Susan's Place Transgender Resources

Community Conversation => Transsexual talk => Female to male transsexual talk (FTM) => Topic started by: owl on February 19, 2010, 12:32:05 PM

Title: Can my psychiatrist prescribe me T?
Post by: owl on February 19, 2010, 12:32:05 PM
I tried my doctor, she said that wasn't her feild, and to ask my psychiatrist.
So can my psychitrist prescribe me t?
Title: Re: Can my psychiatrist prescribe me T?
Post by: Flan on February 19, 2010, 12:56:14 PM
legally yes, but your doc refusing to prescribe is a cop-out, it's another way of alleging that you're messed up in the head.

(ps, who's going to order labs to monitor blood levels?)
Title: Re: Can my psychiatrist prescribe me T?
Post by: Arch on February 19, 2010, 01:03:48 PM
Quote from: FlanHusky on February 19, 2010, 12:56:14 PM
legally yes, but your doc refusing to prescribe is a cop-out, it's another way of alleging that you're messed up in the head.

I was going to say much the same thing. Your doctor's job is to treat patients. Therefore, if you tell her you're trans and that you want to go on T, she really is obligated to do her research and learn as much as she can so that she can treat you. Either that, or refer you to someone else. Plus, as Flan said, will you keep going to your doctor through transition? How is she going to interact with you? Respectfully or not? And will she perform the tests you need or just say that it's not her field? Sheesh.
Title: Re: Can my psychiatrist prescribe me T?
Post by: owl on February 19, 2010, 01:16:52 PM
I already went to the doc, explained my story, and my doctor said it wasn't her feild and she wishes me best of luck. My psychiatrist how ever, already knows my situation. I was just wondering what the chances are of my psychiatrist actually giving me T..
Title: Re: Can my psychiatrist prescribe me T?
Post by: owl on February 19, 2010, 01:54:14 PM
*sigh*

all i asked was, what are the chances.




jeesh
Title: Re: Can my psychiatrist prescribe me T?
Post by: Lachlann on February 19, 2010, 02:17:34 PM
Quote from: Damian on February 19, 2010, 01:54:14 PM
*sigh*

all i asked was, what are the chances.




jeesh

Any doctor can prescribe you T.

For many, they get it via psychiatrist.
Title: Re: Can my psychiatrist prescribe me T?
Post by: Arch on February 19, 2010, 04:21:31 PM
Quote from: Damian on February 19, 2010, 01:54:14 PM
all i asked was, what are the chances.

Damian, I see what you mean, but nobody can really tell you what the odds are. Sure, a psychiatrist is a medical doctor and can prescribe hormones. But everyone I know gets T through an endo, a GP, or the informed consent clinic. I know a couple of guys who do have psychiatrists, but those guys actually get their T through someone else (with approval from the head doc).
Title: Re: Can my psychiatrist prescribe me T?
Post by: Nimetön on February 19, 2010, 05:50:25 PM
From Nimetön: "I wasn't going to get involved in this conversation, but I am concerned with the rigor and legal/medical validity of some of these comments.  I've asked a friend, a doctor from Harvard/MGH, to assist.  This is our response."

With respect to the standards of medical care, your primary care physician (most often trained in internal medicine or family practice) will not prescribe sexual reassignment therapies of any kind unless a formal diagnosis is in place, and they generally are not trained to diagnose GID.  If your psychiatrist is a specialist in GID and has diagnosed you with it, then that psychiatrist may very well choose to prescribe, but usually only after months of counseling.  If you have no formal diagnosis, then you're several steps shy of a prescription.

This following paragraph is offered as a general caution to the forum, rather than a specific statement to you, Damien.  With respect to medical obligation, doctors are under no obligation to treat you, and are free to end their medical/professional relationship with you at any time, just as your carpenter or accountant may refuse to do business with you. Even if your doctor chooses to treat you, treating conditions outside of the doctor's specific training involves tremendous risk of liability to the physician, and risk to your physical safety. For that reason, any practitioner who does not feel qualified to treat a particular condition will refer you to a more qualified practitioner.

- Nimetön / Dr. K
Title: Re: Can my psychiatrist prescribe me T?
Post by: Flan on February 19, 2010, 06:24:54 PM
and by refusing to prescribe and monitor, something a general pract. can do quite well even without formal training in endocrinology, the GP is inferring that transition is a mental health issue and not a physical one. (while it is both, the process of hormone therapy needs to be monitored for contraindications and dosage via ordering of labs and client medical history)

Quote from: Nimetön on February 19, 2010, 05:50:25 PM
...unless a formal diagnosis is in place, and they generally are not trained to diagnose GID. 

My gp isn't trained to diagnosis depression either, and all that stopped me from getting a rx for meds was a check-sheet of questions on their montior. :P
Title: Re: Can my psychiatrist prescribe me T?
Post by: Arch on February 19, 2010, 10:12:38 PM
Quote from: Nimetön on February 19, 2010, 05:50:25 PM
For that reason, any practitioner who does not feel qualified to treat a particular condition will refer you to a more qualified practitioner.

