Therapy is a relative thing i guess, I think I went 3-4 times before getting the greenlight for hormones. I had already been doing them blackmarket (not advised) but think that played in somewhat in the decision to get an MD. I also joined a support group awhile Once you start the mones you can expect changes to become permanent at 6-8 months, in the meantime stay in tune to your inner self Read the literature, be an informed consumer. For myself I feel so much more creative on the pills. calmer, more in control and just felt right....Thing with mones and SO issues, is that she may not want you having breasts, best to be honest and talk it over ahead of her finding your stash of pills..Once you start the mones, you can quit at any time, if you are truly male, the loss of function of reproduction capacity will return after a bit, I never noticed a loss of erections some do, but the orgasms change in focus and intensity and ejaculate becomes clear fluid after awhile...they usually give you spironolactone ofr other antiandrogen along with the estrogens... your therapist (they aren't cheap) should explain all the options for you