Hey guys,

im in the process of seeing a psychiatrist and he has now told me that before i can start, i need to get a report from a clinical psychologist and be evaluated by a social worker before i can start T.  However, he said the process could take between 5-8months.  I dont/cant wait that long before i start!  Im trying as hard as possible to pass as male but im having so much difficulty.  Im planning to transition at work in July, change my name legally etc. but i want to have started hormones by then or at least within a month of transitioning.  Ive been thinking about starting T by myself without the approval of the docs - just starting on Androgel.  Would starting without approval sabotage chances of surgery or anything related?

Just wanted to get your opinions on the matter.
Cheers,
Josh

When I started to therapy, I had been on HRT.  I just told him what I was doing.  He wasn't happy, but he gave me his blessing.  I did finally go to my doctor and now everything is above board.

Janet

You can look at the WPATH standards of care at http://wpath.org/Documents2/socv6.pdf - specifically see page 13, some of which is quoted here:

Quote
Eligibility Criteria. The administration of hormones is not to be lightly undertaken because of their medical and social risks. Three criteria exist.

1. Age 18 years;

2. Demonstrable knowledge of what hormones medically can and cannot do and their social benefits and risks;

3. Either:
  a. A documented real-life experience of at least three months prior to the administration of hormones; or
  b. 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.

I suppose it comes down to whether you can find an endocrinologist who will prescribe you T.  Most of them seem to require a letter from a licensed counselor.  The one that I am currently seeing requires 12 visits (once a week = roughly 3 months) before she will write the letter.

Personally, I would stick to the standards of care as closely as possible.  They are there for a reason.

All the best,
Joseph

Hey,

It is unlikely they will be happy, plus it is very dangerous to self medicate as well.

But as long as you get it all above board after and get your checks and everything, then it will be good.

Where there is a will there is a way!

Jay

My tip would be to do it this way.  Get yourself to a couselor/psychologist as quickly as possible and then make yourself an endocrinologist appointment or whoever you plan to see for HRT.  Some of them don't require the letter (though a lot do), some just want to know that you've been in therapy.  So if you can't get your letter, maybe you can just avoid the part where the person won't give you your letter yet and focus on the fact that you have, indeed, been in therapy.  That way you can avoid the illegal bit because I do not recommend it.

My therapist actually refused to write me a T letter unless my endo specifically asked for one.  She doesn't think I should be required to have her approval especially since more and more endocrinologists don't require the letters these days.

The problem with living here in Hong Kong is that there is very little experience over here and it is extremely expensive to go private.  I have to go the public way which involves waiting months just to get an appointment with a doctor.  So it would be extrememly hard to find an endocrinologist.  My doc said that once i get all the required letters he would be able to adminster them to me.  He has a lot of experience in ->-bleeped-<-.  I was actually quite surprised when he required me to get 2 more letters to start HRT.  I thought his letter or whatever would be sufficient enough if i saw him for a certain period of time....Jeez, i dont know.

Ah.  Sorry, I should've checked.  I didn't realize you were from Hong Kong.  I can't believe you need that many letters!  That's unfortunate.

Nevermind all that WPATH garbage- increasingly few physicians use it.

The situation you're presenting is starting hormones under harm reduction (i.e. i'm already on them, you might as well help me get them legitimately).  While this is a very common thing to do in many places, at least here in the US, it can make some physicians who aren't familiar a bit apprehensive to work with you.