Costs of transition/prescription without a letter?

[Hulud]

So I am going to start out by clarifying the gender pronoun thing in this post, as people tend to get really confused by it. My girlfriend is biologically female, and therefore I am going to refer to her with female pronouns. She likes to look and act like a boy, but as she is not yet a boy, she still uses female pronouns. She's a creature of habit, and doesn't find it necessary or important to use male pronouns until it's dead obvious that she's not a girl.

So, my girlfriend is a busy person. She's a full-time student at a private college with a part time job and a family that is constantly on her case about something she supposedly isn't doing. I, on the other hand, am a full-time student in community college who therefore spends 16 hours a week in class and the other 152 hours of the week doing jack squat.

She has wanted to be a boy for a long time, at least since around the time we met, which was age 12. About three weeks ago, she disclosed this to me and I took it upon myself to do all the research necessary to get the process going. Before you ask me why I'm doing all the work when it's her transition, please re-read the previous paragraph.

So far, I've gotten pretty far. I've written her a fact sheet that is approximately 6 pages long details all the pros and cons of undergoing hormone replacement therapy. She has read it, and is still pretty solid on the decision. However, she told me that she does not want to do it until she can get people to actually allow her to have a schedule in her life and until and she can budget it. That's all perfectly fair, but she kind of unwittingly set this up so that she will never be able to get it going. First of all, I think that she thinks it's super expensive and incredibly time consuming. For a person who is fully insured, I don't think it will be very expensive, and from what I've read, being on T takes up maybe an hour of your time twice a month. She gets freaked out about scheduling things and tends to blow things like that way out of proportion.

It seems that the counseling part can be rather time consuming, but is it really?  And once she actually has a prescription, how much time will she actually be spending at the doctor? (are my estimates on this incorrect?)

I know the copay for counselor's visits and a GP visits on her insurance are really not very expensive, and that the monthly costs for T are not very much either. So, the only thing left is the endocrinologist's copay, which I can't seem to figure out. What was it for you guys?

Also, I've read on here that there are doctors that will give you the prescription without the note from the counselor. How do you find out which endocrinologists will do this?

As a final thought, please don't try to persuade me that because she still uses female pronouns and has come up with reasons to put it off that she secretly deep down wants to be a girl, because that just isn't the case. You're just going to have to trust me on this one, as someone who has watched her go through puberty and middle school and high school and college.

[Wesley_33]

Check for an informed consent clinic where you live. There is a thread in here about it and also in the wiki on here. I happen to see an online therapist just cause it fits my schedule and my moving this last month. So those may be some things to look into and see if they work.

[Annah]

The only thing that caught my attention is that you are doing all the work for her. Part of the journey to figure all this out is by learning it through oneself.

I understand she is very busy, but so am I. During my transition, I was working a part time job (15-20 hours a week), going to Graduate School full time (which also includes about 2 to 3 papers a week and 17 credits per semester), my field education (internship...which is about 15 hours a week) and working in a church (which is everything else in between). However, I still meddled through it because transitioning was so very important to me that it took precedence over my other goals and activities. If you look at my Google Calendar it is lit up like a Christmas tree.

I am not saying she doesn't think transitioning isn't important to her but I do get red flags waving when another person besides herself is exploring her own gender identity up to and including looking at therapy and endocrinologists; no matter what is on her schedule.

Gender identity and exploring the path of that should also have the person be involved in her own research. It's too important not too.

But with that said, she can get an endocrinologist without letters. It's near impossible but there are a few here and there in the US that may actually do it.

[Annah]

That sounds a lot like "I'm not ready to do this yet" to me. I would rather recommend getting her to go and see a gender therapist, and not rushing into hormones. I had lots of excuses too before I was ready (desperate enough) to start transitioning, and they all seemed to melt away despite there being no actual change in how busy I was when I made the leap.

i agree with this. However, with me it seems like she is trying to "fit her transition" around her schedule. I do admire that and I do believe there has to be some sort of preparation but she has do the work (or at least some of it)...not her girlfriend.

[Wesley_33]

I agree with you both. Ones transition needs to be done yourself with help of others not by others with the help of you. But I did want to somewhat answer her question on things without a letter. Why I said about doing the online therapy. I wouldn't say I'm near as busy as you Annah but it fit for me to do it online. Part of my travel into my transition.

