Getting T

[AndrewB]

I don't know where you were reading about WPATH, but this is directly from the latest edition regarding hormone therapy criteria:

1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision and to consent for treatment;
3. Age of majority in a given country (if younger, follow the SOC outlined in section VI);
4. If significant medical or mental health concerns are present, they must be reasonably well controlled.

Or, in the case of adolescents:

1. The adolescent has demonstrated a long-lasting and intense pattern of gender nonconformity
or gender dysphoria (whether suppressed or expressed);
2. Gender dysphoria emerged or worsened with the onset of puberty;
3. Any coexisting psychological, medical, or social problems that could interfere with treatment
(e.g., that may compromise treatment adherence) have been addressed, such that the
adolescent's situation and functioning are stable enough to start treatment;
4. The adolescent has given informed consent and, particularly when the adolescent has not
reached the age of medical consent, the parents or other caretakers or guardians have
consented to the treatment and are involved in supporting the adolescent throughout the
treatment process.

You can read the entire document here, if you're curious: http://www.wpath.org/uploaded_files/140/files/Standards%20of%20Care,%20V7%20Full%20Book.pdf

Sometimes it helps if you find yourself dealing with uninformed medical staff or therapists in regards to WPATH, to inform yourself first and then offer them your findings if theirs are outdated. Hope this helps, brother!

[Pizzaparty78]

Thanks so much Andrew, I must've been reading outdated stuff. I definitely think I fulfill everything on that list, I dont think I have any other mental health things to worry about either. Hopefully things will go well with Dr. Stein and hopefully be on my way to T in not too much time. And if that doesnt work out, maybe finding someone online.

[AndrewB]

Hopefully it works out as planned, dude! Your teen years are pretty crucial, you should definitely spend them running on the right 'juices' if at all possible.  I know the feeling, I was totally nervous about how long it'd take to get on T after my first visit; my therapist totally surprised me with a letter after only 2 sessions (in about just as many weeks, to boot!). I wish you that same pleasant surprise!

[Pizzaparty78]

Hey sorry to bring this back up, but I just had my first appointment today and now have a few questions.
1. My therapist was telling me how we could go see an endo about asking for T, and then they'll tell me whether I can start it or not, depending on my age and all. She didnt even mention a letter or anything. So does that mean, since I have my parent's permission, that as long as the endo says yes then I can be prescribed T?
2. My family has found a way to get a therapist through Kaiser, our insurance, for much cheaper and there are a couple trans-friendly endos, could be just make an appointment with one of them about getting T right now? Or should we go see one of the Kaiser doctors? Thank you

[AndrewB]

Hey sorry to bring this back up, but I just had my first appointment today and now have a few questions.
1. My therapist was telling me how we could go see an endo about asking for T, and then they'll tell me whether I can start it or not, depending on my age and all. She didnt even mention a letter or anything. So does that mean, since I have my parent's permission, that as long as the endo says yes then I can be prescribed T?
2. My family has found a way to get a therapist through Kaiser, our insurance, for much cheaper and there are a couple trans-friendly endos, could be just make an appointment with one of them about getting T right now? Or should we go see one of the Kaiser doctors? Thank you

So I don't have any experience with California laws, but I'm also on Kaiser in Oregon so maybe I can offer some guidance?

1. This will all depend on your state's informed consent laws, if available, as well as Kaiser policy. For me, I asked my primary care physician about HRT and he gave me a referral. That referral got me to an endo, who then sent in the referral for a therapist; without the referrals, specialist and extended care providers (such as therapists) aren't often covered by your insurance, as they haven't been deemed 'medically necessary/recommended' by a physician under Kaiser's umbrella of care. In Oregon, to get HRT, even on informed consent you have to receive a letter from a therapist stating that testosterone is the next step in your transition and that you are mentally and emotionally capable of giving informed consent on the matter.


Also, an endo won't usually just say 'yes,' they'll likely still require a letter or some sort of informed consent, but given that you're not 18 yet, this might be more of a discussion between your parents and your doctor at times than you, if you choose to forego Kaiser facilities and just find the nearest endo. They will be signing papers and paying for the medication, after all.

2. If you want your visits to the therapist covered, call your PCP, have them refer you to an endo, and then go visit that endo about testosterone. They might give you and your parents an informed consent form, order some bloodwork to make sure you're medically capable of handling T—or, if deemed too young, puberty blockers at the very least—and/or refer you to a recommended therapist near you. If all goes well, this should put you on the right track for HRT.

Hopefully this is of some use, although I'm hoping someone who's acquired T through a California Kaiser system will correct me on anything that might be different between state coverages and policies.

Good luck!

[Pizzaparty78]

So I don't have any experience with California laws, but I'm also on Kaiser in Oregon so maybe I can offer some guidance?

1. This will all depend on your state's informed consent laws, if available, as well as Kaiser policy. For me, I asked my primary care physician about HRT and he gave me a referral. That referral got me to an endo, who then sent in the referral for a therapist; without the referrals, specialist and extended care providers (such as therapists) aren't often covered by your insurance, as they haven't been deemed 'medically necessary/recommended' by a physician under Kaiser's umbrella of care. In Oregon, to get HRT, even on informed consent you have to receive a letter from a therapist stating that testosterone is the next step in your transition and that you are mentally and emotionally capable of giving informed consent on the matter.


Also, an endo won't usually just say 'yes,' they'll likely still require a letter or some sort of informed consent, but given that you're not 18 yet, this might be more of a discussion between your parents and your doctor at times than you, if you choose to forego Kaiser facilities and just find the nearest endo. They will be signing papers and paying for the medication, after all.

2. If you want your visits to the therapist covered, call your PCP, have them refer you to an endo, and then go visit that endo about testosterone. They might give you and your parents an informed consent form, order some bloodwork to make sure you're medically capable of handling T—or, if deemed too young, puberty blockers at the very least—and/or refer you to a recommended therapist near you. If all goes well, this should put you on the right track for HRT.

Hopefully this is of some use, although I'm hoping someone who's acquired T through a California Kaiser system will correct me on anything that might be different between state coverages and policies.

Good luck!

Thanks so much Andrew, you've been of huge help. I used to live in Oregon btw, even if that's unrelated lol. My parents have scheduled an appointment with some Kaiser doctors, idk if it's with my PCP or anything, I just know it's with some doctors who have been informed about the situation of me being trans and all. My parents seem to be on board with everything, so I guess I'll see how the discussions go with us and the doctors, I hope this will all go over smoothly and I'll be able to start taking T in not too long of time.  Thank you again man.

[AndrewB]

Thanks so much Andrew, you've been of huge help. I used to live in Oregon btw, even if that's unrelated lol. My parents have scheduled an appointment with some Kaiser doctors, idk if it's with my PCP or anything, I just know it's with some doctors who have been informed about the situation of me being trans and all. My parents seem to be on board with everything, so I guess I'll see how the discussions go with us and the doctors, I hope this will all go over smoothly and I'll be able to start taking T in not too long of time.  Thank you again man.

No problem! I know I wish I would have had a lot more guidance when dealing with doctors and such, especially when it came to Kaiser and their policies, so I'm happy to help now that I've been through the whole ordeal. It sounds like you're extremely lucky to have such supportive parents, and also that you're in a state that's so chill with HRT, as far as I'm aware. So long as you have a goal in mind, I'm sure you'll hit it, given how everything's gone so far.

Oh, and feel free to message me any time, I'm happy to help out.