Starting therapy and HRT

[LJfusion]

After years of hiding from the truth, I finally told my girlfriend, and some of my friends, that I want to transition into a male.
I used to be able to handle it; being called by my birth name, using she/her pronouns, and keeping it to myself how I really felt. But the more I hid it, the worse my depression got. It's now at the point where I haven't gone to work for two weeks because I have to use my birth name there. I also hate going out because people look at my face and see feminine features so they use feminine pronouns when talking to me.
Once I told my girlfriend, she approved and I was able to feel more comfortable because I could now be myself at home. I called up a therapist in my area but sadly he was booked solid for almost two weeks but squeezed me in for the 18th.
After hiding for so long and now reaching my breaking point where I can't even work or go out because I hate what people see/call me, I really don't want to wait any longer to start testosterone. Is it possible to get a letter on the first day of therapy? I want to get started ASAP and cannot even mange having to wait 3 months, I can't even seeing me having to wait another two weeks.
I know the effects of hormones takes a while to show which is why I don't want to wait to start. I want to start feeling okay about myself and want to live again and I cannot do that until people start calling me "ma'am" whenever I go out.

[Laura_7]

*hugs*

Well you might tell you want the letter ...

and going to a therapist can be really helpful ...

if it takes too long you might look for informed consent places in your vicinity ... plannedparenthood could be a possibility ...

so you have a few options...
you might first go to the therapist ...


*hugs*

[RaptorChops]

Your Therapist will probably not be able to give you a letter to start HRT the first day because they need assess you for Gender Identity Disorder. I went to my therapist for about 5 or so sessions before I was given a letter and a recommendation for an endocrinologist. So not to sound like a stick in the mud but transitioning takes a lot of patience. I have felt the same way as you and had to force myself to go to work. I had to go to work every day with the same fears and a serious case of social anxiety. I would have panic attacks driving to work every day. After starting T a few months in I was still feeling the same way but actually a little bit worse. I felt like I was stuck in that period of where nobody could figure out if I was male or female. It took time for me to get mentally sound for the most part (I mean I still get really depressed and anxious). 

You will get through it though, and you will be even more proud of yourself when you get there. You'll feel so much better when you start really seeing the changes you make. So look at the future and be positive. I don't know if you already do but maybe get into some hobbies like working out, cooking, video games, reading, etc. to keep your mind occupied. You'll do great and trust me (I probably say this a lot) if I can do this so can you .

[FTMax]

Maybe. It depends on the therapist and whether or not they've worked with trans people before and have an understanding of our needs. The more they know, typically the faster they prescribe. I wouldn't go into it with the assumption that you will walk out with a referral though. And of course, the referral isn't a prescription. You'd need to take the letter to another doctor who would prescribe to you. So while it may not take you three months just to get a referral, it may take you three months to start because doctors are busy people.

Some providers do offer informed consent though. It is typically found at LGBTQ clinics or in larger cities. That is the route I went. I had an initial appointment around the end of November 2014, and I started T on December 5th of that year. It was a 2 week wait from scheduling to my initial appointment, and then a 3 week wait from my first appointment to the day I got my prescription. Like Laura mentioned, some Planned Parenthood locations offer HRT. You would need to call and make sure that the location you want to go to does, because they don't all offer it.

In the mean time, you could also change your name. You don't need a reason to legally change your name.

I would also tell you to be mindful of your insurance requirements if you eventually want to get other procedures done. Some insurers require a certain amount of time spent in therapy, on testosterone, or living as male before they will agree to pay for top surgery or bottom surgery.

[Alexthecat]

Sometimes therapists won't actually write HRT letters or want to charge you a ridiculous amount for them. Be upfront to your therapist that you are there for your letter and how long he usually sees someone before he will write one. If he won't provide it then you are just wasting your time. I know some well known trans therapists in my area say a minimum of 6 months of seeing them before they even think about a letter. If his answer is not satisfactory then move on to someone else.

