I've been seeing my psychiatrist for the past 2 months, and she's said that when I find an endocrinologist who will take me as a patient, she's willing to approve me for HRT. But the problem is, the only endocrinologist that I could find has an 8 week long waiting period to become a new patient, and I would have to get referred from my primary care doctor.

I haven't seen my primary care doctor, since I just recently got my insurance. So I don't know what to do. Do I just go to him and say "I'm transgender and need to see an endocrinologist for HRT"? I'm so confused and I now feel farther from HRT than I've ever felt

I got in touch with trans women in my area and asked where they got their hormones. A lot of them went to one particular doctor. So he was the one I called.

It worked out. He is very understanding and supportive of trans women but somewhat cautious about health. He ramped me up on E slowly and only added spiro when E wasn't getting the T-suppression he was looking for. Each time he adjusted my pills, he gave me another lab test to see what the effect was on my levels.

My endocrinologist was referred to me by my therapist.

all my doctors are associated with the same hospital

I guess I never realized how important it is to carefully word the title of a thread. I'm not sure what to do, can anyone help?

My psychologist gave me a list of Endo's within a 40 mile radius. I called ALL 7 of them before I found one that would at least give me a consultation. The rest were either NEVER available or were incredibly rude, or wouldn't so much as TALK to me without an approval letter. I was lucky enough that the last person I called was registered as an OBGYN with a transgender medicine practice on the side. Really great guy who understood very well what it meant to be trans and to be held back ~ Didn't even pressure me for a letter because he knew my Psychologist for a long time, so he just trusted that she would send one over (which of course she did) but was willing to treat me before even receiving it.

Don't know what area you're in, but maybe there is an LGBT center or some kind of support group that might have resources? I mean, is that endo the only one in your area?

And as for the PCP referral... well according to a support group I frequent, they maintain the belief that requiring a pcp referral is gatekeeping, apparently because your PCP should have no say in whether or not you're "allowed" to transition. But I can only speculate, don't have any knowledge or fact to back that up. In my experience, someone else living in my same city was also being asked for not just a letter from their psychologist, but a letter from their PCP, parent approval letter, school approval letter... it was offensive >_<, so I'd have to guess that seeing as I was never held back that way considering that I went to a certified gender specialist/sexologist, and this person is ALSO attempting to transition in the same city as me, then it must be gate-keeping. But as I said before, i can't really back that up, so take it with a grain of salt.

However; if its ultimately necessary in the end ~ I say just bite the bullet and spit it out your pcp is a medical professional and should be able to handle it professionally (god willing). I was afraid to tell my PCP (my psych and endo recommended it for obvious reasons, don't want them thinking something is seriously wrong with me after seeing me grow breast tissue and have high levels of E lol), but after I told her she just tells me "hey, we're all medical professionals here, its not something we haven't heard before... granted, its the first time i've ever DEALT with this before, but its not really a new medical discovery either, so don't feel like you need to be embarrassed or anything. We've seen wilder things in our practice."

So i guess when you consider that there are much crazier things out there compared to something as relatively normal as being trans, it kinda takes off a bit of the edge.

Luckily for me my endo is also a GP so I will use him as my PCP from now on.  Maybe there is someone in your area who's practice is similar?  My therapist recommended him to me as he treats a lot of her patients.  I kind of like this setup since it will be easier to just keep everything together under one roof.

Also, my therapist has been willing to make calls to various people just to ask questions regarding "her patients" to gauge the response I will get..   It's really helpful being able to know beforehand who is willing to work with me and who is not.

Good luck, I hope you find someone soon! 

My endo is my primary care doctor. The clinic I went to is catholic and no help so I had to travel.

Ask your therapist if there are any endo's she has worked with before. They often know a few friendly ones.

You could then greet a friendly endo and see if they are willing to be your PC doctor. that solves the referral part.

To sort of defend the Doctors, and I understand the sensitivity of the 'gatekeeping' mentality, bear in mind that their hands are tied. They are not the ones requiring that you first see your PCP; it is your insurance carrier. It's commonly referred to as managed health care. An Endo is considered a specialist. And as such, you need a referral from your Primary. This is never a big deal. If you don't have a PCP, you'll need to get one. Most every, if not all, insurance carrier requires one. Endocrinologist who treat transgendered are few and far between. Both my Shrink and PCP initially gave me referrals to Endos that either did not treat transgendered patients or were not on my approved physician's list. Check your plan before hand, do your own research. Find who you are covered by and ask you PCP for a specific referral. Don't expect your first appointment to be within a week or two. New patients take more time. In the meantime, have your referral letters sent to his office as well as any other pertinent medical info from your PCP.  But give these guys a break. They are here to help us all. They are the good guys.

Riversong,
To be honest it mainly depends on the area you live in. I went the psych route first just because i was a bit daunted of the entire pocess. During our first meeting she told me that during her years of practice she has only needed to write one letter of recommendation for a patient, and that was most likely due to the fact they had other underlieing mental issues.
I was also lucky that the endo i go to is informed consent, so he didnt need a letter anyways.

Resources to point you in the right direction:
Therapist
Local LGBT resource center
Internet search engine
Anyone you may know who could make recs.


