Author Topic: Question about HRT  (Read 2018 times)

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Offline AnneK

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Re: Question about HRT
« Reply #40 on: January 03, 2020, 09:47:30 pm »
I needed a referral from my psychologist before I could make an Endo appointment here in Australia, but that may be because our Medicare system pays for my Endo appointments.

Allie

I live in Ontario, Canada and our health care system covers my appointments and, because I'm over 65, my prescriptions.  I got mine on informed consent.
I'm a 67 year old AMAB who has been thinking about SRS for many years.  I also was a  full cross dresser for a few years.  I wear a bra, pantyhose and nail polish daily because it just feels right.

Started HRT April 17, 2019.

Offline Pammie

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Re: Question about HRT
« Reply #41 on: January 04, 2020, 11:15:35 am »
I have not had a "letter" for anything. I've not even been to a therapist for anything trans related.
Would you not want to? I felt very confused and submerged by the sheer scope and impact of everything and absolutely had to talk to professionals to get informed insights. There was no way u could ever have been capable of just deciding by myself! X
Of course it is back to our mantra at this point “we are all on individual journeys “


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Online Devlyn

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Re: Question about HRT
« Reply #42 on: January 04, 2020, 11:29:00 am »
Gosh. I’d always assumed prescribing E is such a big thing that they would want / need a psychologist letter. - Live and learn!



Compliance with WPATH SOC is voluntary.  Insurance companies may insist on it if you want to get your claim paid.  But a medical doctor doesn't need anyone's permission to prescribe medication if they are confident that it is the right treatment.

Further, these are the WPATH guidelines on Informed Consent. The GICs in the UK, however, are still using earlier versions of the WPATH when administering HRT.

Relationship Between the Standards of Care and Informed Consent Model Protocols

A number of community health centers in the United States have developed protocols for providing hormone therapy based on an approach that has become known as the Informed Consent Model (Callen Lorde Community Health Center, 2000, 2011; Fenway Community Health Transgender Health Program, 2007; Tom Waddell Health Center, 2006). These protocols are consistent with the guidelines presented in the WPATH Standards of Care, Version 7. The SOC are flexible clinical guidelines; they allow for tailoring of interventions to the needs of the individual receiving services and for tailoring of protocols to the approach and setting in which these services are provided (Ehrbar & Gorton, 2010).

Obtaining informed consent for hormone therapy is an important task of providers to ensure that patients understand the psychological and physical benefits and risks of hormone therapy, as well as its psychosocial implications. Providers prescribing the hormones or health professionals recommending the hormones should have the knowledge and experience to assess gender dysphoria. They should inform individuals of the particular benefits, limitations, and risks of hormones, given the patient's age, previous experience with hormones, and concurrent physical or mental health concerns.

Screening for and addressing acute or current mental health concerns is an important part of the informed consent process. This may be done by a mental health professional or by an appropriately trained prescribing provider (see section VII of the SOC). The same provider or another appropriately trained member of the health care team (e.g., a nurse) can address the psychosocial implications of taking hormones when necessary (e.g., the impact of masculinization/feminization on how one is perceived and its potential impact on relationships with family, friends, and coworkers). If indicated, these providers will make referrals for psychotherapy and for the assessment and treatment of co-existing mental health concerns such as anxiety or depression.

The difference between the Informed Consent Model and SOC, Version 7 is that the SOC puts greater emphasis on the important role that mental health professionals can play in alleviating gender dysphoria and facilitating changes in gender role and psychosocial adjustment. This may include a comprehensive mental health assessment and psychotherapy, when indicated. In the Informed Consent Model, the focus is on obtaining informed consent as the threshold for the initiation of hormone therapy in a multidisciplinary, harm-reduction environment. Less emphasis is placed on the provision of mental health care until the patient requests it, unless significant mental health concerns are identified that would need to be addressed before hormone prescription.
Veteran, US Army

Offline Pammie

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Re: Question about HRT
« Reply #43 on: January 04, 2020, 11:30:46 am »
Compliance with WPATH SOC is voluntary.  Insurance companies may insist on it if you want to get your claim paid.  But a medical doctor doesn't need anyone's permission to prescribe medication if they are confident that it is the right treatment.


Further, these are the WPATH guidelines on Informed Consent. The GICs in the UK, however, are still using earlier versions of the WPATH when administering HRT.

Relationship Between the Standards of Care and Informed Consent Model Protocols

A number of community health centers in the United States have developed protocols for providing hormone therapy based on an approach that has become known as the Informed Consent Model (Callen Lorde Community Health Center, 2000, 2011; Fenway Community Health Transgender Health Program, 2007; Tom Waddell Health Center, 2006). These protocols are consistent with the guidelines presented in the WPATH Standards of Care, Version 7. The SOC are flexible clinical guidelines; they allow for tailoring of interventions to the needs of the individual receiving services and for tailoring of protocols to the approach and setting in which these services are provided (Ehrbar & Gorton, 2010).

Obtaining informed consent for hormone therapy is an important task of providers to ensure that patients understand the psychological and physical benefits and risks of hormone therapy, as well as its psychosocial implications. Providers prescribing the hormones or health professionals recommending the hormones should have the knowledge and experience to assess gender dysphoria. They should inform individuals of the particular benefits, limitations, and risks of hormones, given the patient's age, previous experience with hormones, and concurrent physical or mental health concerns.

Screening for and addressing acute or current mental health concerns is an important part of the informed consent process. This may be done by a mental health professional or by an appropriately trained prescribing provider (see section VII of the SOC). The same provider or another appropriately trained member of the health care team (e.g., a nurse) can address the psychosocial implications of taking hormones when necessary (e.g., the impact of masculinization/feminization on how one is perceived and its potential impact on relationships with family, friends, and coworkers). If indicated, these providers will make referrals for psychotherapy and for the assessment and treatment of co-existing mental health concerns such as anxiety or depression.

The difference between the Informed Consent Model and SOC, Version 7 is that the SOC puts greater emphasis on the important role that mental health professionals can play in alleviating gender dysphoria and facilitating changes in gender role and psychosocial adjustment. This may include a comprehensive mental health assessment and psychotherapy, when indicated. In the Informed Consent Model, the focus is on obtaining informed consent as the threshold for the initiation of hormone therapy in a multidisciplinary, harm-reduction environment. Less emphasis is placed on the provision of mental health care until the patient requests it, unless significant mental health concerns are identified that would need to be addressed before hormone prescription.

Thanks - that’s very informative and useful! X


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