It may be enlightening to hear an experienced view on this:

<LI>a documented real-life experience of at least three months prior to the administration of hormones; or <LI>a period of psychotherapy of a duration specified by the mental health professional after the initial evaluation (usually a minimum of three months).
In selected circumstances, it can be acceptable to provide hormones to patients who have not fulfilled criterion 3 - for example, to facilitate the provision of monitored therapy using hormones of known quality, as an alternative to black-market or unsupervised hormone use.

IE:
"Give 'em to me or I'll get 'em how I'll get 'em."
said not as aggressively as all that;
(call me a manipulative beeyatch, no prob.)

but sounds to me like we may have a winner here.
In selected circumstances of course.

sounds like a game show.

I got mine with less than 3 months therapy, but I knew I was TS.  I also had to reaquaint myself with a new therapist during that time since I was forced to switch therapists for insurance reasons.  It was just a matter of talking for a few sessions and letting them know I wanted to start hormones.  I could have actually started after leaving the first therapist, since I had aquired a letter, but I didn't feel ready at that time.  I think that helped with getting a letter from my second therapist sooner too.

Melissa

For myself my route was a little backwards, just like me   My Dr wouldn't do anything until I went to the Gender Clinic in Toronto, which at that time was way to far to travel and the clinic did not have a great rep.  Anyway, Through a Psychologist I was seeing more as a friend not as a client, I found a doctor who was willing to take me on as a patient and to care for me.  She did everything by the book blood workups tests etc... and she insisted that I take care of a high cholesterol problem before she would go forward with HRT, which I did.  That done I was prescribed HRT and started therapy 3 months later.  A bit backwards but you can see the standards are there for medical professionals to use as a guide and really it's up to them how they apply them.  The sticking point would be the surgeons and their requirements.

Just my humble opinion.

Steph

I first started HRT by obtaining them through "Black Market" resources & self medicating -(dumb idea but I was young and stupid years ago!) Now that I am older
"but still stupid!lol  "
I just started living my life as Chynna fulltime ( 4 months prior to HRT) and my primary care physician would always ask me "do I take, have i taken, or am I considering HRT" and he knew I had easy access to obtain them "illegally" anyway. but I never asked for HRT he recommended I start based on that and a few other points he bought to my attention. My boyfriend (a Neurologist) concured with my Doctors recommendation after I discussed my concerns with him because of the effect I knew HRT would have on my body thus our sexual relationship..(not that a girl neede approval..but i do have certain lets say responsibilities to mr. man) but they both ultimatly left the decision up to me.  So I believe he used the first part of that determination to recommend me to a specialist who monitors my condition, does blood work etc. thus I started HRT the right way 3 months ago based on the fact that I was already living as a woman full-time. I guess the medical community in my area is a bit laxed on HRT requirements.
So I have never "officially" seen a therapist except in general discussion at the clinic I work at.

Chynna

Quote from: jan c on June 08, 2006, 01:34:23 AM
In selected circumstances, it can be acceptable to provide hormones to patients who have not fulfilled criterion 3 - for example, to facilitate the provision of monitored therapy using hormones of known quality, as an alternative to black-market or unsupervised hormone use.

Yea, that's bloody annoying and insulting.

If I act unstable and threaten to go illegal because "I just can't stand it anymore!", I can get whatever I want.

But six months of therapy, as a "knowing" patient (always known I was TS), with me PUSHING my therapist to ask me tough, difficult questions (versus this stupid love & light holistic therapy attitude I get)... and I'm STILL waiting for a damn letter.

(EDIT: When I mentioned this frustration to her, she did offer to "discuss your anger issues" in another session though)

There's another requirement mentioned later on about "Consolidation of gender identity" which really bugs me. What the heck is that supposed to mean? I'm not psychotic, I'm not split into "male and female" personas, I'm not trying to perfect some sort of female acting role... I'm just ME. What is there to "consolidate?" It sounds like they're judging my performance at stereotyping female behaviour.

Quote from: Kate on June 08, 2006, 09:17:42 AM

There's another requirement mentioned later on about "Consolidation of gender identity" which really bugs me. What the heck is that supposed to mean? I'm not psychotic, I'm not split into "male and female" personas, I'm not trying to perfect some sort of female acting role... I'm just ME. What is there to "consolidate?"

Exactly, and while I will bow to the experience of others here, and I understand that we are grateful to have a standard of care, this is one of the SUBTLE indicators that well, some of it isn't quite up to grade.
It's a psychotherapist term. I don't have those sorts of problems. I am me. I know what that is. It's not so complex as all this stuff, it really isn't. I lean a little far to the right to be considered on the left. I don't need to consolidate my tendency towards right-handedness, and while I prefer the left hand for some functions, it is true, no split there.

ooh it does sort of smack of some Russian acting school too huh?
"the character here consolidates the female characteristics before the denouement per se begins."

Quote from: jan c on June 08, 2006, 10:06:55 AMIt's a psychotherapist term. I don't have those sorts of problems. I am me. I know what that is. It's not so complex as all this stuff, it really isn't. I lean a little far to the right to be considered on the left. I don't need to consolidate my tendency towards right-handedness, and while I prefer the left hand for some functions, it is true, no split there.

