No letter? And underage?
Sorry to bust your bubble but the chances of that ever happening are very small.
Not impossible but very unlikely.
MAYBE if he gets his mom or dad to sign a permission slip but even than..without a t letter not many doctors will be okay with that.
Why can't he just do like most of us have done?
You want steps? Here;
Get a therapist, get a t letter. Here again, not many therapist will write a letter for someone underage.
So ask the therapist first if he's okay with that, if not find another one. Also ask how many sessions he forces his patients to see him for before giving them a letter.
If by the time he gets his letter, he's still under age, get a parent to sign a permission slip.
If he's of age just go to an endo and get your t.
If he doesn't want to be diagnosed, that's also fine.
Try his luck, meet endos until one accept his parents(or legal guardian) just signing a permission slip.
Maybe he'll be lucky and he'll fall on an endo that's completely fine with that.
If that doesn't work but he still doesn't want to be diagnosed(or doesn't have the money.)
just wait till he's 18 and go to a clinic that has informed consent.
Sign the papers and get t.
Since taking t without his parents being okay with it would be kinda silly,
I'll assume they're okay with it. Well in my opinion having them talk to an endo would be the best bet.
He better be careful as too not be stuck in the middle though.
Ex. trying to find a job while looking male and having a female name is hard.
But if his parents or him have the money already to pay for his HRT, name change and all, go for it.
but if not, i think it would be a bad idea.
Ex. My girlfriend started HRT at 17, she looks HOT, buuut her mom can't afford a name change,
so you have this stunning girl with a male name, you guessed it. She's unemployed and in a very bad spot.
I was diagnose at 14, got on t at 18.
I saved enough money for a name change and gender change.
I got myself two jobs before hand, and talked to my employers about it.
My parents support me, but I didn't want to suck them dry of their money,
and I didn't want to get myself stuck in a bad situation.
If he can't get t now, it's not the end of the world.
He'll survive without it for a couple more months.
It'll only make him more excited once he does get it.
That's my 2 cent.
(More like my 20$ lolol I need to stop writing so much. Sorry!!)