Informed consent

[LJfusion]

I have my first appointment tomorrow with my gynecologist(only doctor covered by my health care plan that does HRT) and I figured tomorrows appointment was going to be blood tests and health questions to make sure I was healthy enough to start HRT when I finally got my therapists letter which I believe is about a month away.
However, I just found out that not only is the OBGYN the only one on my health plan that will even talk about HRT, but she also does informed consent! They called me to explain what may happen tomorrow and they said since I don't have a letter yet they will have me sign a consent form for HRT.
So my main question is will I get to start hormones tomorrow or does informed consent take some time(like two appointments or so)?
The other questions I have I believe I already know the answers too but I want to be sure:
1. They said they will need to do a breast examination. I am not comfortable with my breasts being acknowledged let alone being touched. I think it's required for health reasons before starting HRT. Am I right?
2. They said the same goes for a pelvic exam(luckily not a pap smear thank god!). However, I don't even let my girlfriend see me naked, and I get anxiety just thinking about someone seeing me naked. I don't know what they look for in pelvic exams but I have recently had an ultrasound done and it showed no problems with my pelvic area internally. So I'm reluctant to have this done. Unless it's my only way to start HRT. Would I be able to skip the pelvic exam?

I'm really excited about starting HRT but it seems like the process is going to cause me a ton of emotional distress because of dysphoria.

[KayXo]

They said they will need to do a breast examination. I am not comfortable with my breasts being acknowledged let alone being touched. I think it's required for health reasons before starting HRT. Am I right?

I don't recall ever having a breast exam before the start of HRT. Probably wants to check for cancer or some abnormality, just in case.

They said the same goes for a pelvic exam

Same as above. Never had one. Is done in ciswomen due to uterus and cervix.

I have recently had an ultrasound done and it showed no problems with my pelvic area internally.

You should advise them of this and provide them a copy perhaps.

I'm really excited about starting HRT but it seems like the process is going to cause me a ton of emotional distress because of dysphoria.

Good luck and I'm sure it's nothing. Don't worry about it.

[WendyA]

So my main question is will I get to start hormones tomorrow or does informed consent take some time(like two appointments or so)?
The other questions I have I believe I already know the answers too but I want to be sure:
1. They said they will need to do a breast examination. I am not comfortable with my breasts being acknowledged let alone being touched. I think it's required for health reasons before starting HRT. Am I right?
2. They said the same goes for a pelvic exam(luckily not a pap smear thank god!). However, I don't even let my girlfriend see me naked, and I get anxiety just thinking about someone seeing me naked. I don't know what they look for in pelvic exams but I have recently had an ultrasound done and it showed no problems with my pelvic area internally. So I'm reluctant to have this done. Unless it's my only way to start HRT. Would I be able to skip the pelvic exam?

My first HRT visit with my informed consent clinician was about the same as you described.  She waited (3 days) until she received the blood test results before she called me back up, went over the results with me and phoned in my prescription.

[FTMax]

Hi there,

I started hormones via informed consent. I got my prescription at my second appointment. During the first appointment, they filled out all of my medical history, went over HRT, discussed my goals/expectations, etc. The only physical exam I had was a general height/weight/blood pressure check. I never had a pelvic or breast exam for HRT or any of my surgical procedures. You should expect to have blood taken at some point prior to starting. Some doctors don't, but it seems most do.

Honestly though, even if you have to, it's a one time thing. You do it once, then you've got your prescription. Build a relationship with your doctor. Explain to them how uncomfortable you are with exams. That is likely the reason why I haven't had any.

Best of luck to you!

[melissa_h]

I travelled a bit to my first appt, so the practitioner was kind and prescribed first visit, along with doing initial blood work. Blood results came back a few days later and she left med levels at her standard starter dose.

For some, they will do a review of informed consent along with physical/blood work, and then do a second meeting.

May have helped that I'd read the informed consent paperwork a dozen or so times before coming in and could practically recite it.

Not every practitioner will be the same, some may always require blood work first, and I'd wager some may make a snap decision based on observable health and confidence in the process during the appt.


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