No Hrt Letter Required Says My G.t.

[Carolyn Marie]

After four months in therapy, I asked my G.T. today a direct question about when I might get an HRT letter, and what hoops were

left for me to go through?

To my surprise and delight, she told me that her colleagues at the LA Gender Center had discussed this issue and decided that they neither

needed nor wanted to be gate keepers, and my G.T. would not be giving me an "HRT letter."

What I would get instead is a referral to a gynecologist or endocrinologist who works with the Center. They would counsel me as to the effects

and issues with undergoing HRT, and I would need to sign an "informed consent" form. That's it. I was free to start HRT whenever I felt I was

ready and she would provide the referral!

Shoot, I would ask for it immediately, but I have some big bills to pay between now and the end of the year, so it can wait until late January

or early February, when I was planning to start anyway. I might even wait for my birthday in February, as it seems appropriate to start on

my new "birthday" don't you think?

I wonder if this change in procedure will take hold elsewhere in the G.T. community? I hope so.

Carolyn Marie

[Guest Donna Jean]

Woah!

How cool is that?

Carolyn.....I get first dibbs...

I want to be on video chat with you when you take that first pill!

I want to watch as your eyes roll up in your head and you have that little smile on your face and make that Ummmmmmmmm....sound!

How 'bout it?

Love

Donna Jean

[Guest ChloëC]

Hi Carolyn,

Tho it won't affect me, I would say that is wonderful news, not just for you but for a lot of others. As long as one is under the care of a competent specialist/physician/whatever, it, like so many other things, should be our choice.

This is one more step in the understanding that GID is a meaningful condition, like any other medical condition and should be treated as such. It's my life and my body. As long as I understand the benefits and possible problems of a regimen and I'm willing to accept the risks, as well as agreeing to follow the recommended processes, then it's my decision.

Yet, at the same time, I know it's a terrible and wonderful new power. Instead of having to convince someone else, we just (lol) have to convince ourselves. And there's a lot more to that then we would like to admit. It's like my signature block says - and there's no excuse why we shouldn't have use of that power....and use it.

Hugs

Chloë

[Guest Jean Davis]

Woah!

How cool is that?

Carolyn.....I get first dibbs...

I want to be on video chat with you when you take that first pill!

I want to watch as your eyes roll up in your head and you have that little smile on your face and make that Ummmmmmmmm....sound!

How 'bout it?

Love

Donna Jean

Darn late again.

Think you can make the same exact expressions on the second pill?

I want to watch.

LUV

Jean

[Guest ~Brenda~]

Wow!!! Carolyn,

That is awesome to know!!! Gosh, I did not know that was even possible!! OK, now you have got my motor running. My thoughts are just racing now!!!

Thank you so much!!!

Love

Brenda

[Guest rachael1]

That is wonderful news Carolyn, you must be on cloud 9!

I agree with Chloe that it should be our choice what we do with our bodies as long as HRT is being supervised by an suitably qualified person from the medical profession.

Love

Rachael

[Carolyn Marie]

..

I want to be on video chat with you when you take that first pill!

I want to watch as your eyes roll up in your head and you have that little smile on your face and make that Ummmmmmmmm....sound!

Donna Jean

Ha ha! I'll be so hyper that day, if my eyes roll up in my head it will be because I'm about to fall off my chair in a dead faint.

Carolyn Marie

[Guest Robin Winter]

That's great news! It wouldn't effect me either since my G.T. already said I'd have my referral when I feel I'm ready, but for the sake of others, I hope that trickles this way too

[Guest julia_d]

I see the line "care of a competent physician" and it made me laugh..

For 8 years my uncaring GP has blankly written out a script for a dangerous amount of now barely used conjugated estrogens... never a blood test, never any form of screening whatsoever. But when I ask to be changed to a modern completely accepted (and above all SAFE) HRT course he sat on "ethics" and demanded a letter from a specialist .. guess who is going to get sued for neglect now? I removed my consent for his neglect in the simple way.. I changed doctors that day.

