Has anyone here ever had any experience with an informed consent doctor for the hrt? I live in an area that has a local clinic that specializes in servicing people who are LGBT, & they use informed consent.

How difficult/easy is it for people to get started on hrt by going to these places? How private is it? I have no desire for the details of my medical file to go public. I'm working on getting a job in the federal government, & if they find out I'm undergoing hrt, they might decide I'm not worth the hassle.

Also, it's easy to talk to other people on here about gender dysphoria, but for those not experiencing it, it's not easy. I would prefer not to deal with a psychiatrist, because of the money it would cost, & also because I don't want to play to the 20 questions game. Has anyone else been able to start hrt without seeing a psychiatrist?

Thanks,

Dana

You didn't say where you are located, but I'm in the Chicago area.
I went to an LGBT clinic called Howard Brown. They work under informed consent.
I had one appointment with a medical doctor where he explained the HRT program and took blood to determine my hormone level and general health. At my second appointment we reviewed the lab results, I signed the consent forms and I received the prescriptions for estrogen and spiro.

I was 59 at the time and very much aware of what I am and what I wanted so I saw no need to see a psychiatrist. After I started HRT and started coming out to others I discovered that I had some very supportive friends. Had it not been for them I may have sought out a psychiatrist just to have a person to talk to, also if your young you may find the help of a gender qualified psychiatrist helpful.

My transition is going very well but I can't imagine getting through this without having someone there to talk to most every day.

Hi,

I started HRT in a similar situation. I live in Washington DC, and we have an LGBTQ clinic that has a very good trans health program. It is exceptionally easy to get started. They are still bound to all of the same privacy standards that everyone else is, so there's no greater risk than going to any other doctor.

Informed consent means that you bypass the mental health requirement, as long as there are no extenuating circumstances in your life that would make it recommended. So if the clinic follows informed consent, they may have a mental health person on staff but you probably won't have to speak to them if you don't want to. I was able to start HRT in 2 visits/3 weeks with a doctor.

First visit - Get vitals taken by a nurse, talk to doctor about what I wanted, go over informational packet on HRT, go over my medical history, talk about any concerns I had, get signed in for lab work, and make a follow up appointment ASAP once lab work results are in (usually about a week later).

Second visit - Get vitals taken by a nurse, discuss lab results with doctor, go over prescription and expectations for future visits (quarterly for the first year), go to pharmacy and pick up prescription, come back and meet with a nurse to learn how to self inject.

Very simple. There was no gatekeeping, all of my experiences were very affirming. In terms of your job hunt, as long as you aren't requesting a security clearance, nobody needs to know what kind of medication you're taking.

Hello , It is impossible to hide on your medical history that you are on HRT . You arent prescribed for Aspirins ... Also, for legal name/ sex marker change,  for SRS and for everything transition related , specialist are sharing and updating your medical files all the time .

If you really want to be hidden you Will have to self-med wich is TOTALLY NOT reccommended . As soon as you get a prescription , say goodbye to specialist privacy

It is also very important to see A therapist . Usually you cant skip this step and there is good reason for It ...

Quote from: archlord on February 06, 2016, 05:30:41 PM
Hello , It is impossible to hide on your medical history that you are on HRT . You arent prescribed for Aspirins ... Also, for legal name/ sex marker change,  for SRS and for everything transition related , specialist are sharing and updating your medical files all the time .

If you really want to be hidden you Will have to self-med wich is TOTALLY NOT reccommended . As soon as you get a prescription , say goodbye to specialist privacy

It is also very important to see A therapist . Usually you cant skip this step and there is good reason for It ...

I disagree with everything you've said here. In the sense that OP was speaking on (privacy in regards to employment opportunities), it is absolutely possible to keep your medical history private from a future employer. I've been through multiple interviews and gotten offers from 3 companies in the last month, none of whom know anything about my transition.

Obviously it is inadvisable to keep your medical history private from a healthcare provider, especially medication that you are actively taking. I don't think OP mentioned this at all though.

And seeing a therapist is not a must for everyone. If the option is available to start HRT without therapy, it's something that you have to decide for yourself. Not every transition looks the same.

Quote from: FTMax on February 06, 2016, 05:40:31 PM
I disagree with everything you've said here. In the sense that OP was speaking on (privacy in regards to employment opportunities), it is absolutely possible to keep your medical history private from a future employer. I've been through multiple interviews and gotten offers from 3 companies in the last month, none of whom know anything about my transition.

Obviously it is inadvisable to keep your medical history private from a healthcare provider, especially medication that you are actively taking. I don't think OP mentioned this at all though.

And seeing a therapist is not a must for everyone. If the option is available to start HRT without therapy, it's something that you have to decide for yourself. Not every transition looks the same.

Of course most company arent going this deep with medical history but when I did entrance test for GRC , they reviewed from financial to medical then to the people I talk to . It depends on what job You are aiming for . If you are going for a standard job at government they wont go this far BUT the medical evidence that You are on HRT is here .. Just think of what would happen if you get hospitalised and they arent aware of It ( Risk of blood cut , blood pressure etc) this doctor that prescribed hormones would get severe problems .

