Susan's Place Transgender Resources

How does one go about starting HRT? I'd imagine talking with one's GP would be the first step. How long should one try to live as a guy--dress, walk, talk--before starting it? Are there laws about who can start taking it and when? I live in NY State and I dunno if laws regulating HRT are federal- or state-based. How do I find out?

What if my GP won't give me a prescription, or however it works? Do they need to hear from my psychological counselor, first?

What's been your experience with pre-HRT living, and the quest to get HRT? I really need some advice and reassurance, here.

Thanks.

MJ

Do you live in the UK? The process here is you talk to the GP, then they refer you to a gender therapist and then you may have to spent a few months in therapy before you can be recommended for HRT.

Tbh I have a friend who had to dress as a woman before HRT and it's ridiculous. To assume all women dress in womens clothes is gender stereotyping. Plenty dress in unisex or even like guys clothes. So they are essentially asking you to be a ->-bleeped-<-. How is dressing as male/female pre transition proving anything? It's quite insulting. Sorry, rant over.

It should just be a matter of being referred :)

Quote from: Dreams2014 on September 26, 2013, 07:34:50 AM
Do you live in the UK? The process here is you talk to the GP, then they refer you to a gender therapist and then you may have to spent a few months in therapy before you can be recommended for HRT.

I live in the US--NY State. I found out through sheer accident that NY State has the toughest rules regarding changing one's sex in the entire union. So that has me scared about all the stuff that naturally comes before that final step. But what you describe for the UK seems to make sense. Maybe it's that way in the US, as well. I just hope there's a gender therapist nearby, in my town of Kingston. But with my luck, the nearest ones are in towns that are not only far away, but tough to get to, as well. Although Kingston is a relatively big-ish city. Sorta. The LGBTQ center for my county is in my town, so maybe there's a gender therapist here, as well.

QuoteTbh I have a friend who had to dress as a woman before HRT and it's ridiculous. To assume all women dress in womens clothes is gender stereotyping. Plenty dress in unisex or even like guys clothes. So they are essentially asking you to be a ->-bleeped-<-. How is dressing as male/female pre transition proving anything? It's quite insulting. Sorry, rant over.

Please, rant away. Hearing stories about the realities and frustrations of changing one's gender is a big help.

Thankfully--not for my underfed wallet--I love men's clothing . . . adore it to the point of distraction. Especially Steampunk/Victorian clothing (I'd totally walk around in the goggles, too. Monocle, hat, cane, and all). But generally, I've always been drawn to men's clothing, so for me, it's not a problem. But yes, I can see where, for some people, it'd be horrible to dress as something you're not--not yet--when maybe you can't pass. And just because you wear the clothes, doesn't mean you're ready to have the hormones. It's a rather arbitrary line in the sand.

I doubt I'd be able to pass even in men's clothing--although, some people have thought I was a guy even in women's clothing. From the back, at least. Called me "bro," and what-not--because I have a girly, pretty face and a girly, pretty voice. Without hormones, I'd never be able to pass. People just tend to think I'm a butch lesbian. Hell, I thought I was a butch lesbian, till recently, lol.

QuoteIt should just be a matter of being referred :)

Fingers crossed :-)

If I may ask . . . how far along on your journey are you? What has it been like? I do hope everything's going relatively smoothly for you.


MJ

Tbh things for me haven't really started yet. I'm pre HRT and haven't told my family or anything yet. Told two friends and they were supportive.

My current situation is I have therapy for OCD and I'm at risk of homelessness. So when I have a firm place to live then I can start being referred and stuff. So really I'm roughly in the same position as you are in terms of transition :)

Quote from: Dreams2014 on September 26, 2013, 08:22:28 AM
Tbh things for me haven't really started yet. I'm pre HRT and haven't told my family or anything yet. Told two friends and they were supportive.

I've also told two friends and they were pretty supportive :-)

I'm torn between announcing my plans on Facebook or maybe just emailing my friends/family, and possibly just waiting till after I've started HRT.

QuoteMy current situation is I have therapy for OCD and I'm at risk of homelessness.So when I have a firm place to live then I can start being referred and stuff.

