Susan's Place Transgender Resources

I was just wondering how long it took from seeing your GP for a referal to actually getting on HRT.

I made an appointment directly with a psychologist.  It took three visits over five weeks.  I could have done it quicker if I had not spaced my appointments two weeks apart.

This time seems to be highly variable though depending on who you are dealing with and likely the specifics of your case.


It is better to be hated for what you are than to be loved for what you are not.
André Gide, Autumn Leaves

My Dr did not require a referral.  I had been seeing a therapist for a few weeks but the dr I saw did informed consent and she started me right away after requesting hrt.

It is going to be very variable, depending on where you are and how your health care system is funded.  Where I am, there is a publicly-funded health care system available to everyone, but there are not enough doctors and specialists in it.  So waiting lists are long.  People with the means to do so often pay to see someone in the private system in order to avoid long delays.

My initial intake appointment in the public system went well, but it was going to be four months before I could see a therapist.  So i found a private therapist and paid my own way to get seen right away.  I went back to my doctor for a referral letter so that I could claim the cost on my wife's insurance.

From starting with the therapist to getting my HRT referral letter was about a month and a half.  Right now, I am on a three month waiting list (back in the public system) for my HRT appointments.  Assuming those appointments go well, by the time I start HRT, it will be five months from when I started seeing the therapist.  Had I stayed with the public health care system for therapy, it might have been a year altogether.

But, like I said, it varies a lot depending where you are.

My GP gave me a referral to two doctors, but one of them was actually a plastic surgeon and the other didn't take my insurance.  So I searched online and found an endo who is board certified and takes my insurance. I called their office and they were able to get me in the following week.  After a detailed chat about my intentions, risks, etc. and a lengthy blood draw, he proscribed me Spiro at the end of the appointment. I had a follow up appoint 2 weeks later where I was also prescribed estradiol. Start to finish, the process took maybe a month.

It turns out that the doc knows my GP personally, and I'm pretty sure that the reason it went so quick was that my GP vouched for me. My GP knows my pretty well and has been aware that I'm transgender for over a year.

Quote from: Jessica70 on December 15, 2016, 09:17:10 PM
I was just wondering how long it took from seeing your GP for a referal to actually getting on HRT.

It depends a lot on what country you live in and the healthcare system in your area.  If you live in the UK and are using the NHS, for example, it could be a very long wait of many months.  On the other hand, if you live in the USA and go to an informed consent LGBT clinic, it could literally be a 0 day wait.

2 months, would have been 4 but I was able to get in to a canceled slot with the endocrinologist. The other endos available within my insurance all had longer waits.

About a week start to finish.

From the time I called the crisis hotline to the day my therapist asked "So, do you prefer a morning or afternoon appointment with the endocrinologist?" was three months and one week.  I saw the endocrinologist the day after we decided to proceed with HRT, when I was finally absolutely convinced I needed it.


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QuoteIt is going to be very variable, depending on where you are and how your health care system is funded

That makes me laugh.....I live in a redneck fly-over state. I have full coverage Insurance to the tune of 850.00 monthly through the ACA. My transition is totally self funded. My Insurance company has no interest in my mental health.....or my teeth.....and with a 6500.00 deductible before they pay anything at all for that matter.

Absolute extortion :'(

About 4 months.

Quote from: Jessica70 on December 15, 2016, 09:17:10 PM
I was just wondering how long it took from seeing your GP for a referal to actually getting on HRT.

For me about a month to see a psychiatrist and then 4 more weeks for an appointment with an endocrinologist, but that was through veterans affairs which is always slow but after some discussion it was decided to start me on  spironolactate and  estradiol daily. 

Mod Edit - No dosages please TOS 8.

Sorry about dosages will not repeat. 


