I'm an FTM, pre-everything, 41 years-old. Have started coming out to all my friends/family/co-workers. I'd like to begin testosterone shots and have top surgery, but I'm curious if the "rules" are all dictated by insurance for how long I must do therapy (I see a therapist, but not a gender therapist) or T before I can begin the legal paperwork and have top surgery, or if there are state by state laws.

Any thoughts?

I live in MO. It's not a bad state actually. I do all my transrelated stuff out of Columbia, which has been a surprisingly nice place to start. I paid everything out of pocket though, so I can't help with insurance stuff.

I don't think there are any laws, state or federal, in the U.S. regarding HRT or surgeries. WPATH, which is international, sets guidelines. Insurance companies put their two cents in, typically making medical decisions they're not qualified to make. The amount of therapy you need, and what letters, if any, will be decided by your endocrinologist or surgeon, respectively.

Thanks, Dee!

And thanks, Frank!

I'm in St Louis. Any word on a good gender therapist and an endocrinologist with an open mind?

I am from St. Louis but currently living in Montana. which is probably the worst state I could move to ..to be able to find myself and start to be comfortable with transitioning. Ive been here almost 2 years and never realized that the planned parenthood has started helping transgender with HRT. I kind of wish i would have realized it when i first moved up here but didnt until January of this year. Better late than never I guess. They have been doing this 7 years already which was really impressive to me considering this state isn't very liberal. I plan on moving back to St Louis in August due to the fact that I miss my family terribly and the winters up here are way too long. The summers are wonderful compared to Missouri though. When I was talking to the doctor that started me on T, he seemed to think that I could still see a doctor through planned parenthood when I move back to St. Louis to continue T. So that may be something to look into.

Quote from: JustZac on March 27, 2015, 12:12:31 AM
Thanks, Dee!

And thanks, Frank!

I'm in St Louis. Any word on a good gender therapist and an endocrinologist with an open mind?

I live near Columbia, MO and when I was looking for a therapist I contacted Dr. Maureen Osbourne from Dr. McGinn's website and asked her for resources near me.  She sent me a search from the psychologytoday website for my area.  I emailed a bunch of them with a template email she sent to weed out the ones that just put transgender on their specialties.  Here it is for St. Louis City and St. Louis county:
https://therapists.psychologytoday.com/rms/prof_results.php?sid=1427581777.5089_1730&city=Saint+Louis&state=MO&spec=187&lmore=22

She said this:

Quote
I would blind copy all of them and ask the following questions: Do you work with the WPATH Standards of Care? Have you worked with clients who are transitioning? How many? What do you think the important issues are in helping a client transition? Have you written surgery referral letters? If so, to what surgeons? If they act like they don't know what you are talking about, I would not trust their experience. 

It worked for me.  I got several good responses, and several that told me to take a hike, indicating they put trans as a category when they didn't mean it.

Also, in midimo there is this for trans resources:
http://www.transgenderhealthnetwork.org/trans-friendly-health-provider-list.html

You could contact some of them and ask for reference resources in your area.

Thanks for the info!!