Hello, I was wondering where to start with the medical process. I know HRT is the first major step and that i need a gender therapist's referral to start HRT but there are things that i have trouble figuring out like once i get the referral what will be the cost of seeing an endocrinologist? How long does it take to get an HRT referral from a gender therapist?

Depending on the therapist it could take a number of sessions. My letter took nearly two and a half months. My therapist wanted to be completely certain before she signed the letter. In some places it can be done by just informed consent. Some here have just done a short visit with a therapist then got the informed consent. I would stress that seeing a therapist can be really helpful in navigating all the emotions involved.

If there is a clinic available to you that observes "informed consent" protocols, a referral from a psychotherapist may not be necessary.  You might have to check with requirements of specific caregivers to see what is available and what the steps are.  Costs can depend on whether you have an insurance plan and whether the caregiver is in network or not.  If so, out-of-pocket costs may not be very high. 

Here in Utah, none of the doctors need a referral. Just call around to different places and ask if they need a letter of recommendation! Also, I don't have insurance so everything is out of pocket. For spiro and estradiol combined, the price ranges from $20-$50 total. For my doctor it's a $50 co-pay, with monthly payments after that. Usually it's only around $100 when I see my doctor, so it's not that expensive.


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My letter came after two visits. When I was ready to leave the second appointment Misti asked if I wanted a letter for HRT. I never thought I could take estradiol because of my heart. But nearly 6 months later it's doing all right. I belong to Group Health Washington and my Gp administers the tests and hormone dosage under the advice of the Endo whom i have never met. I also get voice therapy. Since I am not a surgical candidate I don't know what other services I would be able to get. But I hear Group Health is pretty generous with it's care. They recently merged with Kaiser so I don't see too much changing as I hear good things about them too. Not knowing where you live makes it a bit difficult to find people that could help you.  Here are some online therapists that use Skype.  https://www.susans.org/links/search?search=skype&location=

I was seeing a therapist and she just gave me a Dr recommendation when I asked her about hormones.  No letter was required, informed consent.  Have you tried to Google "gender therapist' in your area?  My local gender therapist was a great first step for hormones and Dr and electrolysis recommendations.

Quote from: Kadence1 on January 29, 2017, 03:11:36 PM
Here in Utah, none of the doctors need a referral. Just call around to different places and ask if they need a letter of recommendation! Also, I don't have insurance so everything is out of pocket. For spiro and estradiol combined, the price ranges from $20-$50 total. 

   Have you considered one of the chain store pharmacies like Walmart, Target, Walgrens etc? There are many that have generic pricing  under $10.00 You might give those a try.

    Jeanette

Quote from: josie76 on January 28, 2017, 05:54:50 PM
In some places it can be done by just informed consent. Some here have just done a short visit with a therapist then got the informed consent.

Actually, that's not how informed consent works.  Informed consent actually means you bypass the therapist entirely.  That's what I did - I went to a clinic, talked to a doctor, and got the prescription for HRT.  I did not talk to a therapist at all, not even a short visit.

I do agree that it can be helpful to see a therapist though.  And in fact I did eventually see one for several months, but only after I started HRT.  I found the therapy sessions very helpful.  My therapist also wrote my letter of recommendation for SRS, so it's nice to have an established relationship with a therapist if/when you get to that point (not required though!)

But again, informed consent means that you skip the therapist entirely and go straight to the doctor prescribing the HRT.  If you're absolutely certain that you want to go on HRT, informed consent may be for you.

Quote from: JeanetteLW on January 31, 2017, 01:27:38 AM
   Have you considered one of the chain store pharmacies like Walmart, Target, Walgrens etc? There are many that have generic pricing  under $10.00 You might give those a try.

    Jeanette

Yeah I usually go to Walgreens!! The estradiol is cheap ($10) but the spiro is what's expensive. That's around $30 worth the price though!! Haha


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Quote from: Mirya on January 31, 2017, 12:07:06 PM
Actually, that's not how informed consent works.  Informed consent actually means you bypass the therapist entirely.  That's what I did - I went to a clinic, talked to a doctor, and got the prescription for HRT.  I did not talk to a therapist at all, not even a short visit.

I do agree that it can be helpful to see a therapist though.  And in fact I did eventually see one for several months, but only after I started HRT.  I found the therapy sessions very helpful.  My therapist also wrote my letter of recommendation for SRS, so it's nice to have an established relationship with a therapist if/when you get to that point (not required though!)

But again, informed consent means that you skip the therapist entirely and go straight to the doctor prescribing the HRT.  If you're absolutely certain that you want to go on HRT, informed consent may be for you.

That's exactly what I did!! I want to go to a therapist, just for someone to talk too and for professional advice, but so far the only one I found that I actually felt comfortable with went on leave due to pregnancy so the search continues!! Lol


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The web site goodrx.com is the place to look for the lowest price medication. When I started up on HRT, I discovered that CVS who I used a good deal in the past was the most expensive and Walmart what the cheapest for what I needed.