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I have a telehealth appointment booked in about three weeks and hopefully will emerge at the other end of it with an HRT prescription.

Quote from: Emily LeGoth on July 27, 2026, 07:57:08 AMI have a telehealth appointment booked in about three weeks and hopefully will emerge at the other end of it with an HRT prescription.

Congrats Emily!... Well Done!!... Enjoy the ride!!! 💕🤗💕

Congratulations!

The first step is always the hardest, but also the most necessary. Let us know how it goes!

Quote from: Emily LeGoth on July 27, 2026, 07:57:08 AMI have a telehealth appointment booked in about three weeks and hopefully will emerge at the other end of it with an HRT prescription.

Congratulations Emily! Fingers crossed all goes well for you!

Congratulations! I did Telehealth for mine and had an HRT prescription after it.

Quote from: Emily LeGoth on July 27, 2026, 07:57:08 AMI have a telehealth appointment booked in about three weeks and hopefully will emerge at the other end of it with an HRT prescription.

I did this recently and it was almost hilariously easy. I'm in California and used Planned Parenthood. I hope it goes well for you! 

My first appointment was TeleHealth through the VA. I lived in South Dakota, and my Endocrinology Team was in Minneapolis. It was great to kick things off, but for follow-up visits, I wanted someone I could meet face-to-face so we could get to know each other.

The first prescription will be memorable.


Chrissy

Quote from: ChrissyRyan on July 28, 2026, 09:46:00 AMThe first prescription will be memorable.


Chrissy

I would ask you why but I guess I'll have to find out for myself.  :)

Doc wants to do blood work first. Here's hoping that nothing there torpedoes my plans.  Or that any of the rest of my care team vetoes what I'm trying to do.  I have no idea how trans friendly any of them might be, or not.

I just started on prescription HRT and was really excited and took pictures and stuff. Then I same my birthname on the bottles. It kind of killed my excitement. I kept the picture but it doesn't mean as much as I had hoped. I hope your experience is better and that they sign off on it.

You want them to do blood work first. Anyone who would prescribe without your medical history and lab work would be dangerous.

Hugs, Devlyn

Doc also wanted me to talk to my cardiologist (without going into too  many details, I have a weird heart issue). Cardiologist was open to the idea but wants to do a stress test with echocardiogram first. I've done a number of those over the years and they've yielded uninteresting results, so I'm optimistic.

Good Luck, you'll be fine

Baseline blood draw and labs first along with competent personalized medical situation analysis is important first.

Quote from: Devlyn on August 12, 2026, 12:19:09 PMYou want them to do blood work first. Anyone who would prescribe without [...] lab work would be dangerous.

Why?

There is no absolute medical reason to conduct laboratory blood tests on a healthy adult before prescribing hormone therapy. There are other normal tests that are advisable: weight (BMI) and blood pressure, as per HRT for cis females. Then you do need regular blood tests after you start the hormones. But before you start? The main reason to do so is to provide a baseline from which to assess subsequent treatment. But "dangerous" not to do so? That is a heavy-handed choice of vocabulary.

It's more a case of best practice as per WPATH. We've all seen an example of the kind of over-reaction when requiring all patients preparing for GRS to come off hormone therapy 4 to 6 weeks prior to surgery, something WPATH have now admitted was wrong in their updated guidance.

More important is to titrate doses upwards gradually, monitoring bloods as the patient progresses.

Unless of course there's an issue ... which leads me onto ...

Quote from: Emily LeGoth on August 14, 2026, 05:46:07 PMDoc also wanted me to talk to my cardiologist (without going into too  many details, I have a weird heart issue). Cardiologist was open to the idea but wants to do a stress test with echocardiogram first. I've done a number of those over the years and they've yielded uninteresting results, so I'm optimistic.

... Hi Emily. I'm sorry to hear about that but it sounds like you have it covered.

If it's any help or correlation I have what is known as an 'athlete's heart', which means I'm bradycardic (resting pulse c. 40) with low blood pressure (90/60). So a whole load of check-ups were run on me including stress tests and echo cardiogram.