I'm in therapy for bipolar II and PTSD. At first I thought maybe this gender dysphoria was a result of that, but then I realized I've been feeling this way since I was five. I've always wanted to be a boy, I just didn't think it was possible for me to become one, outside of magic. I thought I was stuck like this--in my girl's body.

Thankfully I'm not at risk for homelessness--though one bad month and I will be, and the months have been getting worse and worse, lately--but I've been without a job for about a forty days and I'm almost out of money. Let alone having money for the new clothes I need and then paying for HRT (which I'm assuming my insurance won't cover . . . God bless America).

QuoteSo really I'm roughly in the same position as you are in terms of transition :)

I hope we both find the way ahead a lot smoother than the way behind us has been.

Hey MaybeJake,

I live in NY, so maybe I can help you.  There are no state laws that require you to do anything before taking hrt.  All you need is a valid prescription which is the tricky part.  The typical strategy is to go to a gender therapist and have them right you an hrt letter.  Usually, it takes around 3 months of therapy, but this differs from each practice and letters are only given based on the therapist's assessment.  I didn't have to wait 3 months, so you might be in luck as well.  After you get that letter, you can then take it to an endocrinologist who will then prescribe you the meds if they deem you are medically fit and qualify for treatment.   The other strategy is to go to an informed consent clinic (Callen Lorde in NY happens to be one of them).  It generally takes about 3 trips and close to three months before you get the meds, but you can avoid most of the typical therapy requirements if you go through this way.  Personally, I say go with a therapist, but it's not for everyone.

As for your presentation, just be your self.  Most gender therapists realize that this is a difficult thing to handle and that presentation doesn't always represent feelings.  It may make things easier for you to dress a certain way, but don't feel that will prevent you from getting hrt (it didn't for me). 

My experience... well, getting on hrt was pretty easy, but transitioning hasn't been and requires a lot of time, patience, emotional courage effort (all things that I need more of).  That's why I recommend therapy even though I realize it isn't necessary for all. 

Quote from: learningtolive on September 26, 2013, 10:31:55 AM
Hey MaybeJake,

I live in NY, so maybe I can help you.  There are no state laws that require you to do anything before taking hrt.  All you need is a valid prescription which is the tricky part.  The typical strategy is to go to a gender therapist and have them right you an hrt letter.  Usually, it takes around 3 months of therapy, but this differs from each practice and letters are only given based on the therapist's assessment.  I didn't have to wait 3 months, so you might be in luck as well.  After you get that letter, you can then take it to an endocrinologist who will then prescribe you the meds if they deem you are medically fit and qualify for treatment.   The other strategy is to go to an informed consent clinic (Callen Lorde in NY happens to be one of them).  It generally takes about 3 trips and close to three months before you get the meds, but you can avoid most of the typical therapy requirements if you go through this way.  Personally, I say go with a therapist, but it's not for everyone.

Then a therapist is the way to go, for me. I think it'd be best, considering how new all of this--actually acting on what I've been wanting for almost thirty years--is to me. It's been just a fantasy for so long, that the reality may be a little, or a lot overwhelming for me. A therapist does, indeed, sound best. I'll contact my insurance company and see if a) it's covered and b) they can find on nearby for me.

QuoteAs for your presentation, just be your self.  Most gender therapists realize that this is a difficult thing to handle and that presentation doesn't always represent feelings.  It may make things easier for you to dress a certain way, but don't feel that will prevent you from getting hrt (it didn't for me).

Yeah, it'd take a while for me to accumulate a new wardrobe, one that finally reflects who I really am. Thankfully some of my clothes are pretty gender neutral, band t-shirts and sweats.

QuoteMy experience... well, getting on hrt was pretty easy, but transitioning hasn't been and requires a lot of time, patience, emotional courage effort (all things that I need more of).  That's why I recommend therapy even though I realize it isn't necessary for all.

