I just went to a therapist nearby the other day and she was wrote me the testosterone recommendation letter the same day. The doctor isn't even an endocrinologist, but he has been doing this for over 20 years. He feels like it is important for him to do since here in the south (I won't disclose location because it might be obvious who he is) there aren't many doctors who are trans friendly. This therapist is basically the only gender therapist in this are and she has been doing this for over seven years. Does anyone think that this might be unsafe? I feel like I am ready for testosterone, but I really didn't just expect her to write the recommendation just like that.

the SOC guidelines are just that guidelines, not rules (at least not in the US). I am on hormones with no therapy at all, for example.

I say go at whatever pace you are comfortable with, if you feel you should have more therapy before starting T then tell your therapist that, but if you really feel ready then go for it. The WPATH SOC is a good document, but I feel the guidelines aren't always appropriate for all people.

The SOC guidelines make it clear that it's the patient's decision when to start T. If you want to start T, it's not the therapist's place to stand in your way.

Yeah just guidelines like they said. They started me right away as well

Therapy should be a choice. Not a "gate" or an obstacle. If you feel you need more therapy, by all means do so.

There are many doctors across the country that don't require a therapist letter at all for HRT. Just some labs, a physical, and an interview. Welcome to the emerging age of informed consent!