It took one visit only to my physician who specializes in Family Medicine to get a prescription for HRT. No therapy required, only informed consent. Now, that prescription had a condition that my blood pressure be checked again 14 days after the doctor visit because of borderline high blood pressure. I had that check done by a nurse. My BP was still considered on the high range of normal, but good enough for HRT.
So, I have that prescription in hand yet I have yet to have that discussion with my wife about my need for this.
Thus, I chose to go to a gender (and family) therapist to help me with my coming discussion with my wife.
I also would like to add how extremely happy I am with my HMO, Group Health of Washington State. They put me on their Transgender Services Program and assigned me a Social Worker who is an experienced therapist herself specializing in the needs of transgender clients. She helped me find my gender therapist. This social worker is the best and free!.
I have been so, so very tempted to start the HRT before talking to my wife about it. But then the good angel inside me slaps me on the hand, and convinces me to talk to my wife first.
I am hoping my therapist gives me both the courage and the tools to have this discussion with my lovely wife to whom I have been married happily for over 40 years. The marriage has been happy, but my self imposed repression of my big secret has been keeping me numb, agitated, and depressed.
I cannot risk losing my wife, yet I can barely handle the thought of another year being forced to remain a man. I refuse to die before I transition first.