Anyone else get the run around with Kaiser?

[missmacyrose]

I have been seen now by THREE different therapists at Kaiser, and still have not received my HRT letter. The first therapist I saw told me that he would do my general intake assessment and my full "gender assessment" would be done at a later session, with the understanding that once the gender assessment was done I would get my hormones. Fast forward 3 weeks later, I saw another therapist because the first one didn't have another appointment available for like 2 months. Second therapist was a bit of a drive too. So long story short, AFTER our session was finished I found out SHE wasn't able to do my gender assessment either. Then 3 days ago, I saw therapist number 3- same deal. They keep scheduling me with therapists who aren't licensed to write me my letter for my hormones. I have another session in 11 days, on the 6th, and they PROMISED me that this therapist could write me my letter, since they said she is like the Transgender department head or something like that. I know she writes all of the SRS letters for people in my area with Kaiser. But what should I do if she still doesn't write it for me? Because I have crossed my fingers for my hormones every single session only to have my hopes shattered, and I'm not sure I can emotionally cope with another no. If she doesn't write me my letter on that day, I think I may be forced to start self medicating. Has anyone gotten a run around like this? Any advice on how to deal with it? I don't want to seem ungrateful because it's still been less than 3 months since I started and I know that's a very fast time to get HRT but still 

[jentay1367]

I would be blunt at that point and ask if their assessment questioms your transsexuality prognosis.  In essence, ask if you're getting the run around. It seems interesting that they keep bouncing you to different people. Almost as if they're trying to get other opinions of you and trying to corroborate it somehow. My therapist used some of the most ignorant criteria to decide if you were trans. For instance, do you sit to pee? do you look at other women's mannerisms to see how they act? She shared those things in the end with me and told me my  letter would have been slowed down in coming if I hadn't answered affirmatively.  You really have to be careful what you tell these people. Unfortunate fact is they're human too, with all the foibles the rest of us have.

[ChloChlo]

Wow, that sounds terrible!  I am curious to see how this turns out for you because my therapist is in the process of referring me for HRT.  I am not sure if she has to send me to see another therapist, or directly to the trans clinic in the Bay area.  At the end of my session Friday she just straight up asked: "Are hormones something you want to do?"

At the time I wasn't sure, but when I got home I sent her a message asking to start the referral process.  Hopefully it doesn't turn into a big long process.  I was scared to start but when she brought it up, but now I can't wait to get the ball rolling.

[missmacyrose]

They are claiming it is an honest mistake scheduling me with the wrong people, and I am generally inclined to believe them based on all my other experiences with Kaiser... they are very trans friendly as a whole. However mistake or not the point is I am completely ready to start HRT and it's just their slow system impeding my progress, which is IMMENSELY frustrating. Apparently, Kaiser only has a limited number of therapists in this area who are able to do the full "Gender Assessment" which is an extensive form they fill out that takes the whole therapy session to complete, and it's the answers you provide there that gets you your letter. I don't want to be the type of person to give ultimatums to people but I plan to tell me therapist that if she doesn't write me my letter I will start self medicating, because I have to wait 3 or 4 weeks between each appointment and I cannot wait that long anymore to start my HRT. Not being on my hormones yet is a constant source of extreme anxiety and distress that consumes almost every second of my life... I think about it constantly, morning to night, from the moment I wake up to the moment I go to sleep, I think about HRT and how badly I NEED it.

[Michelle_P]

The California Kaiser operations have had some staffing contract problems in the Psych department that led to early retirements at the end of last year.  (Retirees after the end of 2016 apparently got much worse medical benefits!  Awesome action for a HMO...).   They're more than a little short-handed.

Generally, once you are seen by a gender therapist you can get on HRT.  Kaiser uses a modified informed consent system.  Ideally, you have an intake session, another gender identity assessment session, and then if all goes well, you get an electronic referral to an endocrinologist.

There are not many gender therapists in the Kaiser systems, and there may be a lack of training on gender issues in many facilities, which can really slow things down.  It's best if you can get connected early to the regional gender issues clinic, the Multi-Specialty Transitions clinic in Northern California, for example, or in Southern California the transgender care nurse coordinators can be reached through the Patient Contact Line at 323-783-0575.

(It took me a while to figure this out.  Finally I just asked my gender therapist if I could start HRT.  She turned to her computer, typed for a second, and asked me if I preferred a morning or afternoon appointment.  I said either was OK, and she said "How about tomorrow at 11?  Dr. C is really good and I've worked with her before."  Um.  OK!  The next day I got a quick check, a short interview from the endocrinologist, and a prescription after signing the informed consent paperwork.)

[missmacyrose]

Thank you very much for the information. There are ten days until my next appointment and I feel like this is really the one. Apparently this therapist writes a lot of letters and my other therapist told me that basically every trans patient in this service area ends up meeting her eventually, so that gives me high hopes that she will give me my letter. And WOW, they got you an endo appointment the very next day? That's amazing. I hope it goes that quickly for me. I'm a very anxious person and it's on my mind constantly.

[missmacyrose]

Just to update: I got my referral today! My therapist said she would push it through in the system and Kaiser's endocrinology department should be calling me to schedule my appointment some time today!

[Michelle_P]

There you go!

Congratulations!  The secret is perseverance, and discovering which buttons to press in the Kaiser machine. 

[jentay1367]

There you go!

Congratulations!  The secret is perseverance,

Amen...That....is a Universal Truth