So I have already been on hormones now for four days and I am not sure if I am just imagining the changes or if they truly are happening, but I feel like I am a lot calmer, less anxious and happier. I also noticed that my hair and skin already feels more smooth and I feel like my facial hair is already growing slower.

Anyway, I been trying to get insurance and a therapist for quite some time. Not just today but other days as well and I never seem to be able to find any. I am in Texas in the U.S.

The place I talked to today seemed so promising but then the lady said Transgender health care doesn't exist in America and that I have to wait for enrollment in November and refused to help me further. My doctor said she accepts all insurance but I guess that is only if its covered I dont know :/

My other huge issue is that my doctor wants me to have a letter of recommendation before our next visit in four months. As it is I been out of work and do not have a lot of money and most therapists I have talked too want $150-$200 a session and will only give me a letter if THEY FEEL like I am transgender and only after at least a few sessions and if I make an agreement to see them monthly. I told her I don't have much money right now and that I believe I am transgender and she gave me a lecture on how its not just about getting a letter. (Although I feel like it is, finding a strangers validation for my actions). Anyway does anyone know if this agreement is usually written agreement like a contract? Because if it is just verbal maybe I should just get my letter and stop seeing her IF she even gives me one. But if that occurs can they revoke their letter?

I just do not know what to do anymore....The stress of dealing with all of these people and having them treat me like I am some immoral idiot is disheartening. Should I look for a new doctor and hope for the best?

Thank you so much for advice everyone!

First and foremost, that "lady" and I use the term loosely, is wrong!  Transgender care DOES exist in the US!

I'm in Connecticut, and we definitely have it here!  As a matter of fact, it is actually illegal in the school sytem to not
call someone by their preferred pronouns, not that anyone that I've heard of has ever been sent to prison for it.  That "lady" was gatekeeping (throwing up imaginary roadblocks) you!

I'd look for a different doctor, or at least refuse to talk to that particular "lady" (secretary?) if I was you. 

Have you tried going to a Planned Parenthood clinic?  Many of them are known for not only giving HRT prescriptions, but can help you find a therapist that can work on a sliding fee scale.  Also, check into your local LGBTQIA+ center, they might have info that could help you.  I don't know about the letter recommendation in Texas, but at least these places should be able to get you started on what you'll need.

Don't give up, there's help out there, despite this backwards political climate!

And congrats for being on HRT!

Ryuichi

Therapy sessions in Massachusetts cost me $155/hour. I attended two to get my two required surgery letters. Having said that, I was living full time with a legal name change already done when I asked. We should each seek the amount of therapy we need, and that's going to vary. Your providers should be following the WPATH guidelines: https://www.susans.org/wiki/Standards_of_Care_for_Gender_Identity_Disorders

Good luck on your path.

Hugs, Devlyn

That is about the same my wife paid when she had therapy a decade ago in Connecticut that wasn't covered by insurance.

Luna - I am so sorry for the crap you are dealing with.  In some places in the US it is more difficult to get help than in others.  Ridiculous but true.  But even where you are there are resources but you will have to work harder to find them.

Ryuichi gives you some excellent suggestions.  I don't know what city/town you are in within Texas but places such as Austin and San Antonio are somewhat more trans friendly.  Also if there are any large universities near you I would suggest checking with them to see if they have a gender clinic.  That's where I went in Minnesota.

I have a friend in San Antonio that is a trans activist - I am going to send her a note and ask for help for you.  Also I am going to do some homework for you.  Look for another post from me.  You can PM me if you want.

Since posting this a couple minutes ago I reached out to my SA friend and I found the following for you on facebook
Transgender Education Network of Texas.
https://www.facebook.com/TransTexas/

I will let you know when I hear from my friend.

Luna, I am sorry that people are throwing up roadblocks for you.  It shouldn't be that way.

I don't understand the insurance system in the U.S., so I can't help you there, but I do know that lots of members on the forum receive their transgender health care through their insurance.  So it definitely can be done.

Getting referral letters for HRT or for surgery does not have to be a big deal. 

HRT is commonly available by informed consent (no letter necessary).  When a letter is required, it typically only takes 2-3 hours of therapist time, some of which is telling your life story, and some of which is the informed consent portion.  A WPATH-trained therapist will not put roadblocks in your way: they want to help you.

Surgery will usually require two referral letters, especially if insurance is paying.  However, they are basically making sure you don't have untreated mental illnesses that would complicate your judgement.  For one of my letters, I had to do two one-hour sessions with a therapist, and one of those was because I had some decisions to make that I wanted help with.  I got the second letter after a half-hour appointment with a psychiatrist.

The right therapist will be trying to get you the treatment you want.  They won't be trying to prevent it.

I live in the U.S. and I don't understand the healthcare system either.    I heard from my friend and she asked what city you are in and echoed the comments of others here - many transpeople go through Planned Parenthood for HRT.

I think with the suggestions here you should get a good start on finding some solutions.