However, these were unrelated to hormone therapy and at no point has anyone treating me with HRT ever intervened or required anything at all to do with heart checks. The only thing I had to do was upload my Consultant Cardiologist's sign-off letter to the surgical team ahead of my GRS.

So I really hope you have a similarly good result on the heart tests and can soon get going with HRT.

xx

Quote from: Tills on August 14, 2026, 10:51:34 PMWhy?

There is no absolute medical reason to conduct laboratory blood tests on a healthy adult before prescribing hormone therapy. There are other normal tests that are advisable: weight (BMI) and blood pressure, as per HRT for cis females. Then you do need regular blood tests after you start the hormones. But before you start? The main reason to do so is to provide a baseline from which to assess subsequent treatment. But "dangerous" not to do so? That is a heavy-handed choice of vocabulary.

It's more a case of best practice as per WPATH. We've all seen an example of the kind of over-reaction when requiring all patients preparing for GRS to come off hormone therapy 4 to 6 weeks prior to surgery, something WPATH have now admitted was wrong in their updated guidance.

More important is to titrate doses upwards gradually, monitoring bloods as the patient progresses.

Unless of course there's an issue ... which leads me onto ...

That's what my research shows, too. There are screening questions that are essential, but upon passing those, I was prescribed estradiol immediately. Had I wanted T-blockers it might have gone differently? I've read about many more side effects for them.

I have had issues with my heart and taking blockers causing ectopic beats (skipped beats) I have had to stop blockers altogether for now. Not sure if it is related but a GP in my twenties picked up that I had a systollic heart murmur but no checks have ever been done, I'm not even sure it is on my medical records because NHS yay!. HRT can and does affect your heart so it is logical to me to have it checked out if they are offering it.

Tills has a valid point about baseline bloods for sex hormones but there are other things that can be relevant like liver function, kidney function and Potassium levels etc these DO need to be known before starting the meds in my opinion.

This from someone who has just thrown caution to the wind and been doing DIY for years ha ha! Do as I say not as I do🤣🤣!

Quote from: Tills on August 14, 2026, 10:51:34 PMWhy?

There is no absolute medical reason to conduct laboratory blood tests on a healthy adult before prescribing hormone therapy. There are other normal tests that are advisable: weight (BMI) and blood pressure, as per HRT for cis females. Then you do need regular blood tests after you start the hormones. But before you start? The main reason to do so is to provide a baseline from which to assess subsequent treatment. But "dangerous" not to do so? That is a heavy-handed choice of vocabulary.

It's more a case of best practice as per WPATH. We've all seen an example of the kind of over-reaction when requiring all patients preparing for GRS to come off hormone therapy 4 to 6 weeks prior to surgery, something WPATH have now admitted was wrong in their updated guidance.

More important is to titrate doses upwards gradually, monitoring bloods as the patient progresses.

Unless of course there's an issue ... which leads me onto ...

I have to agree with @Devlyn

There is very much a good medical reason. Establishing your baseline hormone levels and screening for morbidity (illnesses) is important. In many areas, HRT can be started with informed consent and no medical diagnosis. This could mean that an undiagnosed intersex condition or some other condition results in E levels already in the normal range, and all that is needed is T suppression.

That would be like dumping motor oil into your car engine without checking the level first. Adding unnecessary hormones could be dangerous. Hormones work together, and increasing or decreasing one affects the others. Not just E and T, but all of the body's hormones.

If labs are only done after HRT is started and levels are found to be too high, it is impossible to determine the cause that needs correction.

Just because lab work is not specified as a requirement does not mean it isn't recommended. Transgender medicine is still evolving, and very often it is we who are educating them on best practices.

With respect @Lori Dee you've only confirmed what I said. It might be best practice, as I said, fine.

There's always a balance between safety and, forward momentum. I generally err on the side of safety, hence why I don't advocate DIY treating and argue that blood tests are important along the way to monitor levels. Best practice in the UK means you blood test 6-weeks after starting hormone therapy, and then again at 3 months. Once levels settle testing can be every 6-months or, as now in my case, every 12 months.

