Informed Consent, Family Doctor, Gender Therapist

[Jennagirl]

I am hoping that you can share some of you experience with me.

I finally realized a month ago that all of the negative feelings and frustration that I have been experiencing for the past 15-20 years has to do with gender dysphoria. Can we say light bulb moment? Not usually a slow thinker but damn, 40 years is along time to finally realize something that is right in front of you the whole time! I want to start HRT and be the women I have wanted to be for many years.

I have reached out to a gender therapist and have been put on her wait-list . While I've been waiting, I have spent time on Susans reading a lot about everyone's experiences.

Should I start by outing myself to my family doctor and risk that they say they wont help and now have to deal with that embarrassment every time I have a Drs appt? I know a place 35 minutes away that uses the informed consent method. Do I delay things by waiting for a call from the therapist?

How does insurance handle these things?

Sorry, a lot of questions but I know there is a lot of experiences out there also.

Thanks! Jenna

[Dena]

Welcome to Susan's Place. The safest way to handle this is to handle this is to see your therapist for an appointment or two before moving forward. In the therapy session, you can develop a game plan and go from there. The one exception would be if you have a wife. In that case, if you think she would be receptive, telling her first would be a good idea as secrets will cause friction that you will have to deal with latter. In the case of a marriage, this thread would be useful.

While starting on HRT is important, facial hair remove should also be started early as it's time consuming and you may need to have hair grow out before it can be removed.

The best advice on insurance is to read the policy. Some insurance companies will cover treatment and others don't but it will be stated in the policy.

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[Jessica_Rose]

I wanted my treatment to be as stealthy as possible, and I did not want to wait. I found an informed consent physician about an hour's drive from my home and signed on with a primary care physician at the same location. I did not want anyone around my hometown knowing anything about my visits to the doctor.

I have been on HRT since late March 2017 and so far only two people know about it - my wife and my electrologist. A few folks have made comments about my hair getting longer, but no one has said anything about my slowly changing appearance. I am 6' 1" and have lost about 20 pounds (from 185lbs down to about 165) and no one has commented.

My insurance covered the doctor visits and all of my medications, no questions asked. Although when I picked up my initial supply of estradiol patches the lady clerk at the pharmacy counter was a bit confused, but now all my meds come in the mail so explanations are no longer necessary.

As many folks have said, 'this is a marathon, not a sprint'. Take your journey at your pace under a physicians' care and you will finish the trip safely. Welcome to Susan's, and I wish you the best of luck on your journey!

[Jennagirl]

Thank you Dena for the links.

Thanks Jessica. I will start with call the insurance company. I work for a Catholic hospital so they actually add restrictions beyond what the insurance and pharmacy company's normally cover.

Has anyone had problems discussing HRT with their primary doctor?

Thanks
Jenna

[ainsley]

Has anyone had problems discussing HRT with their primary doctor?

I self medicated for years, then went to my family doctor and told her what I was doing and asked her to prescribe for me so I didn't risk harm to myself anymore.  I showed her the section in WPATH where this was the preferred option for a doctor presented with someone like me (self medicating), rather than turning me away and leaving me to the self medicating without monitoring my blood levels.  She agreed and prescribed and monitored me.  She left the state and moved to North Dakota, so I went to another family doctor in a different system and established care and told her how I came to be on HRT.  She continued my care and is still doing so today.  I have never had any problems with a family doctor and HRT. 

[Jennagirl]

Thanks Ainsley, I have thought about using herbs or other sources  off and on for years and always chickened out before actually doing it. I am glad it worked out for you.

[Jennagirl]

I guess my question is with all the different options of Plan Parenthood, signed consent, endocrinolgist, and therapist, what have you done? Is there a good or bad way?

[Devlyn]

I know you're asking about hormones, but if you want surgery down the road you're going to need a therapist letter. Now on to the shenanigans. 

I went the "unapproved" route, using herbals for feminization. I got good results. When the increasing penalties on not having health insurance and increasing risk of not having it collided, I got health insurance. My first appointment was at the informed consent clinic and I was on HRT a week later. I'm getting an orchiectomy this summer, if they need a therapist letter I'm buying one from someone known for getting it done in one appointment.

Therapy is great if you need it. Not so much if you know who you are and what you want from life. 

Hugs, Devlyn

[Dena]

If you are very sure of yourself, planed parenthood/informed consent may be the way to go. I favor some therapy as it provides a check on your thinking and allows you to work through any issue that could latter prove to be a problem. A therapist who wants more than half a dozen visits before starting you on HRT when you are ready should have a very good reason for delaying HRT. If they don't, you may have the wrong therapist as HRT helps you deal with the biological aspect of being transgender.

[Rambler]

I went with an informed consent route at a local LGBT clinic about 40 minutes from my house because it was the most convenient and cost effective, even with my insurance plan. I started in mid-April and was able to leave from my first appointment with two fistfuls of prescriptions. That being said, I also stopped and decided that I had to start seeing a therapist when I came out to my wife in December of last year. I never asked her for a letter, but we were both more than comfortable with it by the time I made the move. The only reason I didn't early was some things I was sorting out in my personal life. Before going informed consent I did speak with my family doctor. He and his wife (office administrator) were able to give me some resource info because it turned out they have a trans son who had just came out within the last few months. He said he didn't have the experience to feel comfortable starting me off on hrt but suggested he would be willing to take on care once it was established.

[KathyLauren]

I went the WPATH route, referring myself to a therapist first.  After a few sessions, I had my letter for HRT and a referral to a local clinic that did HRT for low-risk patients.  I kept my regular doctor informed of these developments, but she has no involvement in my treatment.

There were delays due to long waiting lists.  The government health system would have had me wait four months for my first therapy appointment, so I paid for a private therapist.  I still had a four month wait to start HRT.  I was lucky, because the higher risk folks that get referred to the endo have to wait eight months or more.

I have had no issues coming out to anyone, and I am now full-time.  I came out to my wife before starting any of this.

[Jennagirl]

Devlyn, I am talking about HRT but I hear you with the therapist. Since the day I finally admitted to myself that I am trans, I have been trying to schedule an appointment with a therapist that has experience with Gender and Trans patients. I am on a waitlist for one and another is really expensive and only takes payment upfront and will give me an invoice to submit to insurance company.

I have an appointment next Friday for a physical and I am going to discuss it with my Dr. If that doesn't go well, I will probably go the informed consent route. I know it sounds like I am trying to rush this but I have lived in a very unhappy state for a long time because I was slow to pick up on all the signs that were everywhere. Now that it is very clear, I want to move forward.

I will let everyone know how the appt goes next Friday.

[Julia1996]

I started with a gender therapist and she gave me a letter for hrt. A gyn does my hrt . My dad is the one who found him. I was 17 when I started so I had to have parental consent plus the therapist letter. I'm still on my parents insurance and it covers everything.