Howto use Informed consent ?

[Ravenna]

How can I used informed consent to starthrt?
I don't think there's any trans friendly clinics near me
I'm in west palm beach florida
I'm seeing an intern therapist next Wednesday
But I'm not sure what she can do

[kathyk]

It's surprising how sparse the pickings are for trans related services in Florida.  I did some quick google searches and found very few doctors and therapists who specialize in transgender medicine. 

However, I did find the name Sharon A. Thrush (Endocrinologist),2669 Forest Hill Boulevard, Suite 100, West Palm Beach, FL 33406.  (561) 968-7600   Can't guarantee that the information is accurate, or that she prescribes medication for HRT by informed consent.  I'll leave finding more information on that level up to you.  A simple phone call should do the trick. 

Remember, if a doctor is comfortable prescribing hormones under Informed Consent that physician will first ask a whole lot of questions, and she (or he) will expect honest answers.  You may be asked to explain whether you have family, financial, or health care restrictions that effect your ability to access therapy and medical services.  And you may also be asked to provide your prior medical records and tests.  This would all be for your safety, and so it's best to supply the information if you can get it.

Here is a link to the University Of California, Medical Center, San Francisco (UCSF), web site for Transgender Health.  http://transhealth.ucsf.edu/trans?page=protocol-hormone-ready   UCSF is a respected trans health provider in the San Francisco Bay Area, and when asked they routinely share information about how they treat and care for trans patients.  Their web site is chocked full of information and as you review the document for Informed Consent you may want to review how they manage all aspects of trans health. 

I now think we girls should always see a therapist to gage our ability to manage transition, and to asses our care needs.  But I also understand how our individual issues sometimes critically interfere with our ability to proceed with transition in a traditional way.  Gratefully WPATH Version 7 has addressed new non-traditional methods, and modified the standards of treatment to provide a greater level of care for our vastly diverse society.

Take care and I wish you well.
K

[Ravenna]

Thank you somuch Kathy! I've heard of her but she doesn't take my insurance and is mega expensive
But I have like 1500 saved up that I could use.
What do you think I should ask when I call : c

[Jessica Merriman]

Unless you have the WPATH Standards of Care memorize front to back and have some understanding of the Anatomy and Physiology of the Endocrine system I would go through a Therapist. There are so many things about HRT you have to be positive of such as Indications, contra indications, untoward effects, life threatening conditions, dosages and methodology the Endocrinologist could turn you down for lack of knowledge of HRT making it almost impossible to do Informed Consent again. Word does travel through medical circles thanks to the computer age. I would HIGHLY recommend you go through a Therapist. I was a career Paramedic/Firefighter and I learn something new every visit I had not though of myself. If I don't know all about it after 28 years then no one does as I was an Elite Flight Medic for a while.

[kathyk]

I have to agree with Jessica about bombing out if you aren't completely ready to discuss your situation with the doctor.  And please don't go the self medicating route without a doctor prescribing for you.  I went with self meds and wish I'd waited to see a doctor or therapist first, but like you there was nothing but frustration in trying to get through a medical system that ignored me.  Plus I had no real free cash to spend, and I was leaving for Michigan very soon after I found that I had to transition. 

Anyway, here is a link for the Florida Atlantic University LGBTQ Resource Center.     http://www.fau.edu/lgbtqa/     
They can give you more information about free or low cost counseling and therapy services available in the West Palm Beach area.  And I found this FAU link for outside referrals.  I'm not sure how accurate it is, but it does have the free and low cost therapy info at the bottom.   https://www.fau.edu/counseling/CAPS%20Referral%20List.pdf
Don't know why I didn't think of this earlier (except I have a mild concussion from falling off a ladder).   

I haven't been a student since 1975, and the LGBTQ center at the old college I attended welcomed me to stop in anytime just as a member of the community.

[TaoRaven]

Informed consent resources:

http://www.icath.org/

http://dl.dropboxusercontent.com/u/932389/Trans/Stepping%20Forward%20-%20Informed%20Consent%20Clinics.pdf

Contrary to what some people think, "Informed consent" does not equate to self medicating, and does not equate to getting a prescription from a doctor without proper medical procedures.

Unfortunately from the Stepping Forward listing, I don't see anyone in Florida, but an ICATH advocate might be able to point you in the right direction. If all else fails, there are therapists that will write you a letter after a skype session, and then your endo can take it from there medically.

For an idea on how to get started, and what to expect, this page might prove useful as well: http://www.icath.org/How-Does-it-Work-.html

Incidentally, "The only absolute medical contraindication to initiating or maintaining hormone replacement therapy is an estrogen- or testosterone-sensitive cancer. Other conditions should not preclude treatment in the setting of informed consent."

If you have questions or need education on the effects and side effects of HRT, ask your physician. It is their job as an Informed Consent provider to make you aware of these and other factors before you begin treatment. Expect to have a LOT of blood drawn, and a lot of lab work done. Make sure you have good insurance to cover the costs of that lab work. Mine runs over $750.00 for each set, done every three months. I end up paying $5.00

Good luck.

[kathyk]

Contrary to what some people think, "Informed consent" does not equate to self medicating, and does not equate to getting a prescription from a doctor without proper medical procedures.

Very true.  And the doctor providing HRT under informed consent still requires blood work and monitoring.

[TaoRaven]

Very true.  And the doctor providing HRT under informed consent still requires blood work and monitoring.

Exactly. But this is the benefit of the IC model. You have the expertise and safety of a medical professional, without having to endure what some consider unnecessary and costly steps, IE months of therapy.

[Randi]

With your proximity to MIA airport, you can travel to Chicago, New York or Boston relatively cheaply,  usually under $300 round trip.  With proper telephone inquiries, you could go to Howard Brown, Callen-Lorde, Fenway Health or similar facilities and get the required appointments with a week or so.

It could be much cheaper to spend the money on airfare and hotels than with a counselor.

In Chicago the "EL" can take you from either Midway or Ohare to the Howard Brown clinic.

http://howardbrown.org/uploadedFiles/Services_and_Programs/Transgender_Health/THInKingBROCHURE2013.pdf

At Howard Brown it's a three step process:

1. First Medical Appointment
2. Hormone Advocate Appointment
3. Second Medical Appointment

You can expect to receive a prescription on your second medical appointment, and the pharmacy is right next door.

[Paulagirl]

I used a combination of therapist, and informed consent. I saw an endo first, who said that traditional SOC are a little heavy handed for someone who is my age, and full time. He said he would be fine with one visit to a therapist he knew well and trusted.
At the therapist's, I made it clear that I would be staying until I got my readiness letter only, and that my Dr. only required one visit.
She basically quizzed me on effects, expectations, and side effects of HRT. Basically making sure I had a good knowledge of what to expect.
She asked a few questions about my past, my present, and where I was headed. She them pronounced me sane, and well versed in HRT, and emailed my Endo.
Simple, professional, and satisfied both Informed consent, and more traditional SOC. guidelines. My total therapy bill with no insurance $90.