I repeat what I said: in a normal healthy adult there is no absolute requirement to test bloods prior to commencing HRT. It's not done for cis females and there's no absolute need to do it for us either. And, with the greatest of respect Lori Dee your suggestion that it's needed because they might suddenly discover the patient to be intersex is a little bit absurd. We should not base decisions for the majority on extremely rare instances that might be present in a tiny minority who somehow had no idea all their life that they were intersex. That's like putting motor oil in the engine of your 4-cylinder Nissan Micra only to discover that it's a V8 Ford Mustang. As is the comment that if you only start testing after you start, and then find levels to be too high you won't know the cause. That's not particularly medically sound.

@Stottie Girl you said that "liver function, kidney function and Potassium levels etc these DO need to be known before starting the meds". No they don't. In a normal healthy adult there's no absolute reason to start running those tests prior to starting. There are loads of medications we can be prescribed as adults that may affect liver and kidney function. We're surely not about to suggest that unless full blood tests are taken prior to these they are acting "dangerously"? Or is that the way this world is now headed? Control.

But you highlighted what I meant: there are 2 red flags why in your case testing would be advisable: 1. your heart condition (I hope you can get this checked) 2. you are DIY-ing,

There's far too much control and coercion out there, and our community suffers from this more than most. And far too many people sticking their oar in: witness for example the way non-experts in the UK stopped UK puberty-blockers in adolescents which had already been approved by medics in the know, and then they even stopped the compromise trials designed to test their safety! Witness too the way my hormones were blocked by another layer of bureaucrats (https://www.susans.org/index.php?topic=253232). Now that was dangerous. So understand, that as someone who has been on the receiving end of recent totally unnecessary gatekeeping and roadblocking, I am particularly twitchy on this topic. Stick another layer of testing in front of a healthy adult patient and you're roadblocking. We really don't need another bunch of bullies standing in our path.

Test levels as you go along, of course. The most important test for a normal healthy adult is not one before you start. It's the one at 6 weeks. Test them before you even start, thus putting another roadblock in the way at the hands of so-called professionals? Nope. It's unnecessary in a normal healthy adult and just exacerbates delays in treatment, significantly contributing to dysphoria. The baseline can be taken 6-weeks after starting which is the approach I was given by the NHS.

Presumably few of you on here are suggesting that when my official NHS Gender Identity Clinic first prescribed me hormones without prior blood tests they were acting "dangerously" ... ?

xx

Quote from: Tills on August 15, 2026, 11:42:43 PM@Stottie Girl you said that "liver function, kidney function and Potassium levels etc these DO need to be known before starting the meds". No they don't.

If they are going to be prescibed Spironolactone, there is a reason to test for potassium as it is a potassium sparing diuretic IIRC. Too high potassium levels can be dangerous.

@Tills

I am sorry that you feel that gathering health data is a form of gatekeeping. Checking the oil on any engine before adding more is not gatekeeping.

In military service, I had to have a physical exam every year. The first one was before I was sworn into service. I never thought of that as gatekeeping.

Every time I see a new dentist, the first thing they do is take X-rays. I never thought of that as gatekeeping.

Knowing the current situation before you change something is always a good idea. Especially when it comes to hormones or anything else affecting the various glands of the endocrine system. Since this is a twitchy subject for you, I will stop here.

Transgender people are not special and we don't need to be singled out for special treatment. Every single medicine ever made changes the body, that's what they are designed to do, yet they don't routinely run blood tests before prescribing every medication.

Don't make out we're some special case. We're not. We're normal. We are just another kind of human being. Don't treat us any differently.

xx

@Tills Hi Tills, Chill baby! I wasn't trying to upset the apple cart there and I did not use the word "Dangerous". What I am saying is it's probably "best practice" to do them. I did not know I would react the way I did having Ectopic beats brought on by first Cyproterone then Spiro. Maybe there is something that would have meant these were not prescribed in the first place? I don't know and my GP's seem disinterested in finding out so I will need to wait until I see a private endo to be sure but I strongly suspect dangeously high levels of Pottassium was the issue with Spiro, I'm unsure what the Cypro cause was. A doctor might have picked up additional risk factors with baseline bloods. Like I say not "Dangerous" but probably "best practice" It should maybe be optional but GP's are so risk averse it's no wonder they send you for them. I suppose, how do you truly know you are healthy unless they check thoroughly?