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Thank you ^-^ hopefully mine won't take too long :3

I hope not.  Good luck[emoji1551]


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Since telling my wife and accepting that I want to transition it's been about 2 months now. It took a while to find a therapist. I can tell you I really did need that! I made a bunch of calls and scoured the net for help in the St. Louis area. There is very little published help out there. There was a private practice that does HRT that says they work with trans but HRT for older ladies beauty is their primary practice. It might have been much faster if I had gone that way. Instead I am going through the incredibly slow process of WPATH to see an endocrinologist that works in one of the large hospitals, teaches at one of the university medical programs, and ONLY takes on transgender patients.

My steps in the process:

Found a therapist. She's a LCSW and has dealt with a few other transpeople before. She is going to see if the endocrinologist's office will accept the recommendation letter from her which they should. She had me start writing down my life memories for a case background. I had about 9 pages the first evening I started. I hope to have the letter just after Christmas.

I moved up my 6 month appointment with my psychiatrist who I see for anxiety medication. Turns out he only does medication and would not do an evaluation for a letter. Got my mess increased due to the increased anxiety coming out has caused.

I found a urologist who would be willing to perform an orchiectomy for trans people. I told her office I would like to get back to them after I get to consult with the endocrinologist. I'd rather have that done early on than have to take spiractolone for any length of time. Plus it has been a focal point of disphoria since I was young. My one issue is my current insurance standards put orchiectomy at 1 year full time living and HRT for coverage or a medical reason from the doctor. I'm hoping to talk about this with the endocrinologist.

Found a new general practice Doctor near the city. On my first appointment after talking with him about all of my other steps I have done he put the official Gender Disphoria diagnosis on my medical chart. That is really important to get my insurance to pay on further steps.


So for now I just wait for the letter. I have to say though writing down my life memories was both therapeutic and emotionally traumatic. Looking back at all the self suppression is really hard to do.

Well I hope your course moves swiftly for you. :)

When I went to my GP in Januari 2015, she immediately referred me to a gender therapist. He had a 4-week waiting list, and after a first intake session, he immediately had me do a plethora of tests. After those were evaluated, I had to write down my experiences with gender dysphoria. That took me another 3 weeks, finally clocking in at 7 pages or so.

We then talked about the whole thing and a session later, I got my referral letter for the endocrinologist (end of March 2015). Then came the other necessary things though, such as sperm banking an another round of thinking and doubting. The sperm banking was done in July 2015, and I made an appointment with the endo not long after that. He had time to see me at the end of August, and my bloodwork came back OK in the beginning of September.

After that, I took another two months to rethink the entire thing, putting my final doubts at ease. In the end, I started taking HRT on the day of my 30th birthday, November 2015.

TL;DR: 11 months, but could have been faster.  ::)

If you're a sane adult, look into "implied consent". Under this scenario, you state to your endo that you understand the mechanics of transition,  what you're undertaking and the inherent dangers of the process. You sign consent forms and get your HRT, effectively citting out the middle man....i. e......the good old therapist.

Took me about 2 weeks. Had one session with a psychiatrist one week and saw the doctor the next week, and I was on HRT.

It took one visit only to my physician who specializes in Family Medicine to get a prescription for HRT. No therapy required, only informed consent. Now, that prescription had a condition that my blood pressure be checked again 14 days after the doctor visit because of borderline high blood pressure. I had that check done by a nurse. My BP was still considered on the high range of normal, but good enough for HRT.

So, I have that prescription in hand yet I have yet to have that discussion with my wife about my need for this.
Thus, I chose to go to a gender (and family) therapist to help me with my coming discussion with my wife.

I also would like to add how extremely happy I am with my HMO, Group Health of Washington State.  They put me on their Transgender Services Program and assigned me a Social Worker who is an experienced therapist herself specializing in the needs of transgender clients. She helped me find my gender therapist. This social worker  is the best and free!.

I have been so, so very tempted to start the HRT before talking to my wife about it. But then the good angel inside me slaps me on the hand, and convinces me to talk to my wife first.

I am hoping my therapist gives me both the courage and the tools to have this discussion with my lovely wife to whom I have been married happily for over 40 years. The marriage has been happy, but my self imposed repression of my big secret has been keeping me numb, agitated, and depressed.

