a highly functioning alcoholic in a very well paid job. My alcoholism is the last transference of a line of addictions, all symptoms of my gender dysphoria. I have been a meth addict and a junkie and a bulimic. I have spent ten years in psycotherapy which helped in many ways. However, I still have large breasts. I don t want penoplastery but I would like a double mastectomy. A plastic surgeon I spoke to ten years ago said that nobody in New Zealand would remove breasts unless they contained malign tumours. Does anyone know the situation in New Zealand ? I ve also started to haemorrage litres of blood clots in an hour at least once during my hitherto arid periods, could this be a result of liver disease?