Hi jesselee,
This will be a long post, but I hope it will answer your questions.
There are two routes people go down to get started on testosterone. Whether or not they are both available to you will depend on where you are located or how far you are willing to travel. It will also depend on your age (if you're over 18). It sounds like the system you're currently working with follows the WPATH Standards of Care, so I'll start with that:
See a mental health professional. After a certain number of visits (there is no required minimum or maximum - any limit you are told is being imposed by that particular doctor), they will write you a referral letter to take to a medical doctor of your choosing who will prescribe, administer, and monitor your hormone replacement therapy (HRT). You can choose to stop seeing the mental health professional after you receive your referral, or continue if you find that the sessions benefit you.
The other path is called informed consent. It is typically found in larger metropolitan areas, but there are some doctors who provide HRT via informed consent. You would skip seeing a mental health professional and instead meet with a medical doctor who would go over the risks, effects, and side effects of HRT with you. At the end of your meeting, you would fill out a form consenting to the treatment, and they would get you started.
There are pros and cons to both. If you do not have insurance, informed consent is generally the route you want to go as it will be less expensive for you in the long run. If you need help coming out, dealing with transition-related issues, or will need future referrals for surgery, it may be best to start developing a solid relationship with a therapist as early as possible to avoid a longer wait down the road.
My advice to you would be to:
(1) See if there are any practices near you that follow informed consent. You will typically find them in larger cities, so you may need to travel but you'd be able to skip a 6 month wait and paying $4800 for therapy for weekly sessions for 6 months.
(2) Look into online therapists. There are quite a few these days, ranging in price from $45-$200 per session. Find someone on the lower end and see if they can give you an estimate on how long you'd need to see them and at what frequency before they'd give you a referral letter.
(3) Start budgeting. If you don't have insurance, HRT can be quite expensive. Most doctors will want to see you quarterly for blood work the first year in addition to paying for your prescription. My testosterone and needles cost ~$75 and I refill every quarter. Every quarter I pay $30 to see my doctor. I pay $10 for labwork because I have insurance. The bill I receive in the mail prior to the insurance adjustment is around $550. So with insurance I pay $115 per visit to get everything I need, or $460 per year. Without insurance, that would be $655 per visit or $2620 annually.
(4) Look into insurance options. It may be more cost effective to get a plan through the Affordable Care Act yourself than to pay for things out of pocket. Make sure anything you look at doesn't exclude transgender care.