Hope that helps some,
~Jen

PS: It is also helpful to know a general location you are in so other members may provide more info if they have it.
Also, i havent had a pcp since  i was kicked out of my peds office at 21. Just have to be able to explain yourself well, and ive never had problems with insurance.

I'm in western New York. I live in Niagara Falls but I feel like I'm most likely to find an endo in Buffalo and don't mind commuting there if need be.

I got my letter first and brought it with me to the doctor's office. Once i showed it to them and asked for a referral, they took care of tracking down other doctors and finding an endo who would work with transitioning clients. Endos are all over the place, chances are your doctor has a list of ones they can refer you to.

I know of two places around there that specialize in HRT for trans clients (though neither look to be really close). The first is Dr McGinn's office (Papillon Center) in New Hope, PA. Also, I know of a place in Stirling, NJ called Healthy Transitions. I myself am in Indiana, but i did look into both of these centers initially (being willing to commute). Chances are your GP will be able to refer you to an endo that's closer, or maybe someone else here is familiar with the area & can help.

River,
I'm not too sure about being able to cross over into Canada, but here is what I have.

Support Groups
Transgender Niagara: Based in St. Catharines, Ontario, Canada
Planned Parenthood:  750 Portage Road, Niagara Falls, NY 14301 (education, resources, referrals)
Brock Pride: 500 Glenridge Avenue,St. Catharines, ON, Canada

Health
Quest Community Health Center: 145 queenston street street, Suite 100, St. Catharines, ON, Canada

John M. Wadsworth, MD................313 Summer Street,Buffalo, NY. 14222..........Phone : (716) 883-5357
Dr. Megan Farrell MD....................225 Como Park Blvd, Buffalo, NY. 14227.........
...............................................892 Main Street, Buffalo, NY. 14202..............(716) 686-8111

Adolescent Transgender Healthcare Team at Golisano's Children's Hospital
601 Elmwood Avenue, Rochester NY............(585) 275-2964
Actually here: http://www.nytransguide.org/health-services-by-region#toc6  (look under Western New York Health Services)

Sorry, but I have to get ready for work.  Hopefully this gets you started on the right track. I would also recommend calling before you go just so you know if they can help you with your particular needs.
Have a great day,
~Jen

PS
Jill,
Nice to meet another girl from Indiana ^_^

Do you have much experience with Dr. McGinn? I didn't know how fast her HRT wait list was as I tried to have a trache shave scheduled with her back in Jan and she wouldn't even perform it without seeing me face to face first for a consult appt (instead of over the phone/internet like most surgeons). For that initial waste of time/money consult, it wasn't going to be until mid-July! So I went with Dr. O out in SanFran.

Getting a referral from your PCP shouldn't be too difficult.  In my experience referrals are dealt with by the office staff and they send over the referall over to the specialist within the same day, if time permits.  Of course, that's only my own experience and how things are dealt with in some specific medical offices.  They will ask you for the diagnosis when writing up the referral and the doctor may want to see you before doing that.  However, you may have to do this before you can see an endo as some insurance companies require a referral from your PCP.  The therapist only gives you a note that recommends you start hormone treatment and the endo uses that as some form of clearance or pre-approval to authorize treatment.  That is unrelated to the insurance companies policies on what they will or will not cover.  Call your PCP and see if you can get the refferal and make the appointment with the Endo in advance.  It may be a wait but it should all eventually work out. 

River... I should think that a referral from any MD would suffice. Given that you have the "blessing" of a psychiatrist (an MD) you should be able to find an endo. At least, that's the way it works up here in the frozen north. My referral came from my therapist, not my family practitioner (CDN for PCP).  I guess the difference here is that in Ontario, I can't talk directly to a specialist, I have to be referred by some other practitioner. Don't know why, but I can't argue with the price

Here's what I was able to find for transgender friendly Endo's in Buffalo
Dandona, Paresh (Endocrinologist)
3 Gates Circle, Buffalo, NY, 14209
716-626-7970 or 716-961-9900

Howard Lippes, M.D.
Williamsville: 297 Spindrift Drive
(716) 635-0688

John M. Wadsworth, MD
313 Summer Street
Buffalo, NY. 14222
Phone : (716) 883-5357

Dr. Megan Farrell MD
225 Como Park Blvd.
Buffalo, NY. 14227
or
892 Main Street
Buffalo, NY. 14202
(716) 686-8111
Good luck and just be patient with all of this. It'll come together for you.

Quote from: Jennifer. on May 28, 2014, 12:04:17 PM
PS
Jill,
Nice to meet another girl from Indiana ^_^

Do you have much experience with Dr. McGinn? I didn't know how fast her HRT wait list was as I tried to have a trache shave scheduled with her back in Jan and she wouldn't even perform it without seeing me face to face first for a consult appt (instead of over the phone/internet like most surgeons). For that initial waste of time/money consult, it wasn't going to be until mid-July! So I went with Dr. O out in SanFran.

(:
No, i dont. I first heard of her on a podcast (or maybe on youtube) about two years ago. I looked into her for HRT prior to starting. I didn't mind the travel or the consult, but after meeting my current endo i dont think i'd ever change / want a different doctor. I am considering her for SRS though, along with two other doctors.