Virginia's Transitioning Guidelines.

[MyNameIsElla]

I'm getting very frustrated trying to find the legal requirements here in virginia I can't seem to find them anywhere. Can Someone please help me.

[FTMax]

Hi Ella,

I live in Virginia, have successfully legally transitioned, and might be able to help you. Can you tell me what specifically you are looking to do?

[MyNameIsElla]

I'm just starting my journey towards becoming a woman so I kindof need to know everything. Like is their a legal requirement for starting hormones in virginia. What about surgery? Also what do I have to do to get all my documents changed here. Also I live in richmond is doctor zinsser any good or should I go elsewhere even though I wouldn't even have to leave town for him.

[Tamika Olivia]

At the outset, I'd suggest reading the WPATH Standards of Care. Most doctors practicing in any area touching transgender healthcare will be utilizing the WPATH 7 standards (though some may cling to 6). You can find the PDF of 7 for free online at the WPATH website. Current standards don't set a requirement for a therapist's diagnosis of Gender Dysphoria, but most Endo's and GP's that prescribe HRT are going to want a therapist to see you first. It's a good idea in any case, because a good therapist can help prepare you for the mental, emotional, and social changes that are going to take place in your life.

I'm not even close to any of the surgeries yet, so I'm not as up on their requirements, but there are standards guiding those in the WPATH as well.

Oh, and you're not likely to find any legal standards guiding the medical aspects of transition. The legal aspects will be governed, but the medical community is generally going to control their own standards, and the law just expects adherence to those.

[FTMax]

Hi Ella,

HRT rules aren't dictated by state or locality. Different doctors require different things, depending on which model of care they follow. In the US, most doctors follow WPATH which says that you need a referral from a mental health professional to start HRT. There is also informed consent, which waives the mental health requirement and gives access to HRT after all the specifics of it have been explained to you and you accept the risks involved.

You're in a good spot in Richmond. Below is a link for the Fan Free Clinic. I'm up in Alexandria, so I can't personally vouch for it, but the clinic I go to in DC is very similar. I'd strongly recommend giving them a call and asking about the intake process. I believe they follow informed consent, so you would just go in and speak to a doctor about starting HRT, do some blood tests, and start. I know they also have mental health professionals on site that you can speak to as well.

http://www.fanfreeclinic.org/client-services/trans-health-services/

Also here is the guide for changing your documents. This was developed by the clinic I go to, and should be valid for everywhere in Virginia. You may need to go online and search for things that are specific to the county you're in if they aren't listed in this packet:

http://www.whitman-walker.org/wp-content/uploads/2015/02/VA-Name-and-Gender-Change-Guide-July-2014.pdf

Surgery is super personal, so I can't really give advice on it. My advice would be to make a list of the factors that are most important to you and work from there. For me, I wanted someone within a two hour drive, who does at least 150 per year of the procedure I wanted, ideally for less than $8000. Your criteria may be different. If Zinsser meets your criteria, then you should book a consult with him and see if he feels like a good fit. I'm FTM so my needs were a little different than yours and were better suited for a surgeon in Baltimore.

[Devlyn]

The Standards Of Care are right here on our site in text form. 

https://www.susans.org/wiki/Standards_of_Care_for_the_Health_of_Transsexual,_Transgender,_and_Gender_Nonconforming_People

Hugs, Devlyn

[MyNameIsElla]

Also I'm still presenting as male do to a lack of funds to buy feminine clothing and other essentials just yet will they deny me hrt based on that or is that just my own fears being present?

[Tamika Olivia]

I've looked into a number of doctors in my area, and some do require presentation before they'll subscribe HRT. This seems to be the exception, instead of the rule.

[FTMax]

Also I'm still presenting as male do to a lack of funds to buy feminine clothing and other essentials just yet will they deny me hrt based on that or is that just my own fears being present?

Like Tamika said, it'll be hit or miss depending on the views of who you go to. I would say anyone that has a significant amount of experience with trans patients will not deny you HRT based on how you are currently expressing (or not expressing) your gender.

[StartingOver]

If Zinsser meets your criteria, then you should book a consult with him and see if he feels like a good fit.

I'm gonna give your mention of Dr. Zinsser a giant +1.  He's extremely trans-friendly, a brilliant surgeon, and very affordable for both FtM top surgery and MtF facial feminization surgery.  Highly underrated surgeon, and well worth checking out instead of getting ripped off by some of the more famous surgeons who aren't producing better results.  Zinsser does not do MtF lower surgery, but he makes beautiful noses, etc.  PM me if you'd like some more info.  For the lower surgery, there's some great options just up I-95 in PA.

But yeah, Richmond is fairly chilled out when it comes to transgender issues.  Great therapists who are so easy to deal with, great doctors for hormones, no gatekeeping in RVA from the medical community.  If you can stick to the WPATH guidelines (which aren't all that onerous), you'll easily transition and find plenty of support here.  As far as I know there's no creepy or crazy Virginia-specific laws that will limit your transition.

Community here is great.  Nobody even looks twice, and I've never been misgendered in any restaurant or bar here.  Trans awareness is huge, and it's an awesome town to transition.

So bottom line, Richmond should rank very high on the list of trans-friendly cities.  You may think the state is full of redneck bigots (and there sure are plenty of areas where those types thrive), but in Richmond being trans is like the least weird thing ever.

[FTMax]

But yeah, Richmond is fairly chilled out when it comes to transgender issues. 

Thank you for that! I've been considering a move once I'm all finished up medically, but I don't want to stray too far out of the mid-Atlantic. Richmond has been on the maybe list for a while, and I think you just helped it bump up a few spots.

[RaptorChops]

Richmond is awesome hands down. I'm actually moving back there in October hopefully with my best friend who is also trans. There are A LOT of trans folk in RVA and a lot of doctors too. I'd say start off by getting your self a gender therapist and talk to them for a bit (I'm not sure of the names but I know there are a few that take all different types of insurance if you have it). They will give you the recommendation for you to start HRT.