Endo is being difficult :(

[Madison2002]

Things had been going far too smoothly, I figured my luck would run out some time... I came out to my family and general practitioner, then found a gender therapist easy-peasy. Now today I visited my endocrinologist. It was the 2nd time I had met him, though the first time was for a checkup on an incidentaloma, and I only came out to him today.

He says that I need a note, though he was very unclear on a note from whom. I assumed a therapist, though he said "no no, those ones can't prescribe medicine. I can't quite remember what they're called...". Does he want a note from a psychiatrist? I've never heard of an endo wanting one from specifically a psychiatrist? I've always heard that a therapist with a master's degree was all that was required, though I have no idea who makes the rules on this stuff... He did say that he has 10 transgender patients, so he's not totally hopeless. I asked him if a note from my primary physician would work instead, and he said that it would "help". What does that even mean?

Should I try to get my therapist to write the note anyway? She has already said that she's more than willing to do so. Finding a psychiatrist, let alone one willing to write a note, would be so time consuming...

[Devlyn]

Welcome to Susan's Place!

It's hard to tell who's being vague from your post. Generally a diagnosis is what they're looking for. If you just told him about transgender today, of course you weren't sent home with hormones. Call and clarify what he's looking for. The WPATH Standards of Care lay out the criteria and responsibilities of each medical provider.

https://www.susans.org/wiki/Standards_of_Care_for_the_Health_of_Transsexual,_Transgender,_and_Gender_Nonconforming_People

Hugs, Devlyn

[Northern Star Girl]

Things had been going far too smoothly, I figured my luck would run out some time... I came out to my family and general practitioner, then found a gender therapist easy-peasy. Now today I visited my endocrinologist. It was the 2nd time I had met him, though the first time was for a checkup on an incidentaloma, and I only came out to him today.

He says that I need a note, though he was very unclear on a note from whom. I assumed a therapist, though he said "no no, those ones can't prescribe medicine. I can't quite remember what they're called...". Does he want a note from a psychiatrist? I've never heard of an endo wanting one from specifically a psychiatrist? I've always heard that a therapist with a master's degree was all that was required, though I have no idea who makes the rules on this stuff... He did say that he has 10 transgender patients, so he's not totally hopeless. I asked him if a note from my primary physician would work instead, and he said that it would "help". What does that even mean?

Should I try to get my therapist to write the note anyway? She has already said that she's more than willing to do so. Finding a psychiatrist, let alone one willing to write a note, would be so time consuming...

@Madison2002
Dear Madison  I see that our lovely member  @Devlyn  has already responded to your questions in your very first posting here.   Other members will be along to answer some more of your questions and concerns.
   
I am so glad that you have just become a member of Susan's Place and that you have shared your interesting and detailed posting with the members here on the Forums. 

I am thinking that you may have lots more questions and concerns, this is the right place for you to be to find out what others have done that may have been in your circumstances.
Be aware that there are a lot of members here that can identify with your situation as you feel free to share it.

Please allow me to warmly WELCOME you to Susan's Place. 
You will find this a safe and friendly place to share with others  and to read about others similar trials, tribulations, and successes.
It is nice that you had signed up so you can share with others and involve yourself with some give and take with other like-minded members.  When frustrated or if you have successes you can share it here if you wish and receive support from others and offer support to others. ....
***It's a very good chance that you might find that you will make some new friends here. 

Please come in and continue to be involved at your own pace. 
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Please look closely at the LINKS in RED, answers are there to many questions that new members ask.

Again, Welcome to Susan's Place.
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[Northern Star Girl]

@Madison2002
Oh, and another thing Madison:
Please stop by the  Introductions Forum  to tell the members about yourself.  You can include some brief information from your first post here on this thread so other like-minded members will be able to share with you and you with them.

Enjoy your time here on the Forums, I trust that you will find this an enjoyable and informative experience.
Best wishes to you.
Danielle

[Alice V]

Hey, Madison!

I'd say depends on your location.
In my country endo requires conclusion of commission that contain psychiatrist, therapist and sexologist. I heard in some countries it's enough to have diagnosis from therapist.

Also welcome here Hope you'll enjoy this place

[Kendra]

One benefit of a local therapist is they maintain a list of local professionals - they usually know who is easy to work with and has good results.  I'd ask your therapist if your current endocrinologist is one they are familiar with.  It's possible you might want a different endocrinologist. 

[Madison2002]

Thank you all for your responses. I live in the United States, and as for the WPATH link posted earlier, my therapist meets all those requirements, "A master's degree or its equivalent in a clinical behavioral science field". I was thinking about printing off that page and showing it to the endo, assuring him that my therapist meets all the criteria. Are endocrinologists obligated to follow WPATH? Is WPATH affiliated with NIH or any other big names?

[Kendra]

Following WPATH helps assure a medical professional they're less likely to run into a situation where you change your mind because you weren't adequately evaluated or didn't have access to accurate information.  This is more of a concern for things that are medically irreversible.  Insurance coverage may require WPATH.   

Since you're in the US, another option is an Informed Consent clinic - Planned Parenthood.  Informed Consent assumes adults can make this sort of decision on their own.

If you have an approval letter written by your therapist and they have a Masters Degree or higher your endocrinologist should be fine with that.  If your current endo refuses to accept the letter I suggest find a different endo.  If they are a qualified medical professional they should be familiar with WPATH.

[kaitylynn]

My endo never asked for the referral letter my therapist provided me, but she did verify my therapist and I worked together.  My surgeon for BA required a referral letter before he would conduct my surgery.

Those sort of referral letters are the only ones I am aware are needed to adhere to WPATH guidelines.