[jlaframboise]

If you're impatient, you could try and find an informed consent clinic (where you sign a sheet instead of see a therapist) as mentioned above, that's what I did. Even then though, it took me about a month to get my prescription and blood work sorted. Don't lose hope for those either. I live in Utah and I found one. It sucks because there's a waiting time no matter which route you go, you just have to be strong enough to know that the wait is going to be really, REALLY, worth it. Look into packing and binding for your own self confidence while you wait, or turn attention to fitness and building a more male physique if that's something you'd like.

[Contravene]

I used the informed consent route too. I've been seeing a therapist for a few months now but I didn't need a letter at all. I just went to see a doctor about prescribing T, she asked me some questions then faxed my new T prescription to my pharmacy a few days later after my blood work came back and was approved.

The biggest hurdle for most people seems to be dealing with the insurance company. At first my insurance wasn't going to cover anything related to HRT. It would have cost me over $300 for a 90 day supply of T. The pharmacy lowered it to a 30 day supply to help lower the cost but it was still going to cost around a hundred dollars. I made a few phone calls and will be getting the 30 day supply of T for $25 now plus the insurance will be covering my doctor's visits and the blood work needed for HRT. I might see if I can get the T to be covered eventually too even if I have to switch insurance companies.

So I would say informed consent is the way to go if you're impatient and absolutely sure you want to start T but look into what your insurance covers too.

[LJfusion]

I've been looking into informed consent but there's no clinics near me. I just got my insurance so I'm been calling around to doctors on my plan and none of them do anything with HRT. So my question is, if that's what I want to do, how would I find a place near me to do informed consent? Do all planned parent hood clinics do informed consent for HRT or would I have to call all the ones near by and ask them? I understand the therapy route will take a long time, and I won't feel better automatically when I start T, but I'll be happier and I'll be closer to feeling okay. I rather start soon and feel better in five months than start later and not feel okay for eight or nine months. Basically, the sooner I start the better because that means I'll be on the track to happiness a lot sooner.

My insurance won't cover anything to do with my transition, however, my therapist said he will tell them it's for depression(which isn't a lie) so they will cover it. That will save me $80 a visit. I'll still use him for help with my transition but I don't want to wait for him to write me a letter. My insurance will cover a doctor visit, and I just have a copay, but as for the blood work and hormones, I know they won't cover. I don't mind that too much. I'm ready to be happy, money won't hold me back.

[Laura_7]

You might look for therapists here:
https://www.susans.org/forums/index.php/topic,162888.msg1400316.html#msg1400316

You might phone a few plannedparenthood places and ask.
Another option might be asking at lgbt centers or transgender groups.

You might also give the next big city near you ... maybe someone has a hint ....


*hugs*

[FTMax]

You'd really just need to call different doctors and ask. It will be tougher to find someone without a therapist's letter. If starting ASAP is important to you, you may need to consider traveling. It may be easier to travel a few times to get started and then see if you can find someone local who would be willing to carry on the prescription and monitor you. If you are willing to divulge generally where you are located, we could probably give you some options.

You would need to call each Planned Parenthood location to find out if they offer HRT or not. Not all of them do.

Your insurance will probably cover your blood work if it covers doctor visits, but you should look through your plan and find out if they have a preferred labs partner (like LabCorp is mine).

Also, as Laura said, see if you can link up with any LGBTQ groups in your area. Often times they will know what kind of local resources are available and who would be willing to work with you.

[jlaframboise]

My informed consent clinic is actually an OBGYN, I know it might be a one time find but maybe see if OBGYN's in your area are trans/LGBTQ friendly from an online viewpoint. I only pay copays each time and about $100 for a vial of T that lasts me more than 6 months. I second finding LGBTQ groups in your area, at least for this part of your transition.

[LJfusion]

I called up a ton of doctors(over 30) and none of them do HRT with informed consent. For professionals, they were very unprofessional when finding out I was transgender.