A therapist is neccessary for SRS consent , I actually need 2 for my surgery with dr brassard on december , It is neccessary for my name change/marker change ( they ask to join therapy report)
It is also neccessary for most FFS surgeon , when I asked for consultation with A few surgeon , most of them asked for therapist letter .

A therapist is NOT something to skip as the first person you harm is yourself

Quote from: archlord on February 06, 2016, 06:04:47 PM
A therapist is NOT something to skip as the first person you harm is yourself

Does everyone who transitions need a therapist? Or are there some people who know what they need, and know how to go about getting it?

Quote from: suzifrommd on February 06, 2016, 07:33:44 PM
Does everyone who transitions need a therapist? Or are there some people who know what they need, and know how to go about getting it?

I knew what i wanted a while before starting my transition and seeing a psychologist.  However you need a proper diagnosis for gender identity disorder that is on the DMS-5 if you want to get further in transition and only a therapist can give this diagnosis.

Transition isnt easy and honestly i wished i didnt have to see a therapist before but it is so nice to have someone neutral that you can say EVERYTHING you want . You realise it just after, it makes you stronger

Quote from: Adchop on February 06, 2016, 03:56:42 PMHas anyone here ever had any experience with an informed consent doctor for the hrt? I live in an area that has a local clinic that specializes in servicing people who are LGBT, & they use informed consent. How difficult/easy is it for people to get started on hrt by going to these places?

It was very easy.  I used an informed consent clinic and after a meeting with the clinician, signing the informed consent we waited for the blood test results.  Three days later we went over the results over the phone and my prescription was called in to the pharmacy.

Quote from: Adchop on February 06, 2016, 03:56:42 PMHow private is it? I have no desire for the details of my medical file to go public. I'm working on getting a job in the federal government, & if they find out I'm undergoing hrt, they might decide I'm not worth the hassle.

It is very private, in the U.S. they are required by law (HIPAA) to keep your medical info private.  Read more about HIPAA here.

Thanks everyone for providing your insight. I'm currently trying get on at the State Department (Foreign Diplomat), so there will definitely be a security clearance request at some point.

I think honestly I'm in a different place than some on this board. I'm not looking for a rapid transformation with lots of surgeries, & clothing/name changes. I'm looking to get started on a half dose regimen of estrogen, to slowly transform my body over an extended period of time. Of course I understand that there will be complications along the way, such as the question about how receptive my body will be to estrogen, & how quickly even a half dose of estrogen changes me. I think this is the best way for me to ease into the body of my preference, without the risk of wrecking everything I currently have worked for.

My gradual changes over an extended period could easily be passed off as testicular atrophy from my former T injections. It would be perfectly logical for me to say that my testes stopped producing T in large enough quantities after quitting (history of low T), & that was the explanation for my body changes.

I'm just concerned how I can do this in secret. I'm a very private person, but we live in an age where privacy is virtually non-existent. I don't feel I have to broadcast to all my future employers my past with gender dysphoria, or my desire to transition. If I were hired with the Federal Government, they couldn't fire me if they found out later on, not without a massive lawsuit.

wouldn't it just be a whole lot simpler to be open about the process. For one thing no ones going to ask you unless there is some really good reason to. The Federal government is probably the best place to be open.

Quote from: stephaniec on February 06, 2016, 10:16:43 PM
wouldn't it just be a whole lot simpler to be open about the process. For one thing no ones going to ask you unless there is some really good reason to. The Federal government is probably the best place to be open.

If I didn't plan to continue presenting as a man, then yes it would be a lot easier. Honestly though, I've convinced myself that as complicated as what I described sounds, it's less complicated than what would come from me opening up about my transition right now, & going full time.

In regard to the federal government being a good place to transition, you are correct. That's why I want to get in, before I allow them to find out. Getting employed by the state department is hard enough already. It's a multi-tiered application process that requires test, interviews, etc. I don't want to give them any reason to think that another candidate is better suited for the job for me.

Im in the same boat with regards to maintaining a security clearance, I would definitely try to obtain one first before publicly transitioning. With regards to work, Im also taking it slow in both socially and medically transitioning, so I think you have a very smart plan.

I went to Fenway Clinic in Boston which does Informed Consent and since I only use them for HRT my medical records with them are independent of my normal providers. Regardless you have to remember that all records are protected by HIPPA and you choose what you get to release.

In terms of getting Hormones I first saw a therapist for a session to determine if I was psychological stable and then I saw a doc for two sessions and after that I got my scripts and was good to go. Probably took a week total from start to finish.

Best of luck with the Foreign  Service Exams!

Hey sorry Im responding on the forum; the site say's Im not allowed to send private messages. I was in the military so I don't really know the recruiting process for the state department. If I recall correctly there is a question on the TS poly asking about sexuality but that is gauged to see the risk of blackmail. Honestly I cant recall anything asking about gender identity, so I cant imagine this will be something that holds you back. Sorry I can be more helpful, Best of Luck!

Quote from: Adchop on February 06, 2016, 10:02:24 PMthere will definitely be a security clearance request at some point.
...
I'm just concerned how I can do this in secret.

