Susan's Place Transgender Resources

Community Conversation => Transitioning => Hormone replacement therapy => Topic started by: ChrissyRyan on December 04, 2018, 08:29:11 PM

Title: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: ChrissyRyan on December 04, 2018, 08:29:11 PM
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

Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: NatalieRene on December 04, 2018, 08:41:06 PM
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.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: Kirsteneklund7 on December 04, 2018, 09:39:14 PM
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
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: AnneK on December 04, 2018, 09:52:35 PM
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.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: Jessica_Rose on December 04, 2018, 09:56:53 PM
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.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: Dani on December 04, 2018, 10:01:26 PM
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.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: Linde on December 04, 2018, 10:23:41 PM
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?
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: NatalieRene on December 04, 2018, 10:27:31 PM
Quote from: Dietlind on December 04, 2018, 10:23:41 PM
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.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: sarahc on December 05, 2018, 06:19:12 AM
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.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: Devlyn on December 05, 2018, 07:35:55 AM
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

Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: AnneK on December 05, 2018, 07:55:47 AM
QuoteMy 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.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: ChrissyRyan on December 05, 2018, 08:08:56 AM
Quote from: AnneK on December 05, 2018, 07:55:47 AM
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
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: Devlyn on December 05, 2018, 08:12:32 AM
Quote from: ChrissyRyan on December 04, 2018, 08:29:11 PM
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.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: Devlyn on December 05, 2018, 08:15:29 AM
Everyone here should intimately acquaint themselves with the Standards of Care.

https://www.susans.org/wiki/Standards_of_Care_for_Gender_Identity_Disorders
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: NatalieRene on December 05, 2018, 08:42:51 AM
Quote from: ChrissyRyan on December 05, 2018, 08:08:56 AM

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.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: AnneK on December 05, 2018, 08:50:53 AM
Quote
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.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: sarahc on December 05, 2018, 10:42:48 AM
Quote from: ChrissyRyan on December 05, 2018, 08:08:56 AM

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.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: GingerVicki on December 05, 2018, 12:39:30 PM
Quote from: sarahc on December 05, 2018, 10:42:48 AM
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.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: Anastasia E on December 05, 2018, 04:09:35 PM
3 years  :embarrassed:

It seems to be getting better in my country, but I'm not getting those three years (of mostly waiting..) back.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: Linde on December 05, 2018, 11:00:29 PM
Quote from: Anastasia E on December 05, 2018, 04:09:35 PM
3 years  :embarrassed:

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?
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: josie76 on December 06, 2018, 03:43:15 AM
When I called a therapist, she got me in the next week. Then I went weekly for about 3 months before she signed the referral letter. It took about a month and a half to get into my endo appointment but I left with a prescription for E that day.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: Anastasia E on December 06, 2018, 09:27:27 AM
Quote from: Dietlind on December 05, 2018, 11:00:29 PM
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?

I feel the effect of testosterone blockers, my skin is a little softer and a lot drier. I think my body hair grows a little slower..

Beyond that? So far nothing  :D
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: NatalieRene on December 06, 2018, 09:47:17 AM
Quote from: Anastasia E on December 06, 2018, 09:27:27 AM
I feel the effect of testosterone blockers, my skin is a little softer and a lot drier. I think my body hair grows a little slower..

Beyond that? So far nothing  :D
How long have you been on HRT?

Initially the hormones are building up. It takes a little time and then it sneaks up,on you one day.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: Anastasia E on December 06, 2018, 10:57:50 AM
Quote from: NatalieRene on December 06, 2018, 09:47:17 AM
How long have you been on HRT?

Initially the hormones are building up. It takes a little time and then it sneaks up,on you one day.

Only 23 days  ;)  It's kinda funny how I didn't really think I'd care that much about breasts.. until I actually got on HRT, now I am like.. are my nipples buzzing?.. I'm probably just imagining it  :laugh:

I know to be patient though. Only thing that frustrates me is that I won't have my blood taken until 3 months in.. I am sure everyone goes 'are the hormones working alright?'. Some confirmation would be nice!
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: Linde on December 06, 2018, 03:40:59 PM
Quote from: Anastasia E on December 06, 2018, 09:27:27 AM
I feel the effect of testosterone blockers, my skin is a little softer and a lot drier. I think my body hair grows a little slower..