[Annah]

I agree with you both. Ones transition needs to be done yourself with help of others not by others with the help of you. But I did want to somewhat answer her question on things without a letter. Why I said about doing the online therapy. I wouldn't say I'm near as busy as you Annah but it fit for me to do it online. Part of my travel into my transition.

Oh I hear you. One of my therapist was through phone consultation only.

[Lynn]

Oh I hear you. One of my therapist was through phone consultation only.

I would not be able to do that! I have phone anxiety (or something) so I'd just get worse instead of better if I did that

[Annah]

i also wanted to note that the physical and mental process of transitioning takes an incredible amount of effort, patience, and time.

Transitioning made my post graduate studies feel like a walk in the park. Ph.Ds, M.Dics...anything and everything pales in comparison than the work it takes to transition.

The actual research of it is probably the easiest and less time consuming part of transitioning; so I am little concerned about the process that she's taking. Not saying it's wrong...but it's a lot more difficult way of executing it.

[Hulud]

That sounds a lot like "I'm not ready to do this yet" to me. I would rather recommend getting her to go and see a gender therapist, and not rushing into hormones. I had lots of excuses too before I was ready (desperate enough) to start transitioning, and they all seemed to melt away despite there being no actual change in how busy I was when I made the leap.

As a final thought, please don't try to persuade me that because she still uses female pronouns and has come up with reasons to put it off that she secretly deep down wants to be a girl, because that just isn't the case. You're just going to have to trust me on this one, as someone who has watched her go through puberty and middle school and high school and college.

Here's the deal. We've known each other for a rather substantial chunk of each other's lives. I know her really well. It's obvious to me that she is not ready, but you see the reason why she is not ready is because she is not prepared to give up this huge amount of time that she thinks she will be spending at the doctor's office. Of course she has reservations about the actual process. I'm sorry but there is no way she will ever be 100% sure about the decision, but she's pretty damn close to that.

I'm not trying to force her into going through with it as quickly and dangerously as possible. I'm trying to gather information for her so that she won't continue to be afraid of seeing the doctor, whether she goes through with the therapy, or goes straight for the prescription. You see, research is what I do. All day, every day, I do research. My girlfriend, on the other hand, is not only incredibly busy but gets a severe headache if she looks at a computer screen for more than a few minutes. She's going to have to be the one who makes all the phone calls and sets up all the appointments, but I'm doing the research. That's just how it is. Even if she didn't accept my help, the fact of the matter is that I would still be doing the research anyways, because I just love doing research. Call me crazy, but that's how I am.

The reason why I wrote her up a huge fact sheet is precisely because I DON'T want her to just jump into it and make a decision she will regret. I wanted her to be sure she knew exactly what she was getting into. I've been to many a psychologist and know that most of them are quite careless, and I do NOT want her to fall into something she regrets because of the carelessness of some "professional" who does not truly care about her.

I understand that you guys don't really respect my opinion on this stuff since I am not transgender, nor do I have any gender identity issues. And I'm sorry if I come off as an ass hole or a bitch but in order for me to get any of the answers I'm actually looking for among the online transgender community, I've found that I have to be pretty aggressive, and weed through a lot of "you don't know what you're talking about" and "you don't really know what your girlfriend is going through" before I actually get the answer to the question I'm searching out. I know that I don't really know what it's like. I know it's a long and windy road. But the thing is, you don't know what my girlfriend is going through either because even if you guys have a mere ONE thing in common with her, you cannot tell me what is going on in her head, why she has made the choices she had, and why she feels the way she does about her decisions.

I joined this website in order to get some answers in order to help her get the process rolling, but every single question I've asked on here I've had to defend fiercely before I actually get any kind of real answer. Before I get an actual answer, I get a whole lot of, "what bull->-bleeped-<-" and "how can you be so insensitive" and  "you don't know what you're talking about" and "it's nice what you're doing, but you're doing it all wrong" etc.

I'm sick of even trying to be nice on here. How does "how much time will she be spending at the doctor?" and "How much does visiting the endocrinologist cost?" lead to an answer of an entire page full of "stop doing all the research for her" and "she has to do the work...not her girlfriend" (I'm sick of being referred to in third person when I'm being directly adressed!) and all forms of "I need to prove to you that I'm smarter and wiser and you don't know what it's like to be transgendered instead of actually answering your questions!" No ->-bleeped-<- I don't know what the hell it's like! I'm searching for facts not criticism of our lifestyle and relationship dynamics!

