When I finally get to go to therapy, how long can I expect to wait before they let me go on hormones? Is it possible to be approved in the first session? Is there a certain number of sessions you have to go through? How exactly does it work?

The World Professional Association for Transgender Health (WPATH) publishes recommendations for the care of transsexuals.
While voluntary, most health care professional adhere to the Standards of Care for Gender Identity Disorders (SOC).

Basically, the SOC recommends three months of therapy before issuing a hormone recommendation letter.

Practically, the time involved could be much longer if the therapist thinks that the patient has conflicting issues.

Theoretically, the time involved could be shorter as the SOC has an "escape clause" leaving the timing to the discretion of the therapist.

Ya! what Renate said. I talked to my therapist over the phone for about 6 months from Hawaii. WHen I got to Chicago I got my letter the first appointment I saw her in the office. So it depends did it take me 7 months or did I get it in the first appointment?

I have seen my therapist on and off for over 4 years .... it was pretty routine in the beginning and I was probably at a point where I could have gooten the recommendation letter and started, but I wasn't mentally accepting of my condition yet and my therapist knew that. 

I took some time off and did some soul searching and came to accept myself as being transgender and someone who was going to eventually go through transition.  I have gone back to therapy after about a two year break ... and my therapist wants to get to re-know me and make sure I am of the right state of mind.  I have since seen her twice and I have a couple more sessions before she'll write her recommedation letter.  I fully understand and am accepting of this, because it is such a huge step to take in the process.

Most of the time these therapy session are going to be spread over a couple of months and usually each appointment will have a few weeks in between.  Therefore it may take a several months & several sessions before your therapist is comfortable enough with knowing you to write such a letter.  It's takes patience and persistence on your part, but it's also being consistent with who you are and your therapist will read that in your sessions.  Just be yourself, be honest, and openly communicate about your goals and plans and you'll be fine.

Best of luck, Jennifer R.

Consider asking the therapists you're interviewing what their guidelines are too... and if they follow the SOC.

Also keep in mind I don't think the SOC mentions anything about the *frequency* of sessions. One therapist might want to see you every few months, another might require weekly visits.

~Kate~

It all depends on the therapist, really.

Mine approved me on the first visit and he's a follower of the SOC. I said I thought it was unreasonable to expect me to go out and try to pass without HRT and he agreed.

Zero time here in New Zealand.
Went and saw my doctor, he contacted the Endocrinologist, had an appointment with the Endo and walked out with a script for T-blockers*















*I had already been full time for 3 months, however.

it's supposed to take 3 months. doesn't matter how many sessions.