Do you have to go to Therapy to start Hormones?

[MissNatalieL]

I am a 23 year old Transwomen, and I have recently talked to my doctor about being Transgender. She was amazing about it and said she has dealt with quite a few Transgender people, so that made me feel very comfortable!

Why I was talking with her she mentioned a couple times that whenever I am ready, to come back and see her and she can help me start on Hormones. I was a bit iffy hearing that because I grew up thinking "who I am isn't normal and is wrong, so it's better to just keep it to yourself and not do anything about it". I told her pretty much that and she had told me to check out a couple Therapists, and that after talking with one I will start to feel more comfortable about who I am and if I really do want to make that transition or not. We talked for maybe 15 minutes about it, but despite her telling me to see a Therapist, the last thing she told me was still "whenever you are ready come back and see me and we will get you started".

After I left the office I was the happiest I had ever been in years! She changed my whole look on everything, and helped me realize that hey, it's not impossible to be who you really want to be, in this day and age people are becoming a lot more accepted with it, even more than they were say 10 years ago, and that it is easier than how I had originally imaged to become who you really want to be! I went into that office planning to talk to her about it and just see to what she had to say, and came out a whole new person. It has been about a week since I went, and every day I grow more and more ready to start hormones, as I am ready to be the women I really want to be...

I have been meaning to call the Therapist she recommended, but I have been a little nervous to, manly because I am not a person that likes to talk out things to people, especially professionals, and as of right now I really don't feel like I need it... I am not unhappy with feeling like I can't do it anymore, and the voice in the back of my head has changed from "yea you could do it, but you don't have the kind of money to afford it" to "I wonder when I will start to see me change !?".

My question is, do I really need to see a therapist before starting hormones? Is there something that the therapist needs to tell my doctor to say "yes, shes ready" or is it just something that would help me out? Like could I get a therapist after I have started transitioning if I really felt I needed one why going through all the changes in life?

[sarah1972]

It may depend on your doctor. Most try to follow the WPATH standards of care which recommends a letter from a therapist. But there is no mandate.
What is important is proper medical supervision of hormone treatment but that should be the case if your doctor made the offer.

Therapy may help you navigate through the process and provides a safe ground to discuss your feelings and your progress.

If you ever plan on surgeries it is also good to have a history of therapy since there are very little surgeons willing to do anything without the two recommended letters.

Best is to ask your doctor.

[MissNatalieL]

Thank you for the reply

I had just contacted my doctor with it (I am so glad my doctors office has a messaging system right on there website ), I will most likely hear something back within a couple days, a lot quicker than if I were to make an appointment.

My doctor was the one that had brought it up though... I *WAS* always curious about Hormones, but as I said, I grew up with "no that's wrong, you can't do that" so it was shoved to the side quite quickly, but just talking to her about how I have always felt and been, she just, what seemed like out of nowhere said "whenever you are ready to start hormones come back and see me".

Yes I have heard though that you need supervision why taking them, and she will definitely be the one that does that as she is amazing! I am a quite healthy person though, 6' tall (I used to like that but now I wish I was shorter ), 145lbs, never had problems with blood pressure, blood sugar, anything along those lines, and my only medical conditions are IBS (diagnosed in 2002), Depression (diagnosed in 2006 (and yes it was transgender related) but I am since "cured" and it has not affected me for about 3 years), and now Gender Identity Disorder...

I am quite sure I will find a therapist when changes start to show, as that will be the hardest point for me, that moment where people start to realize what is going on with me, just to talk things out about what is changing in life for me and what is happening in it, as I wont have any family members that would listen to me about it. So I might even consider finding one now just to see a couple times so they know me from the beginning.

Edit:
If I remember correctly she had actually brought up me starting hormones before giving me the information about therapists. She also told me that where I live (Michigan, USA) is a pretty good place for Transgenders, as most of the resources are around where I live, the furthest I believe she said was a Surgeon that was about 2 hours away.