Well said!

And this is why I think my therapist (apart from preserving her income) is hesitant in handing me a letter - I don't ACT the part. She herself transitioned after a life-long history of persistent crossdressing, including apparently an obsession with wearing panties, buying panties, and hanging out in panty sections of department stores (stories of security escorting her out). I think I counfound her... I don't fit into her expectations based on HER experiences.

I mean OK, my hair is a bit long (growing it out 'cuz I want longer hair) and coloured (hated the grays), my beard is almost gone (lasering it off because I hate it), my eyebrows are shaped a bit (who wants a monobrow anyway?)...

But I otherwise show up for therapy in guy's street clothes (society still pegs me into the male box, so why make a fuss? Clothes cover your skin - they don't make you female), wearing men's underwear (panties don't control my lower parts or turn me on, so...?), speaking in a semi-male voice (I'm working on it, but why do I need to fake a voice anyway?), I don't insist on a female name or pronouns (all secondary, social conveniences - I'm still me regardless of what you call me)...

And heck, I bet there are those reading this who are now wondering about my TSism, too, lol.

So I suppose my "consildation of gender identity" isn't going very well in her eyes. But for me, it's ALL about being *female*, physically. Those other things are largely a RESULT of that, not a means to it.

Quote from: Kate on June 08, 2006, 10:42:19 AM...
I don't ACT the part.
...

^*chortle* I SO understand not acting the perceived part, but that "consolidation of gender identity" thing, for me, has already happened (In my own opinion), there is note of it here on this forum for that matter. But even so my wardrobe is almost exactly what it was when I presented as a guy, which is to say jeans, sweatshirts and t-shirts an, not that anyone should care, GUY undies. ^{*twirls finger in the air*}. So what? Apparel does not make me who I am.  My hair is long because I can not stand short hair, my ears are pierced a few times because I wanted them to be. They are reflections of myself, not what makes me, ME.

I am with Kate when she says...

Quote from: Kate on June 08, 2006, 10:42:19 AM...
Those other things are largely a RESULT of that, not a means to it.

An yet, I am having no problems at all in the transition path. (Not to be confused with not having problems because of transition.)

So for whatever it is worth, presuming I can count (which is debatable, ), my experience with start of therapy to HRT was roughly 5 sessions over 4 months, with HRT starting on the same day as the 6th session. ^*shrug* If it means anything. I to started I was TS at the very start.

Quote from: Kate on June 08, 2006, 10:42:19 AM...
And heck, I bet there are those reading this who are now wondering about my TSism, too, lol.
...

^*wink* As long as they stay out of my way they can wonder all they like

Kate, in an earlier thread you mentioned that your therapist would be willing to give you a recommendation for HRT, but based on your own diagnosis.  You said you are waiting for the therapist to diagnose you first.  My question is: If you know you are TS and have been all your life, why do you need her to diagnose you?  So that you can have it officially on record and have insurance denied?  I think I just don't understand your motivations for the route you are taking.

Melissa

Quote from: Melissa on June 08, 2006, 11:34:39 AM
Kate, in an earlier thread you mentioned that your therapist would be willing to give you a recommendation for HRT, but based on your own diagnosis.  You said you are waiting for the therapist to diagnose you first.  My question is: If you know you are TS and have been all your life, why do you need her to diagnose you?  So that you can have it officially on record and have insurance denied?  I think I just don't understand your motivations for the route you are taking.

I doubt an endo would prescribe HRT if the referral letter ONLY quoted my own self-diagnosis. That's pretty much the same thing as me walking into an endo's office with NO letter, telling him/her I'm TS, and asking for HRT. I'm assuming that's not enough for most docs?

It shows you have been in therapy.  I would suggest trying it, it may save you a lot of frustration.  I know my doctor was pretty lax about the letter.  She just wanted to make sure I had one.  Besides, if an endo does turn you away, go to another one.

Melissa

Quote from: Kate on June 08, 2006, 12:08:12 PM
I doubt an endo would prescribe HRT if the referral letter ONLY quoted my own self-diagnosis. That's pretty much the same thing as me walking into an endo's office with NO letter, telling him/her I'm TS, and asking for HRT. I'm assuming that's not enough for most docs?

as I understand it, and I was specifically angling for a letter in one case, that is not a letter. The therapist's statement to you was a verbose form of 'no, no letter'. 

A letter has to meet seven specific points. But take what you can get as Melissa said to the endo.

(what I've decided to do, in a small part from what I've seen on this and similar threads here, is go to see a urologist and then an endo. Cards out on the table. This therapy bidness ain't for me.)


Posted at: June 08, 2006, 10:47:19 AM

---

ERM Kate do you think your therapist was a therapist that transtioned
or a transsexual that got a degree (sounds recent from the lingo usage) and became a therapist?

I had about five visits in with my therapist, less than three months.  She offered the letter as an option to me as I will still unsure what path I was heading down.  After I scheduled visit number six she faxed me the paperwork and then sent the letter to the endoc after the next appt.  I transitioned about five months after that

The second time around I showed up at my therapist's office, told her who I had seen, provided a tonne of documentation, and she typed up the letter on the second visit.  We were talking about putting deposits in for surgery at that point even though I had yet to go FT again at that point.