Not "will"--"should." You're talking about an ideal world. I've had a couple of trans friends whose doctors not only refused to perform any trans-related treatment but also refused to provide a referral, on the grounds that such a referral would be tantamount to facilitating the trans person's aberrant desires. Damian's doc may have been passing the buck, or she might have been referring him to someone she thought was a more qualified person. But I wouldn't bet on the latter.

Some doctors will in fact learn about a condition (trans stuff, anyway) so that they can treat it.

Of course a doctor does not have to continue treating a patient, at least in my experience in the U.S. My earlier statements were predicated on the supposition that Damian's doc would continue to be Damian's doc. Sorry if I didn't make that clear.

I've heard of folks in other health care systems having a devil of a time terminating the doctor-patient relationship and getting a new doc. I wonder how that works if the situation is reversed and the doctor doesn't want to work with the patient.
Title: Re: Can my psychiatrist prescribe me T?
Post by: tatiana on February 20, 2010, 04:44:00 PM
As Nimetön explained it pretty well. Kudos to you and Dr. K.

It's just matter of finding a good medical team to work with you (GP, psychiatrist, and endocrinologist) who specializes in the area of GID. If you do, your chances of being prescribed hormones greatly increases.

It's good to do research and see if there's any support groups around. An awesome local FTM counsellor directed me to a psychiatrist and even an endocrinologist/gyno. It helped my GP by doing the research for him and I requested for the referrals, even though the gender stuff puzzled the hell out of him. lol.
Title: Re: Can my psychiatrist prescribe me T?
Post by: Radar on February 21, 2010, 10:43:05 AM
Quote from: FlanHusky on February 19, 2010, 12:56:14 PMlegally yes, but your doc refusing to prescribe is a cop-out, it's another way of alleging that you're messed up in the head.

Not necessarily. My GP told me she could prescribe me T but wasn't familiar on what to look out for in the tests and bloodwork and correct levels. I preferred her to be honest with me about that then me under the care of a doctor who isn't experienced with transgender HRT. That's why many use endos for their HRT treatment and monitoring. I'd rather be safe than sorry.
Title: Re: Can my psychiatrist prescribe me T?
Post by: owl on February 21, 2010, 02:08:15 PM
meh

thanks for all your help guys, now i was just referred to a obgyn or whatever to get T
Title: Re: Can my psychiatrist prescribe me T?
Post by: Radar on February 22, 2010, 11:36:54 AM
Quote from: Damian on February 21, 2010, 02:08:15 PM...now i was just referred to a obgyn or whatever to get T.

That's a new one on me. :icon_blink:
Title: Re: Can my psychiatrist prescribe me T?
Post by: Arch on February 22, 2010, 07:30:15 PM
Quote from: Damian on February 21, 2010, 02:08:15 PM
now i was just referred to a obgyn or whatever to get T

Wow, I have never heard of this, either. But whatever works. Good luck, Damian.
Title: Re: Can my psychiatrist prescribe me T?
Post by: Osiris on February 23, 2010, 12:19:22 PM
An obgyn IS an endocrinologist, just specializes in reproduction. They are just as qualified to write a script for T as any other endo.
Title: Re: Can my psychiatrist prescribe me T?
Post by: owl on February 23, 2010, 03:06:47 PM
so a obgyn is a endo to? great :D, thanks for that, my mom is calling the obgyn right now actually as we speak.
Title: Re: Can my psychiatrist prescribe me T?
Post by: Arch on February 23, 2010, 08:00:20 PM
Quote from: Kvall on February 23, 2010, 05:14:42 PM
Er... I think it's the other way around. Some obgyns specialize in endocrinology (e.g., women's infertility), but not all obgyns do.

This is the way I have always understood it, and a brief Google search seems to confirm it. Osiris, where are you getting your information? Are you really referring to all OB/GYNs or just fertility specialists?
Title: Re: Can my psychiatrist prescribe me T?
Post by: Osiris on February 23, 2010, 08:49:35 PM
My bad. I guess cause I live in a small town the only endo we have here is an OB/GYN so I connect the 2 cause of that.
Title: Re: Can my psychiatrist prescribe me T?
Post by: tatiana on February 23, 2010, 10:16:51 PM
Quote from: Osiris on February 23, 2010, 08:49:35 PM
My bad. I guess cause I live in a small town the only endo we have here is an OB/GYN so I connect the 2 cause of that.

I was originally referred to an ob/gyn that dealt with fertility issues I believe, but I was told it was an endocrinologist back in 2005. I only found out this year that the doctor is an ob/gyn when I tried to get a referral after starting hormones this year when the doctor's office called all confused.

These doctors are pretty confusing, eh?