Secrets and security clearances do not go together.  If you have secrets and they find out, you won't get a security clearance.  If you already have a security clearance and they find out, you will lose it, you will likely be fired, and possibly have disciplinary action taken against you.  Having a secret make you a target for blackmail.

If that is the job you want, it is in your best interest to have everything out in the open.

Speaking specifically of the Foreign Service of the US Department of State, I can through in a little insight from one of the security investigators.  First of all, there are no medical questions until you are offered a position -- which can come after the written and orals, but even if you pass those, a job offer is not guaranteed.  In some years because of the budget, there is simply no intake of new applicants.  That is not a reflection on your personal qualifications, but the political mood in Congress.  And many more people pass both exams than there are slots to fill.  Less than one percent of the people who take the written exam are ever hired.  And if you are not the child of a congressman, the odds against you increase.  State if the most politicized of any part of the federal government.
Unlike other government agencies and departments, there is no poly in State.  Your clearance is granted on the basis of your background investigation, starting at elementary school.  And with your birth record, to demonstrate that you were not parachuted by the Russians into Nebraska some 25 years ago. If your friends and neighbors do not think you are weird, then you are not weird.  And State is not nearly as close-minded as we might think it is.  Open gays and lesbians are hired on an equal basis.  There has been one FSO who transitioned MtF on the job while serving in an embassy overseas.  But if you fall into one of those groups, expect no privacy.  The PR people with trumpet you around the world as an example of how liberal an d open to gender diversity the USG is.

All that being said, the various legal protections, which are taken very seriously by the feds, to not apply until you have been offered a position, have accepted in writing, and sworn the oath.  Given that there are gazillion qualified applicants for every position as an FSO, my advice would be not to volunteer any thoughts of gender dysphoria until one is already hired and "one of them."  The FEHBP for State is also unique, and there is a firewall between your medical info you may wish to keep private and anyone in the Department.  But if you do keep it a secret, then the Overseas Medical Benefits will not apply to your condition.  (OMB are cost-free total expenses paid for anything that happens overseas, not a minor perk.)

So for advice?  First, pass the exams, which you will not do if you apply the first year out of a four-year university.  Deal with all that other stuff later.

It really depends on the clinic, your background, medical history, etc.

After many years of reflection, I opted for Informed Consent.  I also use the Howard Brown clinic in Chicago.  A very positive and welcoming experience for me. At Howard Brown, basically, you're given a diagnosis of Endocrinal Disorder, and a prescription for hormones.

I think, in the scope of informed consent, you're on a really good path. I sense there's tremendous freedom in how you can approach your transition in terms of pace.  I'm frequently asked about pace, faster, slower, etc.  There's control, their goal is not to throw pills at people, but to manage to the right amount of medication to achieve an acceptable hormone level.  Going slower, is usually an option, and it'll just mean fewer pills, and not increasing it if your E levels don't hit the full female range right away.

If you're getting into security clearance, a good thing to check on is what diagnosis does your clinic provide for informed consent?  Gender dysphoria will look a little different than Endocrinal Disorder. Not sure if they get to see your meds, that will be the most telling.

IMO, I do think some of this is tied to who does what.  Dysphoria strikes me as something you'd look to a psych related professional to get.  Endocrinal disorder is something a medical practitioner can diagnose without a psych eval process.  That's just guesswork on my part though.

Good luck .... if you're really good on your path, I think you'll find E does wonders for your mind set.

I did informed consent at a trans clinic. The waiting room was a little scary because the amount of people in there were comparable to an emergency room's waiting area. They did a 1 hour intake interview type of thing with a therapist and took blood. Then the next visit they prescribed the hormones. Mine also billed it as a hormone imbalance.

I'm also a dod contractor with a clearance and transitioning on the job. Maybe it would be harder to just be starting though. I've been here for almost 10 years. Federal contractors are protected, so there "shouldn't" be any issues there.

I wouldn't lie on your clearance paperwork. That's how you don't get the clearance and they don't typically get you one unless it's required for your job, so you wouldn't get the job either. Bank on the idea that they WILL find out. If the secret is big enough for you to hide it from them, it's big enough for the enemy to use it to blackmail you. For mine, they didn't talk to any of the references I listed. They found their own and sent the FBI to their houses. I know this because those people asked me why that was happening. Apparently they don't tell them why.

Emileeeee

Unless you are working as a contractor for one of the intelligence agencies, transition on the job certainly eliminates the fear of blackmail.

Your clearance, at whatever level (I am guessing Secret), needs to renewed every five years.  And of course they never speak to the people you list as references -- they know they will be favorable to you, so why bother.

There is a part of the re-investigation may be a bit of a hang-up.  One part is the question:  Have you ever consulted with a mental health professional?  You have, and it is all innocent; your gender presentation does not affect your loyalty.  But it does put your file into different slot than can delay adjudication for up to a year, and even with your written permission, some mental health professionals refuse to speak to the investigators.  Which means you go into a still different slot.  It is a hassle, but worth it.

I do fall into that bucket, so I guess I have a different perspective.