Hi there,
I transitioned in place in Alexandria, starting in 2014. I'll be completely done with everything after this summer.
Therapists - I don't have any real advice on. When I was starting out, my work schedule was all over the place and I discovered that there is such a thing as online therapists. I started speaking with one, had a bad experience, switched to another, and got the referral I had been needing for top surgery. The only in-person mental health folks I have seen have been at the clinic I go to for HRT. They (one therapist and one psychiatrist) both wrote me referral letters for my bottom surgery, but I didn't have any real therapy sessions with them so I don't know that I could really speak to how good they were or weren't. They did what I needed them to do.
Doctors - I go to Whitman Walker Health in Washington, DC. They are informed consent based, so I did not need a therapist referral to start HRT. Very, very fast and easy process to get started. It's also very convenient because they have so many things in house. All in one building, I can see my doctor, get labs done, go to a pharmacy, see mental health people, and get legal advice. They also operate on a sliding scale for people without insurance, and take 99% of the insurance policies available in the area. I've never had a bad experience there.
Surgeons - I saw Dr. Fischer in Baltimore, MD for my top surgery but there are closer options available. I just liked her results and experience the best out of the consults that I had. I had a hysterectomy done at GWU Hospital in DC. They do that procedure on transmen all the time there apparently, and I had a great experience with them. I recommend it to everyone. There is a surgeon at UMD who does phalloplasty. I am not sure if she does anything for MTFs, but she is relatively new at it so I'm not going to her.
Laws - No weird laws. Changing your name here is cheap and easy compared to other states. Gender marker is a little more convoluted, but also not difficult. You just need to have your doctor fill out a form, send it to the DMV office in Richmond, and wait for a letter back. Then you take that to the DMV office near you and they update everything. I was born in MD so I'm not sure what the process is to change a VA birth certificate.
Honestly, I have had a great experience here. No issues whatsoever finding appropriate healthcare. All my legal stuff went through very smoothly.
Being in northern Virginia and working in DC, I have never had any issues with people responding negatively to my transition. It's very progressive here. I know the community in Richmond is also very good, and if I were to move anywhere in the state, it would be there.