My views are this.. just starting out, then fine.. maybe a gender specialist should at first authorise some course of HRT .. but after that surely it's up to the patient and their GP which is the best specific medications to take.. Most people are stuck 6-12 months between appointments with specialists here.. WE have to take control and stop being sheep in this process. I see so many girls with bad outcomes after following the imposed rules and never having any say at all that I wonder why they even bothered saying anything in the first place.

We have to be aware that it is OUR life.. it doesn't "belong" to these self appointed "experts" .. my consultant empowered me with some little words.. "after a lifetime and 10 years transitioned you probably know far more than I do about the whole process" .. and he has 40 years professional experience...

Why are we denied a say when even the experts agree that those of us who have been there and know what we are doing are likely more competent to treat ourselves than they, sitting in their ivory towers of life or death power are.

[Guest Kayliegh]

Congrats, CM!

You’re on your way!!!

Love - Kayleigh

[Guest NatalieRene]

I don't know if this is everywhere or if it depends on what doctor you talk to but my doctor's office manager (I pushed the wrong button on the automated answering machine maze and accidentally bypassed the semi problematic receptionist that insisted Dr. Lipson doesn't do hrt) at GWU Hospital and the first thing the manager asked was if I had my hrt letter.

[Carolyn Marie]

I don't know if this is everywhere or if it depends on what doctor you talk to but my doctor's office manager (I pushed the wrong button on the automated answering machine maze and accidentally bypassed the semi problematic receptionist that insisted Dr. Lipson doesn't do hrt) at GWU Hospital and the first thing the manager asked was if I had my hrt letter.

It's my impression that the LA Gender Center has worked out their new protocol with the doctors they refer clients to, so there isn't an issue.

Carolyn Marie

[Sakura]

the place i go to in philadelphia is a lgbt clinic you dont need letters or even a therapist to get hormones you go in they do a short intake tell you the risks and you sign the informed consent paper

when i moved from IN to PA i needed a new place to get my hrt all drs i talked to said i needed a new referal letter so finding this place was a god send since me and my last shrink were not on the greatest of terms i didnt feel like jumping threw hoops to get another letter

not sure how it is were your at in th world but the Dr visit and labs are only like 80 bucks and HRT its self is dirt cheap at wal mart i pay 27 ish dallors a month for both my spiro and estro so its fairly affordable

any way congrats

Sakura

[Guest NatalieRene]

It's my impression that the LA Gender Center has worked out their new protocol with the doctors they refer clients to, so there isn't an issue.

Carolyn Marie

That is so cool. Hopefully it makes it's way to everywhere, but I hope that while not required to do so that people are still encouraged to also see a therapist to assist them their emotional well being while in transition. I agree the fact that therapists are no longer a gate keeper is great but my therapist has really helped me a lot. I can't imagine going through this without her support and thought provoking sessions.

[Guest NatalieRene]

not sure how it is were your at in th world but the Dr visit and labs are only like 80 bucks and HRT its self is dirt cheap at wal mart i pay 27 ish dallors a month for both my spiro and estro so its fairly affordable

any way congrats

Sakura

OMG that is cheap. Why the heck do things in the DC metro area have to be so expensive?

[Guest Zabrak]

Nice!

[Guest yvonne]

After four months in therapy, I asked my G.T. today a direct question about when I might get an HRT letter, and what hoops were

left for me to go through?

To my surprise and delight, she told me that her colleagues at the LA Gender Center had discussed this issue and decided that they neither

needed nor wanted to be gate keepers, and my G.T. would not be giving me an "HRT letter."

What I would get instead is a referral to a gynecologist or endocrinologist who works with the Center. They would counsel me as to the effects

and issues with undergoing HRT, and I would need to sign an "informed consent" form. That's it. I was free to start HRT whenever I felt I was

ready and she would provide the referral!

Shoot, I would ask for it immediately, but I have some big bills to pay between now and the end of the year, so it can wait until late January

or early February, when I was planning to start anyway. I might even wait for my birthday in February, as it seems appropriate to start on

my new "birthday" don't you think?

