I am 17 years old, looking to start testosterone. My parents are now okay with me starting, we just need to get a letter of recommendation and an endocrinologist. I am currently seeing a counselor about everything, but he doesn't know much about the whole process. My question is, would he be able to write one or would I need to be seeing a psychologist or a psychiatrist? Also I live in Alabama and it would be great to go to someone that takes our insurance (BlueCross BlueShield PEEHIP). Thanks

I believe he can if he is a licensed counselor.  If his knowledge is limited he should look at the WPATH standards of care at http://www.wpath.org/uploaded_files/140/files/Standards%20of%20Care,%20V7%20Full%20Book.pdf

According to that book on page 26:

The recommended content of the referral letter for feminizing/masculinizing hormone therapy is as follows:
1. The client's general identifying characteristics;
2. Results of the client's psychosocial assessment, including any diagnoses;
3. The duration of the referring health professional's relationship with the client, including the type of evaluation and therapy or counseling to date;
4. An explanation that the criteria for hormone therapy have been met, and a brief description of the clinical rationale for supporting the client's request for hormone therapy;
5. A statement that informed consent has been obtained from the patient;
6. A statement that the referring health professional is available for coordination of care and welcomes a phone call to establish this.
 


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Wow really? I thought you had to be seeing a psychologist or psychiatrist and get a letter from them. I will definitely talk to him about this and show him the WPATH standards next week when I see him again! If that's the case, he could easily give me an evaluation and write a letter of recommendation. Thank you, I will find out more! 

Whether your counselor can write the letter will depend on what his credentials are -- his degrees and licensing. Generally, a person needs to have a Ph.D. (or equivalent) and a state license to comply with the WPATH requirements. If he doesn't meet them, the chances are fairly good that he's working with, or supervised by, someone who does, so he might be able to refer you (or get that person to sign off on the letter, if it's a supervisor).

There are also clinics and practitioners who operate on an informed consent model, which doesn't require a letter. Given that you're a minor, your parents would probably have to be closely involved if you went that route, but if they're on board with you starting T, that shouldn't be a problem.

Best of luck!

For HRT, any kind of therapist/counselor/psychologist/psychiatrist can write you a referral. It's only surgery that requires specific credentials for referrals. If he doesn't know much about the process, it may be helpful to look up "HRT referral letters" online to give him a template to work with. Then you'd need to find a doctor who's willing to prescribe. It doesn't have to be an endo. It could be a general practitioner, endo, gynecologist, etc. Mine is just a regular MD.

Depending on what level of insurance coverage you have, it may be easier to get your visits and T covered by a regular doctor. On some plans the copay is higher if you're seeing a specialist, which an endo would be.

Awesome, thank you guys. I am going to talk with him about it.