Hi,
I just wanted to share my experience with getting therapy and testosterone in south central/south eastern Pennsylvania because I had some trouble figuring out what to do and where to go and some of the posts on it were a few years old.
I live just south of Lancaster city, and I figured out through research that my options for having therapy and medical stuff done at the same place were Alder Health Services in Harrisburg and the Mazzoni Center in Philly. I then realised it would suck to have to drive an hour or more every week for therapy, but then I figured out that Alder Health actually has a new(ish) office at Liberty Place in Lancaster city.
Some background info on me is that I'm 19, but only recently figured out that I've been trans this whole time because I've only recently figured out what being trans actually is. I also don't have insurance. This is just what I experienced in this process so don't expect your process to be exactly the same! It varies for everyone!
Step 1: Therapy
I called Alder health and asked for the Lancaster office. I explained that I wanted to see a gender therapist so I can get my letter to start testosterone, and then I made an appointment. It ended up being less than a week from the day I called, which I thought was pretty good. My therapist's name is Alexis Lake and she's there on Tuesdays (and at her private practice in Lititz on some other days idk). For the first appointment, you are told to come a bit early for paperwork and to bring income documents. The appointments are 50 minutes and Alder has a sliding scale fee, so each appointment for me is like $40 (I make $260-300 a week).
For my first appointment (May 30th 2017), one of the first questions she asked was why I'm there. I said right away that I'm there because I've decided I want to start testosterone and I need a therapist's letter. The rest of the appointment was pretty much me crying and trying to explain stuff while crying. I asked how many visits it usually takes before I can get my letter, and she said the fewest it's ever been is 3, and that there was only one time that she didn't write a letter for someone and it was because of emotional/anger problems and she didn't feel comfortable doing that yet but then the guy just went somewhere else. She's worked with hundreds of trans patients, she said.
One thing I noticed is that almost every appointment I would have to remind her of something I said in a previous appointment, because she doesn't write down everything. Which is good if you don't want her writing everything you say down, but I found it slightly annoying that I had to keep reminding her about things. By the 3rd or 4th appointment, the topic of coming out to my family, and everyone else, came up. I hadn't come out to my family yet, so we made a plan for how I would come out, to who, and in what order. I think that if you're already out to everyone you'd be able to get your letter a lot sooner.
On my 5th appointment, with a bit of pushing, she said that I could make an appointment with the doc in the Harrisburg location. Unfortunately, they can't do HRT stuff in the Lancaster office. This 5th appointment was a week before July 4th (also a Tuesday) so my next appointment was scheduled for the week after July 4th, July 11th. The next day I called Alder Health, explained that I got permission from my therapist to make an appointment. I got an appointment a lot sooner than I was expecting, July 10th. I knew my therapist was a little hesitant about writing the letter right away, but I found her email address and explained that my appointment for HRT was before our next meeting but that I really want to keep the appointment so I could start T as soon as I could. She said that I could keep the appointment and that she would write the letter.
I was worried that she would forget or not have time, so the Thursday before I asked if she would send it to me or if she would send it directly to the office. She sent me back a draft and asked if there was anything that should be changed. My name was spelled wrong and one detail could be omitted and I replied with that very promptly and then waited. The day right before, a Sunday, I was worried so I emailed again. She then finished it and emailed it to the doctor she thought I would be seeing at Alder that night. It came pretty close, but it worked out okay in the end.
Step 2: Bloodwork
My first new patient appointment for HRT was $100 paid up front (this is listed on the Alder website, the follow up appointment will be $75). It was in Harrisburg on N Cameron St, about 50 minutes from me. They took my weight and then I waited in a room for a doctor. She did normal physical stuff, like looking in your ears and eyes and checking your reflexes. She asked about medical history, and about what medical problems my family members have. Just normal new patient physical stuff. The big thing about the first appointment is that you'll get bloodwork done. She saw I didn't have insurance, and asked me if I new how much the blood work would cost. I said not really, how much? And she said like $300-400 depending on the lab. I will update this post when I know the price. She also said that it only takes a few days for the results, so they will contact me when they have them. She also told me what prescription I'll get so that I could look around for the best price. I later searched on
GoodRx.com and 200mg in a 10ml bottle was like $50. She also said I would start injecting every other week, and that I'd need bloodwork done every 6 months. Then my blood was taken (should have been taken).
I guess I'm thin and have bad veins or something, but the assistant guy was the one that was supposed to take my blood. I came in with complete confidence like I was going to be really manly about it, but he stuck the needle in and all I heard was "oh ->-bleeped-<-". He tried again on the same arm, but blew out my vein, and none of my blood got in the tubes (I think I had to fill 3 tubes). He then said he couldn't do it, and that he would give me a lab order so I could go to another lab to get it done. At this point in time I was really concerned. Like that's pretty dumb... but there was a lab like half a mile away, so I drove there and signed in and waited. The nurse there also saw I didn't have insurance, and took the lab order to check what the price for me would be. She then came back and said $693. So I said "oh..okay I'll try somewhere else". Lol. I got really mad at being in this whole situation, but I called Alder Health back and said that it would be that much, and that I'd wait for the doctor to be able to try to take my blood. They said I should come back there and that they will take care of it. So I went back right away and the doctor took my blood a different way and then sent me home.
Step 3: Prescription
The next day, when I told my therapist what had happened, she said that they handled that pretty poorly and that that whole thing shouldn't have happened. Her and the recepionist who's worked with Alder for awhile said that it would be brought up in a meeting so it doesn't happen again. I asked about what would happen at the next appointment, and they cleared it up for me. If my bloodwork is okay, I will go back for the follow up appointment and get my prescription. Then, I can pick up my prescription (there's a CVS 5 minutes away from there) and go back there to learn how to inject it. I just have to let them know that I'll be back for that, or if you want to do it another day you just have to tell them when you will be back. I'll probably update this post when that's all done.
Hope this helped someone figure out what to do or at least know what to expect. If you have a question I didn't answer you can message me.
Here are the other posts I found when I was trying to look stuff up,
https://www.susans.org/forums/index.php/topic,213976.msg1895896.html#msg1895896 https://www.susans.org/forums/index.php/topic,192680.msg1722584.html#msg1722584