I wonder if this change in procedure will take hold elsewhere in the G.T. community? I hope so.

Carolyn Marie

Carolyn Marie,

After studying "the procedure" for "the process" of the standards of care for months and reading this site for months, I finally called to make an appt with a GT and had my first appt less than a week ago. When I had my first phone call to interview her (in my process of selecting a GT), I told her that what I hoped to accomplish is to go through the required 3 months of therapy and my objective was to get a letter to approve me for HRT. She told me that was no problem on her end. I decided ahead of time that there was no point in beating around the bush and I wanted to be upfront about what my objectives were from the outset.

Nearing the end of our very first session together, she asked if I wanted hormones and felt they were right for me. I looked her in the eye and said there was no doubt in my mind that it would be of great benefit to me and I was willing to follow the "standards of care".

She smiled and said they don't do it that way, anymore, and it wasn't necessary to undergo therapy for 3 months first. To my surprise, she said there was no doubt I suffered GID and an immediate referral for hormones was no problem for her. I about fainted.

She went on to say that the Dr. she'd referred previous patients to for HRT had left the area and she'd have to do some more research to find a replacement physician who was willing to do the treatment.

I don't know if the "letter" is needed here or not and I don't know if I'll get one or not. I'll find out more tomorrow when I have my next session.

After that, she said, "you really don't like that thing do you?" I told her no, I don't. She asked if I wanted surgery and I said no, not at this time. I think she'd have written me a letter for SRS on the spot, too.

I'll post after tomorrow and we'll see what comes next. I may have DDs in a few days......unless I get a bad batch.

Congrats to you and hugs,

Yvonne

[Carolyn Marie]

That's great, Yvonne. I guess that answers my question as to whether L.A. was the only place that new philosophy was catching on.

Great news for everyone.

You should still consider at least some time in therapy, though. I've found it tremendously helpful in finding my inner-woman, and

also being able to discuss my issues about my wife and kid and bringing them on board with my transition.

Good luck to you.

HUGS

Carolyn Marie

[Guest mia 1]

Well that's it. Pay off those darn bills, and start popping the pills.

Congrats sweetheart,you made it.

Mia

[Guest yvonne]

That's great, Yvonne. I guess that answers my question as to whether L.A. was the only place that new philosophy was catching on.

Great news for everyone.

You should still consider at least some time in therapy, though. I've found it tremendously helpful in finding my inner-woman, and

also being able to discuss my issues about my wife and kid and bringing them on board with my transition.

Good luck to you.

HUGS

Carolyn Marie

Sweet Carolyn Marie,

I wasn't totally clear on what all happened, I'm sorry for that.

My GT feels I'm ready for HRT right now and I agree, based on my own situation. She says she can't believe how well I've not only coped with it in the past, but also how well I've adapted to everything right now.

I went on to tell her that I'm committed to 3 months, 12 sessions, of therapy regardless what happens, unless she torques me off or it turns out we don't work well together. It doesn't look like that will be an issue, either. I had no problem in opening up to her at all, I liked how she and I related to each other.

I like her so well that I have 2 appts this week, a day in between. I have no idea where it will go and she told me it will take a few more sessions and she'll start probing and prying. I know it will be beneficial and I'm looking forward to it.

At the conclusion of the 12 sessions, I'll have a better idea what it's all about and I expect she and I will discuss whether I should continue or not or change the format to less frequent visits. I'm not so arrogant or impatient as to think I have a clue what's right, given what I know now. I expect to learn a lot, I'm an extremely willing student.

I'm also sorry that I didn't congratulate you on reaching your own milestone of achievement, getting your own letter. Way to go, girl. I'm very happy for you.

Hugs,

Yvonne

[Guest Donna Jean]

Carolyn, Sweetheart...this isn't directed at you...I's just some general info...

Let me just interject something here.....

Of course what we do with our own bodies is our own business...