I never thought of OBGYNs so maybe I'll give a few a call tomorrow and see and they do informed consent.

I also searched the internet for some LGBT groups and only found one. That one seems more point at the youth group(17 and under) and I'm 19. Since my therapist offers a transgender group, I will be asking him about that and hoping he has enough sign ups to do a group(he said he needs 5+ in order to be approved for the group). But other than him, there's no transgender groups for me to join around where I live.

I would be willing to travel however, I cannot afford to travel and pay for the T. So I need to stay relatively close to my home. Also, I get weak when my blood is taken. I have no problems with needles as I have 4 tattoos and I have no problem with blood but for some reason, use a needle to get my blood in a bag, and I about pass out. So whenever I get blood drawn, I can't do much and especially not drive. I always signed up for the blood drive at school for this reason 
So it wouldn't just be me that needs to go, it's my girlfriend and she's a full time worker and student and doesn't have the time to take an entire day to go upstate with me.

Are there any other options for informed consent? I tried planned parenthoods and GPs near me, next will be OBGYNs but are there any others I should check? Do endocrinologists do informed consent?

[FTMax]

Some do. I would try: general practitioners, endocrinologists, OB/GYNs, and Planned Parenthood locations. Beyond that, you will probably not have any luck. You may very well end up needing to get a referral, or to save money until you can afford both the trip and hormones to go somewhere that offers HRT through informed consent.

If you are near any universities or colleges (not community colleges, something 4 year), you could check there as well. If they have an affiliated hospital, they might offer it with a referral. They may have LGBTQ student groups that you could ask. Every campus also has some kind of student health center and you could call and ask who they refer students to if they come in requesting HRT.

Also, I'm not sure how you're asking the folks you're calling, but what I did when I started looking was ask if they offer HRT for transgender patients, and if they did, what they require in terms of referrals in order to start treatment.

And on the topic of those youth support groups, you could always get the contact information for whoever is in charge of the groups and ask if they know anything about local resources. It's not just a bunch of kids hanging out, somebody's there watching them and directing their activities.

[LJfusion]

So I went to my insurance's website to get a list of number to call regarding HRT.

Now this might be a stupid question but what I found in regards of OBGYNs are two types, either a PCP(where females would go for general check ups) or reproductive endocrinology and infertility which says they help women and men with problems regarding the reproductive system or regarding infertility. Should I try giving both type of OBGYNs a call or is a specific one of these options I need to try?

[Laura_7]

So I went to my insurance's website to get a list of number to call regarding HRT.

Now this might be a stupid question but what I found in regards of OBGYNs are two types, either a PCP(where females would go for general check ups) or reproductive endocrinology and infertility which says they help women and men with problems regarding the reproductive system or regarding infertility. Should I try giving both type of OBGYNs a call or is a specific one of these options I need to try?

You might try all of them.
Sometimes gyns work together with specialized endos, who do hormone treatment.


*hugs*

[LJfusion]

So after calling about 30+ places, today, I finally found one doctor that does HRT. None of the endocrinologists(all of the 7 on my insurance plan) will do anything regarding HRT for transgender patients, which is always the best thing ever.

However, the OBGYN office I called has about five doctors on staff. The only one that has transgender patients was the only one that wasn't in the office today(go figures) so I have to call back tomorrow regarding the requirements. The good news it that even if she requires the letter, I found the only provider on my insurance that deals with HRT in transgender patients and no where to go in the future after I get my letter. Fingers crossed she does informed consent, but if not at least something good came out of this.

On another note, ever since I finally came out as a trans guy, I found myself seeing more and more positives even with very negative situations. Before I was very negative, in fact, everyone called me a pessimist and got mad at me. Now that I'm on my way to being the me I've always wanted to be, I am so much more optimistic. It's crazy what the slightest bit of joy can do to someone. Now I'm even more optimistic than the people who got upset when I was negative. I never thought I'd see the world as a great place to be, but now I do.