Beyond that? So far nothing  :D
I cannot use skin or body hair as indicators.  i never got adult male skin, and I also never got body hair.  My body was mostly leaning female for all my life.

My breasts are growing for almost 3 years now, and I am around a large A cup/almost a B cup now.  But that all started before I ever head about HRT.

Thanks, this means I am not the only one who feels nothing from estrogen!
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: NatalieRene on December 06, 2018, 04:15:10 PM
Quote from: Anastasia E on December 06, 2018, 10:57:50 AM
Only 23 days  ;)  It's kinda funny how I didn't really think I'd care that much about breasts.. until I actually got on HRT, now I am like.. are my nipples buzzing?.. I'm probably just imagining it  :laugh:

I know to be patient though. Only thing that frustrates me is that I won't have my blood taken until 3 months in.. I am sure everyone goes 'are the hormones working alright?'. Some confirmation would be nice!
I started noticing changes after about 30 days and had strange looks at 60 days and passed at 90. If that is you in your avatar you'll be fine, your bone structure won't be a problem going forward.

Your confirmation will be that day when you put your seat belt on and feel a jolt of pain. You'll know when that happens that things are moving along.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: KathyLauren on December 06, 2018, 04:29:21 PM
From first call to first therapist appointment was about 3 weeks.  About a month until I got my letter.  Then three months to see the doctor.  Two weeks before I had my prescription.  Total, about 5 months.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: Swedishgirl96 on December 07, 2018, 01:05:12 PM
I took contact with the health care system in december 2016, told a nurse I was transgender. They made an appointment for me with a psychiatrist.

In march 2017 I meet a psychiatrist who wrote me a referral to a gender identity clinic.

*Long waiting time*

In april 2018 I had my first meeting with a doctor at the gender identity clinic.

In august 2018 I got the diagnosis transsexual.

The 7th november 2018 I had my first meeting with my endo.

The 5th december I got a prescription for HRT.

Now Im waiting for getting an appointment from my local clinic for injections. I hope they will be able to see me soon.

Thats Sweden. Before you get any treatment you need to have a diagnosis here. And I can't do any appointments, the doctor does that for me and send me a "calling", a letter with a prebooked appointment. So all I can do is wait and make sure that I will be able to come to my appointments. Otherwise I have to ask them to book another appointment for me but then I have to wait another couple of weeks.

But at least it is as close to free of charge as it can. I pay a small fee for a doctors appointment (33 dollars) with a roof at 116 dollars, after that it is free for me, for the rest of a 12 month period, to visit anyone or anything in our health care system. Its called high-cost protection and it activates automatically.

There is a separate high-cost protection for medicines. Its a bit complex but it is like a "discount stair". The higher the cost is for medicine the higher the discount is until you reach the roof of 249 dollars. Then it is free for a 12 month period. For all kinds of prescribed medicines.

And the government pays for all traveling costs to any clinic, but of course they just pay for the cost of the cheapest way of traveling. So I use the most convenient way for me and use it as a discount.
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: ChrissyRyan on January 02, 2019, 10:30:49 PM
Thank you ladies for sharing.  This is useful information. 

It seems like waiting times are long in the UK for some transgender related services.

It also seems the USA, it can take maybe two to three months to first see a physician to start HRT.  Sometimes it is quicker.

But I see that times do vary across the board.


Chrissy
Title: Re: Typical mtf timelines from start of therapy, to HRT letter in hand, to HRT start
Post by: sfbarbie on January 19, 2019, 06:27:20 PM
I did not have to see a therapist or anything prior to starting. However, I'm not sure if that is because I was already seeing an endocrinologist for my thyroid and I just made an appt with her and then said I wanted to start them so she put me on them after we had a talk.