Has anyone here tried "Informed Consent" for HRT

[Sofie L]

Here in Ontario, the Ministry of Health seems to have adopted a simplified Informed Consent model, where family doctors are being encouraged to undertake complete control of ushering their patients along their gender transition path. This has been in response to the insane wait times at what was previously the only gender program provider in the province. Unless my HRT runs into complications, my GP doesn't foresee me needing to see an endo, or anyone other than herself for that matter. My GP will eventually be able to sign me off on my surgeries, as well. Very simple, with minimum stress. I read the horror stories of people in other jurisdictions, and I know how lucky we are in Ontario now. 

[arice]

Here in Ontario, the Ministry of Health seems to have adopted a simplified Informed Consent model, where family doctors are being encouraged to undertake complete control of ushering their patients along their gender transition path. This has been in response to the insane wait times at what was previously the only gender program provider in the province. Unless my HRT runs into complications, my GP doesn't foresee me needing to see an endo, or anyone other than herself for that matter. My GP will eventually be able to sign me off on my surgeries, as well. Very simple, with minimum stress. I read the horror stories of people in other jurisdictions, and I know how lucky we are in Ontario now.

Wish Alberta would move that way too... currently hanging out on the waiting list for our GIC. My GP is awesome and incredibly supportive so I wish he could do more to help me along.

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[ChiGirl]

Informed consent is the only option around here. I've generally been very happy with, but my doctor isn't always accessible.  But that's as much because of the way the clinic operates as anything. I also have a GP who is trans friendly, but doesn't prescribe HRT.  Between the 2 docs, I'm pretty well covered. Other than hearing twice as often how I need to lose weight! 


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[KathyLauren]

Oh, well they called it informed consent at the office but that does make sense that it wasn't informed consent.

Yes, technically, all HRT treatment is by "informed consent".  You have to sign off on informed consent in all cases, even after mental health evaluation by a psychologist as recommended in the WPATH SOC.  No doctor carries the kind of liability insurance that would be required if they didn't have you sign your informed consent.

The "informed consent model" being discussed here differs from the WPATH model in that there is nothing else except informed consent.

[Korra-]

The reason I ask is that I have my HRT appointment coming up and I was curious what sort of success people have had with this route. My provider seems to be supportive, but I am their first transitioning patient so they may be a bit apprehensive. Do you think if I bring a letter of Informed Consent it might help my chances of starting HRT sooner? Thanks in advance for the advice.


Darcy

Sadly no. None in my area I've had to rely on self medding for my whole transition

[JoanneB]

I've gone the "Informed Consent" route. Knowing I was trans 50 years left no question in my mind and dealing with being trans for about as long also left no doubt as to what I really needed to do to take on the Trans-Beast.

Part of taking on the beast was seeing a therapist, mostly for all the associated baggage. I know many only see one just for the coveted "Letter" which I always saw as the "CYA Letter" for the doc. Nothing like having some backup if/when the court summons shows up in the mail

[AnneK]

Oh, well they called it informed consent at the office but that does make sense that it wasn't informed consent.

I think it just means you consent to whatever treatment you're getting.  They're making sure you understand, so as to avoid surprises and lawsuits.  I had that at the dentist recently, when I had a tooth pulled.

[JeanetteLW]

LOL  If that means researching what I could find about HRT and starting on it. Then telling my doctor and having him agree and getting a prescription and doing it right, then yes.  I did it a little backwards.
   The VA does work on an informed consent basis following the Wpath Standards of Care. They don't ague with you about being trans. They do confirm with you that you believe you are trans and provide services to facilitate your transition short of surgical or cosmetic procedures. I read something in their literature that they should get informed consent paperwork done but I haven't actually had it done yet.
   
   This isn't probably what the topic was intending but it is along those lines.

  Hugs,
    Jeanette

[FTMax]

LOL  If that means researching what I could find about HRT and starting on it. Then telling my doctor and having him agree and getting a prescription and doing it right, then yes.  I did it a little backwards.
   The VA does work on an informed consent basis following the Wpath Standards of Care. They don't ague with you about being trans. They do confirm with you that you believe you are trans and provide services to facilitate your transition short of surgical or cosmetic procedures. I read something in their literature that they should get informed consent paperwork done but I haven't actually had it done yet.
   
   This isn't probably what the topic was intending but it is along those lines.

  Hugs,
    Jeanette

If they are following WPATH standards of care, they are not simultaneously following informed consent. They are two different models.

[JeanetteLW]

If they are following WPATH standards of care, they are not simultaneously following informed consent. They are two different models.

  The VA does what it does. I may have been mistaken in regards to the WPATH reference as I cannot now find a reference to it. I did find a reference to informed consent.

This is from the VHA Direct 2013-003 Q&A
VHA DIRECTIVE 2013-003 February 8, 2013

A-3
8.  What are the guidelines for clinical care and the informed consent process?

a.  Effective clinical care for transgender and intersex patients ideally involves an interdisciplinary, coordinated treatment approach with special attention to the needs of the individual patient and collaboration among multiple specialties, notably:  gynecology, mental health, primary and specialty care, women's health, pharmacy, and urology.  For all treatments and procedures, informed consent and shared decision-making needs to be the basis for individualized care that weighs the possible benefits and harms, with an emphasis on the lowest (safest) dose to achieve benefits.   

b.  For treatment plans that include cross-sex hormone therapy, VA clinicians must, consistent with requirements of informed consent (VHA Handbook 1004.01), discuss the risks, benefits, and limitations of cross-sex hormone therapy with the patient.  Signature consent is not required for cross-sex hormone therapy.  Ongoing monitoring of treatment is required.

  Hugs,
    Jeanette