[Hulud]

I'm through with this website. I'm sick of asking questions and getting nothing but criticism.

[Annah]

Hulud, no one here is belittling you or putting you down because you are not trans. That's a little unfair if you really believe that.

If the general consensus from people who actually gone through this transition and done these very steps all state that you doing all the research is not the best thing for her because she needs to do this too, then you really should look at that and think about it rather than saying "I'm not coming here anymore." If you have done the research, then you will also see that it is not a good idea for you to do all of it...despite her schedule...and you can note that in your research as well. 

When you say you are doing all the research, you are worried about this and that...and ect etc it kind of shows me you are more into this transition than she is. You have signed up here, you have looked up information, you are asking the questions. Go to any therapist, they will tell you this isn't a good sign.  If someone feels the need to transition, then them finding out any shred of evidence is almost normal. Having a 3rd party doing all the work will tell the therapist and the endocrinologist, she probably isn't ready but you are wanting her to be ready by doing the work for her.

If you get this upset and wanting to leave because of what other trans people are suggesting, then you and your girlfriend are going to have a long, difficult, and tiring road of transition. Because there will be more serious and mind blowing encounters you and her will encounter that will make our comments look like a walk in the park.

When we suggest her to do the research, it was not our way of saying your stupid or your girlfriend doesn't know what she's doing.

You asked for advice, and you got it. It's advice you didn't want to hear but the advice is sound. It's sad you took it so offensively.

[Cen]

Time actually spent in appointments isn't too bad.  I went with a therapist and it took about 6-7 50 minute sessions over about 3 months, followed by one visit with the referred doctor when I had my letter.  If therapy is the route she wants to take, it isn't too hard to fit it around a busy schedule.  If you can find a therapist who will work online or over the phone that also cuts out travel time.

I'm not sure what insurance your SO has, but the vast majority in the U.S. specifically exclude anything related to GID.  Some health care providers will fudge paperwork to get it covered, but it's best not to count on that.  My treatment so far has all been out of pocket, but it has been affordable on low wages while going to school.

The cost varies a lot depending on where you go.  My therapist charges $40/session on a sliding scale, the N.D. (doesn't have to be an endo) I am seeing for HRT charges $160 for a visit, and the labs they use for blood work charge $60 up front, or $100 billed later.  Follow up visits are going to be after 6 weeks at first, then farther apart as time goes on.  So, about an hour every 1.5 months or less with a doctor.

I've read of others here having to pay much more than what I've had to (I think someone said up to $900 for their lab work in one thread!?), so it's hard to really know what to expect without doing some local research.

If you think your partner is misinformed regarding cost and time requirements, and you feel this is keeping them from seeking treatment, I don't see any harm in letting them know they have options.  That's about as far as it should really go, though.

[Wesley_33]

I'm pretty sure I answered your question best I could before I agreed that she should be looking not you. If she isn't willing to even put 30 mins into looking things up and reading them without you doing it she's not ready. Plan and simple. Sorry no one here is going to support her when she isn't willing to put in any work. No one here said anything to you about not being trans. Hell if most of us had supporting SO like you we would be beside ourselves. Again this doesn't change that SHE needs to do the leg work if this is what she really wants.

[Jennifer_Lynn]

I put in 2 years of research talking to people, reading many different forums and trying to keep up with the ever changing Standards of Care and the most important thing finding doctors that I can trust.  I have talked to other transsexuals, set up a support system, I have found a gender therapist I can trust. I have set both short term and long term goals. Since I'm male to female I started electrolysis months ago. The doctors where I live know nothing about transsexuals so I have educated them and connected them with resources to support me. I have 3 very close TS friends who I talk to everyday. We support each other because when it really comes down to it, all we really have is each other. Unless you are a transsexual, you will never understand. You may say you do, but you really don't. Nothing personal its just the way it is. Transitioning to me is a full time job. Those who must work have two full time jobs. And as you add things it snowballs quickly out of control. Transition is not for the casual person. It is hands down the hardest thing you will ever do in your life Period! I am transitioning because its either do this or go crawl under a rock and die. To me and everyone else who is transitioning its deadly serious. I would never ever even think of having someone else do my research or control what drugs I take. Now I'm not saying you don't care or are not trying to do the right thing. If she wants to make it happen she will. The best you can do is continue to be her friend and support her in whatever choice she makes. We should all have such good friends, but the truth is usually something different.

Isabella