I am sure this wuestion has been asked before, sorry. 

How long does it usually take before your therapist will write you a recommendation letter for HRT?  I read 3 months, but my therapist said its typically a year.  She did say the policy may have changed and she would research it.

You thoughts, anyone?

According to the WPATH guidelines, your therapist should not make you wait AT ALL. It is entirely your decision and yours alone when to go on hormones. I can provide you the exact page reference if you need it.

However, not all therapists agree to the WPATH guidelines, so your therapist may do it differently.

It seems to vary a lot from country to country.  I'm used to hearing the three month figure in the USA, but we also have 'informed consent' clinics such as some Planned Parenthood operations.  I had talked to my therapist about this, and we agreed to just wait until we both thought I was in a place to make the decision on my own.  That looks like about three months for me.

Thank you, Ladies!!

Suzi, yes please....if you can direct me to the WPATH guidelines I would appreciate it.

Quote from: CourtneyMarissa on May 03, 2016, 12:31:24 PM
Thank you, Ladies!!

Suzi, yes please....if you can direct me to the WPATH guidelines I would appreciate it.

http://www.wpath.org/uploaded_files/140/files/Standards%20of%20Care,%20V7%20Full%20Book.pdf

Last paragraph on page 25:

QuoteIt is important for mental health professionals to recognize that decisions about hormones are
first and foremost a client's decisions

There's no legal requirement for HRT letters, to visit a therapist, or how long anything should take. The WPATH SOC is a best practices document that some medical people follow, some say they do and don't, and others ignore. A doctor doesn't actually need a recommendation letter to prescribe you HRT, but they don't have to see you either - its up to them what their preference is. Not all therapists or doctors are actually any good either.

If you need/want therapy go for it, otherwise look at alternate options. Its going to vary very much depending where you are (or how much money you have). I chose to see a therapist for a year before I started, but it wasn't for letters. I found therapy helpful to clarify my thoughts, but I'm not asking permission of anybody.

Personally I'd try to find recommendations from trans people post for good doctors/therapists in your area. If you can't find any I'd suggest making a post asking, with the subject and location in the title so that people who might know are more likely to respond.

There's been posts in the forms before about red flags to watch out for in therapists and doctors. Worth reading.

The practice should be that the client requires an assessment of their understanding of the issues, what the affects will be and the reason for them wanting HRT. As long as there are no 'flags' such as mental health issues that may be contrary to HRT (psychotic, DID etc) then there is no reason for any delay in going on HRT. The therapist, if they are good, may suggest that you return for further counselling to deal with other issues such as PTSD or family issues etc but that is not an impediment to HRT just good medical practice to ensure you have a happy and healthy transition. A good therapist is also there for you during your transition to help you with any personal problems you may face.

In some countries the therapist may also need to write letters for your gender change on legal documents such as a passport, driving licence, Tax Office etc. The letter basically says you are under medically supervised transition to your affirmed gender and that your documents and records should be changed accordingly.

One issue is that any medical professional can do the assessment but many family doctors do not feel confident and refer people to psychiatrists with specialisation in gender issues. That creates a big waiting list. Hopefully this will change with the new education programs that are being launched by WPATH and others.

I am in Philly PA USA. Where I go they take blood and schedule an appointment a week When my therapist and PA agreed I could handle the next steps I was prescribed HRT. I am glad I had their guidance and I needed the therapy time to address a lot of issues.

A friend of mine had started recovery and had to wait 3 months.

I should note that going through a huge HMO with it's own therapy teams can get a little tricky.  I seem to be caught in a slight tug of war between my 'primary therapist' that I initially saw, and a gender issues specialist, over who will refer me to the HMO's transition specialists.  On a high deductible insurance plan, this is going to cost me a bit in money and time for the extra sessions.  I suspect I'm seeing the HMO version of gatekeeping.

Anyway, I'm bringing the WPATH standards to my next session.  Worst case, I blow them off and get prescriptions from one of the 'informed consent' clinics in the area.  I have to pay for everything either way.

I was always of the mind that you had to have that letter. I finally got one from a gender therapist a few months ago. So then the day arrived that I was going to come out to my doctor. Which I did so. She accepted the fact that I identified as female and referred me to endocrinology.

My health plan's protocol required me to first meet with a psychologist. Twice I meet with her and then an appointment was made for endocrinology (next Wednesday which I am so excited about).

The letter? Never once was I even asked about it. In California at least it appears that your wanting to go on HRT is enough for the medical establishment to assist you.

Diane

Thank you all so much for the replies.  I'm blown away at home much support I can get on this site.

Rachel Lynn it was finding your thread about your transition that brought me here to Susan's.  So to have you reply to one of my posts is like...making my day!

I will discuss with my Therapist on Tuesday about the timeline again.  I want to start HRT as soon as I can, but I do have some major issues I need to get worked out first.  Namely, how and when to come out to my wife of 11 years.

I can tell you all that since coming out to my therapist and Doctor that I am Transgender I have lost 14 pounds and my blood pressure is now back down to a normal range.  It's obvious to me that keeping this secret was absolutely killing me.

Thank you all again!

Courtney