I have a feeling the therapy will do me good, as well. I need as much patience, emotional courage, and a willingness to put in the time and effort to see this through as I can get. I've never been good with follow-through, tending to give up when I get stymied. At least with certain things. I don't want to back out of this when the going gets rough, and at the very least, a therapist should help with that. Right now, I feel as if I could take on the world, but once I'm in the thick of things, that feeling mght not last. And anyway, I've waited all my life for this. A few more months won't kill me, though at the moment, it feels like I'm going nuts even just wearing my old girl-clothes. It's become intolerable, really, but I suppose putting up with it is the order of the day.

Thank you so much, Learningtolive, for your knowledge and advice.


MJ

One additional suggestion is to ask your prospective gender therapist if they would be willing to mark the treatment down for something besides Gender Dysphoria.  Not all insurances will cover this, so you may have to be marked down for something else like anxiety or depression.   

Quote from: learningtolive on September 26, 2013, 10:53:25 AM
One additional suggestion is to ask your prospective gender therapist if they would be willing to mark the treatment down for something besides Gender Dysphoria.  Not all insurances will cover this, so you may have to be marked down for something else like anxiety or depression.

SMART! And I already have a history of depression (as well as mania . . . I'm bipolar) so that'd only help my case.

Thank you again! :D

L2L beat me to it with the comment on starting your initial contact off with your insurance company.  Call it depression and anxiety at first and get a copy of your policy.  It is starting to change with many companies depending on laws they are subject to being forced to cover treatment for transgender issues in which the same treatment would be covered for other people.  Therapy, Hormones and SRS being the likely things covered.  I believe that in general, surgery to correct secondary sexual characteristics (Face/Boobs/voice/Adam's Apple) will remain in the not covered for a while as it is considered elective.  Curiously enough, speech therapy is covered on my plan as well as therapy, hormones and SRS.

As for announcing yourself to a wider audience, I would probably recommend a few sittings with a therapist.  I'm not suggesting that talking with others at this point is a bad idea, more that it is very nice to have someone with some experience to bounce ideas off of while searching for the best way to explain your situation to others and even to yourself.  Also, having someone to talk to in the event the news isn't taken as well as it should be by some is huge.  Any therapist trained or experienced with gender issues should also have a strong grounding in dealing with these kinds of interpersonal issues and providing mental support to you in the time ahead.

new york state is not that hard to change genders. All you need after a few months of hormone replacement therapy, you go to DMV to change your sex marker and you declare yourself as living as the gender you choose and your all done. Same thing with social security and pass port as long as you have proof of hormone replacement thing. You just cant change the gender marker on birth certificate without srs but most work places dont look at that.

Quote from: Murbella on September 26, 2013, 03:36:16 PM
L2L beat me to it with the comment on starting your initial contact off with your insurance company.  Call it depression and anxiety at first and get a copy of your policy.

So do I call them, and just tell them that I'm depressed/anxious, and that I need a copy of my policy? Or do I mention that I'm looking to get gender therapy and HRT because I'm depressed and anxious over being the wrong gender, and that I need a copy of my policy?

QuoteAs for announcing yourself to a wider audience, I would probably recommend a few sittings with a therapist.  I'm not suggesting that talking with others at this point is a bad idea, more that it is very nice to have someone with some experience to bounce ideas off of while searching for the best way to explain your situation to others and even to yourself.  Also, having someone to talk to in the event the news isn't taken as well as it should be by some is huge.  Any therapist trained or experienced with gender issues should also have a strong grounding in dealing with these kinds of interpersonal issues and providing mental support to you in the time ahead.

I actually announced my plans to pursue HRT and eventually SRS on my Facebook wall--I wanted to tell everyone I knew, who mattered, once and for all (except for my mother, who doesn't do the Facebook-thing) so there were no surprises when I started dressing differently and acting differently. (Not massively different, compared to how I before, but definitely noticeable.) They've been amazingly supportive, so far. Their coolness is more than I ever expected. And I expected a lot.

I've bounced my ideas off my counselor--after dithering over it for weeks--but I'm still not sure what to say when calling my insurance company to see if they cover a gender therapist and if they can recommend one in my area. I just feel unprepared to deal with them, and unsure what to ask and how to ask it without screwing myself over, somehow.

What should I ask and how, exactly, should I ask it? I hate to be a bother, but I'm really nervous about this.