I cannot risk losing my wife, yet I can barely handle the thought of another year being forced to remain a man. I refuse to die before I transition first.

   I told my VA primary care doctor last Friday 1/20/2017 that I felt I was transgender or I guess a transsexual would be more appropriate.  He offered to refer me to mental health and I have an appointment with a psychiatrist on 2/23/2017 for initial screening and then hopefully onto a gender therapist shortly there after. I could be wrong about this, he could discover I am just crazy.
   For myself I went contrary to every piece of rational advice I've read by putting the cart before the horse. I started HRT then confessed to my primary care doctor. He made no suggestion for me to stop and only assured me I am not the first to do so and offers to assist me with my desires by ordering labs tests and making the referral.

QuoteI could be wrong about this, he could discover I am just crazy.

QuoteMy dressing up and wanting to be like a girl never left me. No it never left, not through a stint in the Navy, not through  20 years of marriage. not after having kids, not after the divorce nor into becoming a grandfather.

I will put any amount of money on you being transgender. I am a bit more cautious about transsexual because that is a higher bar but I am not about to rule it out.

Quote from: Dena on January 26, 2017, 04:36:32 PM
I will put any amount of money on you being transgender. I am a bit more cautious about transsexual because that is a higher bar but I am not about to rule it out.

Thank you Dena. We'll have to see what the shrink thinks next month.

Informed consent for me! I actually had a bigger problem getting the PHARMACIST to fill the prescription over the doctor prescribing it!

Quote from: LShipley on January 27, 2017, 09:03:01 AM
Informed consent for me! I actually had a bigger problem getting the PHARMACIST to fill the prescription over the doctor prescribing it!

Really?  How so?  Did they not want to fill estrogen for a male bodied person? (Assuming you are mtf)

 I related this elsewhere but it fits into this thread also.

Yesterday I contacted my VA primary care doctor and requested to get my HRT meds through the VA if possible. His response back was to inform me he was ordering them. So about 4 days for me to reconsider wanting to obtain them through the VA and now the wait for them to arrive. (typically 5 - 7 days)

I did therapy for 6 months, then decided it was time to pursue HRT.  I saw my GP and was nervous has hell!   I rambled, as I do about details and she was SO nice and reassuring.  I have actually been floored at how compassionate and accepting all of my medical team has been.  I am pursuing a "low dose" route (about half currently) and have gradually gone up from VERY low, but they have always been understanding and supportive for which I am grateful! 

Quote from: Donna on January 03, 2017, 06:13:28 PM
It took one visit only to my physician who specializes in Family Medicine to get a prescription for HRT. No therapy required, only informed consent. Now, that prescription had a condition that my blood pressure be checked again 14 days after the doctor visit because of borderline high blood pressure. I had that check done by a nurse. My BP was still considered on the high range of normal, but good enough for HRT.

So, I have that prescription in hand yet I have yet to have that discussion with my wife about my need for this.
Thus, I chose to go to a gender (and family) therapist to help me with my coming discussion with my wife.

I also would like to add how extremely happy I am with my HMO, Group Health of Washington State.  They put me on their Transgender Services Program and assigned me a Social Worker who is an experienced therapist herself specializing in the needs of transgender clients. She helped me find my gender therapist. This social worker  is the best and free!.

I have been so, so very tempted to start the HRT before talking to my wife about it. But then the good angel inside me slaps me on the hand, and convinces me to talk to my wife first.

I am hoping my therapist gives me both the courage and the tools to have this discussion with my lovely wife to whom I have been married happily for over 40 years. The marriage has been happy, but my self imposed repression of my big secret has been keeping me numb, agitated, and depressed.

I cannot risk losing my wife, yet I can barely handle the thought of another year being forced to remain a man. I refuse to die before I transition first.

Thanks Donna, this answered a number of questions I had.  Group Health is pretty good.