So I'm not really sure what to think about this. I'm trying very hard not to expect too much but I can't help but be a little excited about this. But I'm not sure if much will come out of this until I receive that letter for hormones from my therapist.

See, what happened is about a month or two ago, the last time I visited my primary doctor's office, I called them and asked to be referred to an endo. Prior to that, I let her know right off the bat that I suffer from GID and gender dysphoria. And maybe a few weeks later I received some missed phone calls about this referral. Yesterday, I finally was able to get a hold of someone who could set up an initial appointment with an endo named Dr. Chehade. I need to look them up again, but I think I saw this endo's profile online. I let the scheduler know that I may need a letter for hormones first (yeah, I awkwardly explained that I wanna transition from female to male, only because she asked about the nature of this referral I requested for from my primary doc).

But once she asked what insurance I had and I told her, she seemed receiving about it and just scheduled me for February of next year!^^ She said Dr Chehade would not have wanted to schedule me if he wasn't going to treat me at all. But then I think maybe she was just sayin' that. I dunno. My therapist has no idea. I was supposed to see him on Monday, a couple of days ago, for the third time, but he cancelled our appointment on the last minute because his son was still out from school for Thanksgiving break.

So is it possible that I do not need a letter for hormones, depending on the endo's standards of care? I wish I could find what his are on his website. Perhaps I will request them from his office. Has anyone else had any experiences with finding an endo without the help of a gender therapist and being able to obtain HRT without the letter? Thanks.

Cogratulations man

Quote from: Elis on December 02, 2015, 01:36:07 PM
Cogratulations man

Thanks, Elis.

I did find out a few minutes ago from the office that I actually do require a letter, as I suspected. However, even though I told them I do not have one yet, because the appointment is a couple of months from now, that could possibly give me the time I need to obtain a letter and anything else that may be necessary to bring to my initial consultation. So the office wants to keep this appointment.

Right now, I got my fingers crossed; hopin' for the best and preparin' for the worst. Yet I'm determined to win. Cause we are all winners.

Hey Phoenix,

I know you found out you need a referral, but I wanted to follow up on that for anyone reading. The WPATH Standards of Care are recommended practices, not required guidelines. It is entirely possible to find doctors, specialists, and top surgery surgeons who do not require referral letters from mental health professionals.

As to having your letter by the time of your appointment, it's definitely a possibility and I would ask your therapist about it at your next meeting. At the very least he should be able to tell you how far along in his process you currently are, and from there you should be able to figure out what things you need to address with him before he'll give you a referral.

A good therapist should be able to tell you either how many more sessions they think you'll need to have, and/or what topics they need to cover to be able to write your referral. If they can't tell you either of those things, there is a chance that they are viewing you as a source of residual income and not a patient with needs.

Quote from: FTMax on December 03, 2015, 02:15:16 PM
Hey Phoenix,

I know you found out you need a referral, but I wanted to follow up on that for anyone reading. The WPATH Standards of Care are recommended practices, not required guidelines. It is entirely possible to find doctors, specialists, and top surgery surgeons who do not require referral letters from mental health professionals.

As to having your letter by the time of your appointment, it's definitely a possibility and I would ask your therapist about it at your next meeting. At the very least he should be able to tell you how far along in his process you currently are, and from there you should be able to figure out what things you need to address with him before he'll give you a referral.

A good therapist should be able to tell you either how many more sessions they think you'll need to have, and/or what topics they need to cover to be able to write your referral. If they can't tell you either of those things, there is a chance that they are viewing you as a source of residual income and not a patient with needs.

What up, Max?

Whoa, you serious? I don't need a letter for some endos? Man, I wasn't sure. But this one, the one who scheduled an appointment with me does need one. I have more info now about the necessary documentations my endo will need by the date of the initial consultation.

Oh, I see. I couldn't think of the right terms for what I meant when I asked for a copy of The WPATH Standards of Care. And what is WPATH short for exactly?  Yeah, still new to this trans "slang" even though I identify as such. I will keep this stuff in mind even if I have to write it all down.

And now that you mention it, Max, the next time I go see my therapist next wednesday, I'm gonna ask him those very same things you recommend cause you been through that, man and you know whatchu talkin' 'bout. And I hope he really isn't in it for the money. But, dude, people like that, unfortunately, do exist. That is true.

Yep! Every medical professional has discretion when it comes to working with trans patients and can choose to apply the existing standards as they see fit. Some of them follow it exactly as written, others apply things on a case-by-case basis. The WPATH (World Professional Association for Transgender Health) developed the Standards of Care to promote best practices and develop supportive policies for trans people seeking to transition. The Wiki maintains a copy of the most up to date SOC here:

https://www.susans.org/wiki/Standards_of_Care_for_the_Health_of_Transsexual,_Transgender,_and_Gender_Nonconforming_People

For the most part, you'll find surgeons following it as written, because surgery is a huge deal and not to be taken lightly. The best way for the surgeon to protect themselves legally is to treat the standards as best practices and follow them exactly. But there are many practitioners prescribing HRT who take a more informed consent approach, or who combine both approaches based on patient needs. You'll notice in reading through that there is no required length of time that a person needs to see a mental health professional before obtaining a referral for HRT, but there are topics that mental health professionals should be addressing in their sessions. Comparing what is listed there and the answers your therapist gives you should help you see what he's all about.

Quote from: FTMax on December 05, 2015, 10:47:08 AM
Yep! Every medical professional has discretion when it comes to working with trans patients and can choose to apply the existing standards as they see fit. Some of them follow it exactly as written, others apply things on a case-by-case basis. The WPATH (World Professional Association for Transgender Health) developed the Standards of Care to promote best practices and develop supportive policies for trans people seeking to transition. The Wiki maintains a copy of the most up to date SOC here:

https://www.susans.org/wiki/Standards_of_Care_for_the_Health_of_Transsexual,_Transgender,_and_Gender_Nonconforming_People

For the most part, you'll find surgeons following it as written, because surgery is a huge deal and not to be taken lightly. The best way for the surgeon to protect themselves legally is to treat the standards as best practices and follow them exactly. But there are many practitioners prescribing HRT who take a more informed consent approach, or who combine both approaches based on patient needs. You'll notice in reading through that there is no required length of time that a person needs to see a mental health professional before obtaining a referral for HRT, but there are topics that mental health professionals should be addressing in their sessions. Comparing what is listed there and the answers your therapist gives you should help you see what he's all about.

Hey, thanks man.  I will definitely read this all before I see the therapist next time. I heard about this but never read into it as I should have some months ago. Yeah, I feel like he does not address the GID/dysphoria as often as he does my financial and home troubles with my father.

I'm hoping he does that because he is concerned about my safety and whether or not doing HRT in the current living situation I am in is even feasible. Still, its better to be safe than sorry. So I want to really read this as soon as possible and see if what my therapist practices really lines up with the procedures explained here in the WPATH Standards of Care, as you have previously suggested.