Oh I'm chilled about this, which is kind of my point Sarah ( @Stottie Girl ). There shouldn't be a major drama made about beginning HRT and we shouldn't be treated any different from any other medication. All medicines ever made change the body, which is what they are designed for. We're not somehow special, or any more special than any other patient receiving meds.

I hope you can get your heart situation checked. That's the kind of thing I'd be on to if it were me.

I'd also want to emphasise that in a normal healthy adult before starting HRT far more important than running blood tests are measuring weight, BMI, heart rate, and blood pressure. Those are important indicators of risk factors. Which is why they are all routinely performed for cis females. Lifestyle choices are also far more important than relatively unnecessary prior blood tests: stopping smoking (including vaping); moderating alcoholic consumption; exercising regularly; eating a healthy balanced diet; monitoring weight to be inside healthy BMI range; trying to get good quality sleep: these should all be the focus for any individual beginning hormone treatment and, happily, none of them involve any one else lording it over them. They are in the individual's own hands.

I kind-of think I've put across in a fairly reasonable way my views on this. So I'll step out now. I just hope @Emily LeGoth that you can get underway with this soon and that no one else acts as a roadblock to your life. Very best wishes for you.

xx

Quote from: Tills on August 16, 2026, 03:37:48 AMOh I'm chilled about this, which is kind of my point Sarah ( @Stottie Girl ). There shouldn't be a major drama made about beginning HRT and we shouldn't be treated any different from any other medication. All medicines ever made change the body, which is what they are designed for. We're not somehow special, or any more special than any other patient receiving meds.

I hope you can get your heart situation checked. That's the kind of thing I'd be on to if it were me.

I'd also want to emphasise that in a normal healthy adult before starting HRT far more important than running blood tests are measuring weight, BMI, heart rate, and blood pressure. Those are important indicators of risk factors. Which is why they are all routinely performed for cis females. Lifestyle choices are also far more important than relatively unnecessary prior blood tests: stopping smoking (including vaping); moderating alcoholic consumption; exercising regularly; eating a healthy balanced diet; monitoring weight to be inside healthy BMI range; trying to get good quality sleep: these should all be the focus for any individual beginning hormone treatment and, happily, none of them involve any one else lording it over them. They are in the individual's own hands.

I kind-of think I've put across in a fairly reasonable way my views on this. So I'll step out now. I just hope @Emily LeGoth that you can get underway with this soon and that no one else acts as a roadblock to your life. Very best wishes for you.

xx

Thanks @Tills , The heart thing stopped as soon as I stopped the blockers (well a couple of days after) never had a squeak of trouble after that. I'm sure if they can't find anything in the blood tests they'll be sending me off for more tests. I'm likely going to be referred to a gastro surgeon now after my abdominal Ultrasound as they think I have a porcelain gall bladder now. It never rains but it pours.

RE other factors I am acutely aware of my BMI, I have my own BP monitor (no issues with BP) I'm a non drinker, non smoker, non vaper, and I'm on a balance nutritious diet tring to get my weight down. Other than the weight I'm pretty healthy, so I thought.

Write this in granite. I'm doing a full blood test if I decide to do any body or mind altering medication.
I feel a good example. If you have unknown Afib which is an irregular heart beat you can have a build up of a clot in a section of your heart, a blood clot.
I've researched estrogen can cause blood clots which could be life threatening to someone with unknown Afib and not on blood thinners.
I would also think you would what a bases to work off of your present estrogen and testosterone levels.

@Emily LeGoth  @Kristy7  @Stottie Girl  @KristaFairchild
      @ChrissyRyan  @Karen_A  @tammy753  @tgirlamg

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