Quote from: izzy on September 26, 2013, 07:16:19 PM
new york state is not that hard to change genders. All you need after a few months of hormone replacement therapy, you go to DMV to change your sex marker and you declare yourself as living as the gender you choose and your all done. Same thing with social security and pass port as long as you have proof of hormone replacement thing. You just cant change the gender marker on birth certificate without srs but most work places dont look at that.

It's really that easy?

I read somewhere that it was especially hard in NYS. I guess that was just bull puckey.

At any rate, THANK YOU for the information. That sets my mind at ease quite a bit :-)

at first i thought it was difficult too but the way the state and federal laws are, as long as you live the gender that you are legally living, it will be a go.

Quote from: MaybeJake on September 26, 2013, 08:13:49 PM
 

So do I call them, and just tell them that I'm depressed/anxious, and that I need a copy of my policy? Or do I mention that I'm looking to get gender therapy and HRT because I'm depressed and anxious over being the wrong gender, and that I need a copy of my policy?

I actually announced my plans to pursue HRT and eventually SRS on my Facebook wall--I wanted to tell everyone I knew, who mattered, once and for all (except for my mother, who doesn't do the Facebook-thing) so there were no surprises when I started dressing differently and acting differently. (Not massively different, compared to how I before, but definitely noticeable.) They've been amazingly supportive, so far. Their coolness is more than I ever expected. And I expected a lot.

I've bounced my ideas off my counselor--after dithering over it for weeks--but I'm still not sure what to say when calling my insurance company to see if they cover a gender therapist and if they can recommend one in my area. I just feel unprepared to deal with them, and unsure what to ask and how to ask it without screwing myself over, somehow.

What should I ask and how, exactly, should I ask it? I hate to be a bother, but I'm really nervous about this.

They are legally obligated to present you with a copy of your policy and your coverage if you request it.  If you just call and ask for a current list of what is covered they will provide that for you.  As far as submitting a claim for your therapy, ask your therapist for an itemized bill.  In general you should just be able to submit this bill directly to the insurance company and be reimbursed.  You can then either call or email your insurance company and also inquire about other transgender related coverage.  I am rather sure that they could face legal action if they stop covering your therapy after already starting as long as the therapist continues to bill under the same codes.  Keep in mind though that if your therapist is "out of network" they could either refuse coverage or cover at a lower rate (normally 70% as opposed to 90-100%).  If that becomes a problem, they will also be required to be able to provide you with a list of "in network" providers.

Oh, and congratufriggenlations on having the courage to boldly out yourself on facebook!!! ;D  Personally I'm far more timid and was simply advocating the tact I'm taking on this.  More power to you in your method though.  I will do that at some point, but I'm not anywhere near confident enough, nor am I able to actually begin transitioning at this point so it would be somewhat of a hollow coming out.

Quote from: Murbella on September 30, 2013, 03:52:54 PM
They are legally obligated to present you with a copy of your policy and your coverage if you request it.  If you just call and ask for a current list of what is covered they will provide that for you.  As far as submitting a claim for your therapy, ask your therapist for an itemized bill.  In general you should just be able to submit this bill directly to the insurance company and be reimbursed.

So, find and see the therapist first, somehow pay for them, then submit the bills to the insurance company? Oy, I foresee a problem. I can't pay the bills I've already got :-/

QuoteYou can then either call or email your insurance company and also inquire about other transgender related coverage.  I am rather sure that they could face legal action if they stop covering your therapy after already starting as long as the therapist continues to bill under the same codes.  Keep in mind though that if your therapist is "out of network" they could either refuse coverage or cover at a lower rate (normally 70% as opposed to 90-100%).  If that becomes a problem, they will also be required to be able to provide you with a list of "in network" providers.

Argh--this whole thing is so confusing. What to do when, what to do first. . . .

QuoteOh, and congratufriggenlations on having the courage to boldly out yourself on facebook!!! ;D

Hah, a bit premature, maybe, but it was the fastest, most efficient way to tell almost everyone I know at once. Though it did take me forever to get up the courage to hit the "Post" button :-)

QuotePersonally I'm far more timid and was simply advocating the tact I'm taking on this.  More power to you in your method though.  I will do that at some point, but I'm not anywhere near confident enough, nor am I able to actually begin transitioning at this point so it would be somewhat of a hollow coming out.

