Just as the title says. I'm finally (mentally) ready to actually start transitioning, but alas: no trans-friendly/gender therapists in my area, or even my state. Just my luck. Haha. I'd move, but I still have to stay for at least another year for my last year of college.

Does anyone have any suggestions as to what I should do?

Welcome to Susan's Place. For starters, google "city LGBT" and "city gender therapist". If it's really true that there isn't one in the state, you have the option of using a Skype therapist and have your sessions online. I admit when I transitioned there wasn't a therapist any closer than 400 miles from me and relocation was the only way I could get treatment but that shouldn't be needed today.

As you are in college, you might see if your school offers therapy. It possible the school therapist has had some training though they may not be a full gender therapist.

We issue to all new members the following links so you will best be able to use the web site.

Site Terms of Service & Rules to Live By	Standard Terms & Definitions	Post Ranks (including when you can upload an avatar)
Reputation rules	News posting & quoting guidelines	Photo, avatars, & signature images policy

You don't need a gender therapist in order to transition. Any therapist can write referrals. It is just helpful to find someone who is already familiar with the process. A few ideas:

- Go to the counseling department or student health services at your college. Sometimes graduate level students need to get clinical hours and will do free therapy. I'm sure someone would jump at the chance to work with a transgender person. If they don't have that, they may still be able to refer you to someone nearby that will work with you, and may even be willing to call on your behalf to confirm that they'll work with a trans patient.

- Look into online therapy. This is what I did for my referral letters (with Dr. Graham Peveller). There are quite a few options out there now depending on what your budget is. I will say, if you're going for more than just referral letters (like you've got stuff you need to work out or you need a lot of hand holding), you will probably want to find a therapist that does Skype sessions because the text based chats can be impersonal and hard to feel connected to.

Not all physicians require therapy prior to transition. I did not get my recommendation until I had already been on HRT for 4 years, and only requested a letter from my former therapist after relocation to where I could not find a physician that did not require one.