I am getting so annoyed by the fact that all dr. require that note. I understand this is a big decision, but it is something i have known about myself and wanted my whole life i wish it was easier..... If anyone knows of any doctors in the houston or austin area that does not require a note to start you on hormones i would really appreciate the help. I just don't have the time between school and moving around to see a therapist for who knows how long to get diagnosed with something i already have known i had my whole life. Thank you i appreciate the help.

One of the biggest reason Endo's are requiring letters in most places is they are tired of getting into lawsuits when the person bypasses Therapy and then has regrets later. Where I live Endo's use Therapist's letters as a pre screening tool. More times than not if a person has had Therapy the cases of post HRT regret are very low. Yes you can still find places to do informed consent, but they are dwindling somewhat. They are still out there though. HRT is not like going to a store and buying something which can be returned it is a life altering procedure for the most part. I would urge you to see a Therapist and make sure and be prepared for ALL the issue's you can face both socially and privately. 

i know and understand all the risks and how socially alienated i will be by some, but i believe finally being who i am will actually give me happiness in my life and a new strength to handle those situations. I think that is stupid that dr. are getting sued for patients deciding it is not what they want i feel like their body is their responsibility and them choosing to do hrt is no ones fault but theirs the dr. was doing his job. I think its so dumb how so many people do stuff and then it doesn't work out so they blame everyone else. I for one am wanting to do this or at least get it going before returning to school because once school starts i can't just take off or always have time to come back for 3 months of counseling. I understand what i am getting into and i am taking responsibility for my body and actions i just wish the healthcare system and government would let me.

It's just the way it is. I know it can be annoying but that's the breaks.

Sorry, but transition and HRT is a medical procedure. It would be no different than someone going to a hospital and saying they think they need their appendix out and to schedule a surgeon. It just wont fly. You would have to be evaluated, lab tested, MRI and consults. That is just the process.