I know how you feel. Having outted myself, it feels as if I haven't done anything since to make myself more of a man. No money and no forward momentum. It's driving me nuts.

Quote from: MaybeJake on September 30, 2013, 09:13:21 PM
So, find and see the therapist first, somehow pay for them, then submit the bills to the insurance company? Oy, I foresee a problem. I can't pay the bills I've already got :-/

Argh--this whole thing is so confusing. What to do when, what to do first. . . .

Hmm, for some reason when I was typing the prior comment I thought you had already started.  Reading comprehension for the win.  In that case you kinda have 3 options for therapy...
1) Find a therapist who will attempt to bill your insurance directly or at least work with you to get all that sorted out
2) Go through your insurance company to provide a list of therapists who can bill them directly and start calling them up to weed out those with no transgender experience.
3) Find some form of LGBT center nearby and start talking to them, they will probably have resources that will work on a sliding scale

QuoteHah, a bit premature, maybe, but it was the fastest, most efficient way to tell almost everyone I know at once. Though it did take me forever to get up the courage to hit the "Post" button :-)

I know how you feel. Having outted myself, it feels as if I haven't done anything since to make myself more of a man. No money and no forward momentum. It's driving me nuts.

Even with my limited coming out I know what you mean.  The first major roadblock is gone, now I get to start fixing this right?  Take a second to relax, and remember that hormone mediated transition takes a year or more to really work its magic.  The next several months or so will have you thinking about what to do next constantly, but on the time scale of transition it's small, and in the time scale of the rest of your life it's rather insignificant.  You really have gone through one of the more complicated parts of all this by blasting everyone with what you intend to do.  Now is kinda the time to try and keep as much of your affairs in order and attempt to stay positive while you wait for the various peripheral things to slip in place allowing you to move forward.

Quote from: Murbella on October 01, 2013, 02:26:37 AM
Hmm, for some reason when I was typing the prior comment I thought you had already started.  Reading comprehension for the win.  In that case you kinda have 3 options for therapy...
1) Find a therapist who will attempt to bill your insurance directly or at least work with you to get all that sorted out
2) Go through your insurance company to provide a list of therapists who can bill them directly and start calling them up to weed out those with no transgender experience.
3) Find some form of LGBT center nearby and start talking to them, they will probably have resources that will work on a sliding scale

I think for now, I'll go with the third one. Already called my local center and found out when their group for transgendered people meets. No doubt I can get some more info there.

QuoteEven with my limited coming out I know what you mean.  The first major roadblock is gone, now I get to start fixing this right?  Take a second to relax, and remember that hormone mediated transition takes a year or more to really work its magic.  The next several months or so will have you thinking about what to do next constantly, but on the time scale of transition it's small, and in the time scale of the rest of your life it's rather insignificant.  You really have gone through one of the more complicated parts of all this by blasting everyone with what you intend to do.  Now is kinda the time to try and keep as much of your affairs in order and attempt to stay positive while you wait for the various peripheral things to slip in place allowing you to move forward.

You're absolutely right . . . thank you for the reality check, lol. I've been wanting everything to happen at once. And every little step forward feels like it's the hugest step I've ever taken, even though it's really not. Perspective is what I've been needing. And patience. But after waiting for what's come to feel like forever, it's hard to muster up either.

Thanks for mustering it for me :-)

You know, you're awfully good at cheerleading while still being realistic. You could do this for a living.


MJ

Happy to help Jake and thank you for the wonderful complement.

My wife is the one going into social work.  I'm an engineer and an unusual one in that I have people skills.  If anything I was merely passing on the advice I do my best to give myself every day while I sort through similar issues.  I have always found that helping others with problems, be they academic or of other natures, is one of the best ways to learn how to deal with the same problems in your own life.  It is therapeutic for me to teach others and results in a net improvement for all involved (hopefully).  Pass it on by sticking around and adding your learnings and insight to others where you can ;D