Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start

[ChrissyRyan]

As mtfs, many start gender therapy, obtain a therapist letter for HRT, then see medical professionals for blood tests and possibly exams, then they finally have prescriptions for HRT.

With realizations of possible different procedures outside of the USA and for informed consent clinics, which may result in different timelines,

How long after calling a therapist was your first gender therapy appointment?  That is, how long did you have to wait for that first therapy appointment after you called to set it up?

How long after that first therapist appointment did it take to obtain the therapist's letter for HRT?

After receiving that HRT letter, how long did it take to get that first medical appointment?
Some doctors have a very long wait, especially so sometimes for new patients, regardless if in private practice or based at a clinic.

How long after that first medical appointment did it take to have your first HRT prescriptions?
Did you have to see more than one doctor, perhaps your general practioner doctor and an endocrinologist?

Then to sum it all up, what was the total amount of time from calling to setup the first gender therapy appointment to having your first prescriptions for HRT?

Chrissy

[NatalieRene]

My first therapy appointment was the next week. It took a couple of months to get my HRT letter and then it took a month to see my endocrinologist for the initial appointment. I don't remember the exact amount of time, maybe in total 3 or 4 months from setting up the first therapy appointment and getting the prescription for estradiol.

[Kirsteneklund7]

I found I could obtain HRT as fast as I wanted via informed consent. I already had  a months gender therapy under my belt at the time.

When I spoke to an endocrinologist doctor about potential HRT I walked away with a script!

Specialist clinic in Darwin made it very smooth and convenient.

Sent from my SM-G930F using Tapatalk

[AnneK]

I asked my doctor for the referral 3 weeks ago.  Still waiting to hear back from the endocrinologist.  It's informed consent in Ontario now, so no therapist.

[Jessica_Rose]

I live in Colorado. I called for an appointment in mid-January 2017, and the first available one was on 23 March. I went the informed consent route and picked up my estradiol on the way home from the appointment. No therapist letter required.

[Dani]

It all depends on how soon you can get an appointment with your Endocrinologist. I called the day after my therapist gave me the hormone letter and I got an opening within in a few days because of another patient's cancelled appointment.

Just the luck of the call. Other girls have had to wait several months for an Endo appointment.

[Linde]

I think my whole path went slightly different.  I talked to my normal doc, an Internist and semi friend of mine, what is going on with me, and if he could prescribe estrogen.  He said he can't, but picked up the phone and called an endocrinologist.  Bingo, I had an appointment for 3 days later.  Because being TypeII diabetic, I get a blood test done every three months, and I had just one one.  I took the test results with me, and an hour later I had my prescription for Estradiol patches in my hand!
Nobody even asked for a letter from a therapist.  However, my therapist feels that Finasteride alone is not good enough to drive me into fem-dome with high speed, and she wrote a letter recommending higher doses of estrogen and the addition of Spironolactone.
And again, this letter is not required for me to continue to receive estrogen.  I wonder, if it is up to the individual physician to require the recommendation letter for CYA purposes?

[NatalieRene]

I think my whole path went slightly different.  I talked to my normal doc, an Internist and semi friend of mine, what is going on with me, and if he could prescribe estrogen.  He said he can't, but picked up the phone and called an endocrinologist.  Bingo, I had an appointment for 3 days later.  Because being TypeII diabetic, I get a blood test done every three months, an I had just one one.  I took the test results with me, and an hour later I had my prescription for Estradiol patches in my hand!
Nobody even asked for a letter from a therapist.  However, my therapist feels that Finasteride alone is not good enough to drive me into fem-dome with high speed, and she wrote a letter recommending higher doses of estrogen and the addition of Spironolactone.
And again, this letter is not required for me to continue to receive estrogen.  I wonder, if it is up to the individual physician to require the recommendation letter for CYA purposes?

My experience was from 2009 and 2010. Maybe it's changed since then.

[sarahc]

My therapist cleared me for HRT after my first session two months ago because I clearly had been dysphoric for decades, I was very sure I was ready to transition and I had no other mental health problems. Also because she is a highly experienced gender therapist, and she knew what she was doing. It will be 3 months from my first appointment to getting hormones, mainly because it took a while to get an appointment with the GP I wanted (who is also very experienced with transgender folks and won't need to refer me to an endocrinologist). I'll be starting hormones next month.

[Devlyn]

Just speaking from a US perspective:

I was socially transitioned, hormonally transitioned, and with a doctor's referral for surgery in hand when my doctor contacted a therapist and said " My patient needs a letter from you to book her surgery date". We set up an appointment, she reviewed my history, and wrote me a letter. It was a week from call to letter.

Going to a therapist on your Harley with a ZZ Top beard and saying "I think I might be a woman" is going to be a slow process, because you are still questioning your gender.

Showing up as someone already living as a woman and ready for surgical changes is a completely different story.