[Dena]

Welcome to Susan's Place. I am a firm believer in some therapy. The reason is a bit complex but for starters their is always doubt in our mind that makes us wonder if this is the correct decision. Next is therapy deals with life issues as well. We accumulate a lot of damage before we ever face up to this and we continue to deal with it during our transition. Therapy helps us work through these issues cleaning up any emotional baggage we may have. Therapy is also needed for some of the medical services we want like HRT and several of the surgeries.

If all of the above items are addressed in therapy, you will be able to enter your new life free of the past and it's much more likely your transition will be successful. I found this to be true in my life and I have no regrets about the therapy I received.

If you fear therapy, you might want to look at "the transition channel" . Part of your therapy will be something like this. There are no trick questions and often there is no wrong answer. Often it's just exploring ideas making your thoughts clear in your own mind.

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[Lady Sarah]

The short answer is "NO". I got started on HRT without a therapist letter. However, if you are not on HRT, most physicians will not prescribe it until you have such a letter to show them.

[MissNatalieL]

Thank you all for the replies I have wrote my doctor, I should expect a message back tomorrow or Tuesday to see what she has to say with me starting Hormones before Therapy, so I will let you all know.

I think tomorrow I am still going to call the place she had gave me to talk to them about getting starting with therapy as well though, I just hope it's not to expensive . She said that my insurance company is quite good when it comes to Transgender related things, and that I shouldn't expect to pay more than $60 per visit, which she said would only be about once a month, MAYBE twice a month, does that sound about right?

I do know what you mean though Dena. My past is a bit... messed up... to say the least. To sum it down as short as I can make it, when I was 12 I seen a story on the news of a Transwomen who had lost her job, her family, her friends, pretty much everything because she transitioned, I had instantly went into depression after that because I knew that's how I was and that would happen to me if I ever came out about it. Fast forward 2 years (and many sleepless nights and suicidal thoughts later) and I started Antidepressants, they helped but I got addicted to them and at age 19 I quit them. I have been off them ever since and depression free since age 21, so yes, my past has had the best of me at times, but currently in my life the only thing happening right now is wanting to start hormones finally. That is the only reason I am iffy on Therapy (right now) because as of right now the only thing on my mind is what I have to do to start hormones, and if I were to go to therapy I am unsure what I would talk about, apart from my past that I don't worry about anymore. I am sure you can tell I have never been to any type of therapy before though...

[Devlyn]

It sounds like she will prescribe on informed consent, that's great. Your concerns about talking to doctors are common, I feel the same way. I went informed consent for HRT, then decided to get an orchiectomy. At that point, two letters were necessary, one from a therapist, one from a psychologist. Both were single appointment one hour deals. It's not as scary talking to them as you expect.   

Hugs, Devlyn

[MissNatalieL]

It sounds like she will prescribe on informed consent, that's great. Your concerns about talking to doctors are common, I feel the same way. I went informed consent for HRT, then decided to get an orchiectomy. At that point, two letters were necessary, one from a therapist, one from a psychologist. Both were single appointment one hour deals. It's not as scary talking to them as you expect.   

Hugs, Devlyn

It feels so nice and comforting having someone tell me exactly what I want to here, hehe Thank you so much though I am hoping it all goes how I want it, but will be happy either way. Have you seen a therapist for anything other than an orchiectomy?

[Devlyn]

No, first and only appointment with a therapist.

I was upfront about not desiring therapy because I know who I am and what I want. The questioning phase is well behind me, I think that is a critical point. I walked in well dressed and confident in myself.

Hugs, Devlyn

[MissNatalieL]

That's good! That is how I feel, I am not questioning it anymore. My earliest memory I can remember is my mother letting me paint my nails, and come almost 20 years later and that hasn't changed at all... I am just ready to get started at this point, and I am so excited for the day I get to start.

I heard back from my doctor though, she told me she can not prescribe the hormones, and that when she said to "come back so she can get me started" it was her referring to sending me to a specialist that will prescribe them for me. Despite me not going to therapy she still said she would send my referral to them (and has told me she already has), and told me congratulations, so that is sounding like good news! I guess I should be expecting a call from the specialist as my doctor only said she was sending the referral. But I also called this morning and set up an appointment to see the therapist she recommended, I see her on November 6th, so depending on how quick I get to see the specialist, I may go to therapy before then anyway.