Informed consent is becoming more common, but is still a bit of a rare bird. Rarer than that would be a doctor willing to work with a new patient entirely online. Unless you live in a very rural area where telemedicine is common or have already established care, the chances of finding a physician willing to work with you remotely are very low.
BUT - the number of appointments you need to begin and maintain HRT are really very low. You should expect to meet with a doctor once or twice before starting HRT, quarterly for the first year as you find an appropriate dose, and then once or twice a year after that. They would be able to email or fax you a copy of your lab work which you could have done at any lab testing facility (and those are everywhere). So even if your only option is the doctor on the other side of the state, I'm sure you could work something out with their office to limit the amount of traveling you'd need to do. Plus, once you've established care and have a prescription, it is much easier to switch a different doctor without having to jump through hoops. So you could do your traveling to get started and then work on finding someone locally to switch to.
In terms of informed consent:
- If you are not located near or able to travel to a large city, the likelihood of finding someone to treat you on an informed consent basis drops significantly.
- You could try calling Planned Parenthood locations that are accessible to you. Some of them do offer HRT with informed consent, but not every location does so you might need to call around.
- You could consider doing online therapy to get a referral letter for HRT if there are doctors closer to you that will prescribe with a referral.