Hugs, Devlyn

[AnneK]

My experience was from 2009 and 2010. Maybe it's changed since then.

It certainly has in Ontario.  In March 2016, the protocols were changed to make things  a LOT easier.  In the past it was necessary to talk to a shrink at the Clarke Institute (now CAMH) and you needed a year of RLE before you could get anything.  Now RLE is no longer part of the process and even surgery requires 2 evaluations from a variety of providers, no shrink required.  However, surgery requires a year on HRT.

[ChrissyRyan]

It certainly has in Ontario.  In March 2016, the protocols were changed to make things  a LOT easier.  In the past it was necessary to talk to a shrink at the Clarke Institute (now CAMH) and you needed a year of RLE before you could get anything.  Now RLE is no longer part of the process and even surgery requires 2 evaluations from a variety of providers, no shrink required.  However, surgery requires a year on HRT.

The real life experience (RLE) requirement for starting HRT in theory sounded reasonable in some ways.  But without the medical transitioning (HRT) to aid in getting the body to conform to gender before RLE was problematic.  In fact for many, it was harsh and dangerous to mind and body.  So the World Professional Association for Transgender Health (WPATH) removed that RLE requirement for obtaining HRT.

I think most of us think that was a good decision.

Chrissy

[Devlyn]

As mtfs, many start gender therapy, obtain a therapist letter for HRT, then see medical professionals for blood tests and possibly exams, then they finally have prescriptions for HRT.

With realizations of possible different procedures outside of the USA and for informed consent clinics, which may result in different timelines,

How long after calling a therapist was your first gender therapy appointment?  That is, how long did you have to wait for that first therapy appointment after you called to set it up?

How long after that first therapist appointment did it take to obtain the therapist's letter for HRT?

After receiving that HRT letter, how long did it take to get that first medical appointment?
Some doctors have a very long wait, especially so sometimes for new patients, regardless if in private practice or based at a clinic.

How long after that first medical appointment did it take to have your first HRT prescriptions?
Did you have to see more than one doctor, perhaps your general practioner doctor and an endocrinologist?

Then to sum it all up, what was the total amount of time from calling to setup the first gender therapy appointment to having your first prescriptions for HRT?

Chrissy

The WPATH guidelines do not require therapy, they require an assessment of several things, including dysphoria, availability of support, and underlying mental health concerns. The assessment can result in a diagnosis, or a recommendation for further treatment, accessing support, etc.

[Devlyn]

Everyone here should intimately acquaint themselves with the Standards of Care.

https://www.susans.org/wiki/Standards_of_Care_for_Gender_Identity_Disorders

[NatalieRene]

The real life experience (RLE) requirement for starting HRT in theory sounded reasonable in some ways.  But without the medical transitioning (HRT) to aid in getting the body to conform to gender before RLE was problematic.  In fact for many, it was harsh and dangerous to mind and body.  So the World Professional Association for Transgender Health (WPATH) removed that RLE requirement for obtaining HRT.

I think most of us think that was a good decision.

Chrissy

Wow Canada has it rough back then. My real life experience for one year started after HRT. I was on HRT and 90 days later I started the clock and came out at work then left shortly later because they passed me up for promotion. I then charged them my going hourly rate and did work on the side with them until I had enough money from them for my SRS which was roughly $25000.

The job I went to had no idea I was trans and I didn't tell them. There was the glass ceiling and the constant getting hit on at work but the people where nice. I wish the company hadn't gone under.

[AnneK]

Wow Canada has it rough back then.

I think part of the problem at the Clarke Institute was the program was set up as more of an obstacle course, rather than one to actually help people.  This is for Ontario residents and I don't know about the rest of the country.  For years, the only place in Canada for GCS was a clinic in Montreal.  Lately there are new clinics starting up, one in Toronto and one in (I believe) British Columbia.

[sarahc]

The real life experience (RLE) requirement for starting HRT in theory sounded reasonable in some ways.  But without the medical transitioning (HRT) to aid in getting the body to conform to gender before RLE was problematic.  In fact for many, it was harsh and dangerous to mind and body.  So the World Professional Association for Transgender Health (WPATH) removed that RLE requirement for obtaining HRT.

I think most of us think that was a good decision.

Chrissy

The old RLE requirement prior to HRT was the primary reason I didn't transition 25 years ago. It was terrible guidance.

[GingerVicki]

The old RLE requirement prior to HRT was the primary reason I didn't transition 25 years ago. It was terrible guidance.

That was me too.

[Anastasia E]

3 years 

It seems to be getting better in my country, but I'm not getting those three years (of mostly waiting..) back.

[Linde]

3 years 

It seems to be getting better in my country, but I'm not getting those three years (of mostly waiting..) back.

I just realized we are almost at the same point with HRT, and just divided by the big pond.  Do you feel any changes already?  I don't feel anything, could as well have bought candy for the money!  How about you?