The purpose of a therapist is to gauge that a person is a candidate for HRT or SRS...too many people think that just by changing sex (yes, that's what it is) all of their problems will be solved...

There are people that are not truly Transsexual and HRT or SRS would a be terrible mistake!

The second part, is that doctors want to cover their butts!

They don't want to prescribe for you, only to have you come back later and say "Look what you did to me!"

Liability...that's the name of the game...

That is the reason that a doctor wants a letter from a therapist saying that you are a transsexual and of reasonably sound mind...

Simple as that.

Also remember....

Seeing a therapist is not a career move....

My therapist cut me loose after my HRT letter and my surgery letter...

He said that I really had no reason to continue unless I wanted to talk with him...

I do like him, but....I'm just fine now...the problems associated with my Gender Dysphoria are gone now...I'm transitioning now and happy!

I know a couple that have been seeing a therapist for years and will continue to do so...most of us need nothing like that!

HUGGS!

Donna Jean

[Guest]

Even if some didn't require therapy getting it is a good idea. This is a too important life altering decision to not get guidance. Breasts don't disappear without surgery if you change your mind and some do change their minds according to my email. As transgender people we are often forced to be someone else for part of our lives. This can take a toll. Some develop clinical depression or other mental issues that need treatment. Underlying conditions can usually be treated with medications that get the situation under control rather quickly. People have to be metally healthy to get surgery approval. HRT is not only prescribed for transsexuals but for transgenderists as well. Both will need to go through RLT. The therapist will aslo help you decide if surgery is right for you as it's not for everybody. If no other condition is found most will get a letter within 3 months and therapy can be discontinued if it is no longer needed. I do reccomend staying in touch as a therapist can help with RLT issues and be your guide if you need it.

Most Endocrinologists require a letter from a therapist for HRT. Some may not. Others will require you to be in RLT living the role. In some cases your GP will prescribe HRT. Do make sure though that they test your levels occasionally as not all do. This is for safety reasons. Some therapists are anticipating that GID will be dropped from the DSM as a mental condition in 2011/2012 and may have relaxed their standards already. In the future therapy may not be required or a letter needed. Even so I'd still recommend therapy While GID itself should not be a mental illness because it is a natural inborn condition it can cause problems from the time that ones "true self is supressed. Any other illness caused is a byproduct not the cause itself. The depression or suicidal ideation didn't cause GID. GID caused the depression and suicidal ideation. A homophobic society can cause this as well. Therapists are not there to be the bad guy they are there to help you. Having a clear mind will help make your RLT more successful.

Laura

[Guest Eth]

That's awesome! I wish it was so easy over here in PA... but all I hear are horror stories about this state . (not like that's going to stop me from trying...)

[Guest yvonne]

That's awesome! I wish it was so easy over here in PA... but all I hear are horror stories about this state . (not like that's going to stop me from trying...)

Hi Eth,

What's so hard about this? 3 months of therapy with a Gender Therapist(GT), then, if you qualify, a letter to start HRT. This isn't a game and there are a lot of tricks our brains can play on us. Why we think we feel the way we do isn't always due to the causes we think they are. This the job of the GT, to help you sort things out and be certain that you really are GID, for sure.

The last thing you'll want to do is grow boobs, only to find out this isn't what you want and be cursed with boobs the rest of your life.

The standards of care seem to me to be quite reasonable, logical and in place for good reason. There's no reason to try to go around them.

I'm going through the process right now and have my 3rd (of 12) sessions in a few days. It's been enlightening and very beneficial and we're just getting started. I believe, as many do, that the therapist experience is a good one and should not be avoided, but embraced.

I wish you the best,

Yvonne

[Guest qRachelp]

After four months in therapy, I asked my G.T. today a direct question about when I might get an HRT letter, and what hoops were

left for me to go through?

To my surprise and delight, she told me that her colleagues at the LA Gender Center had discussed this issue and decided that they neither

needed nor wanted to be gate keepers, and my G.T. would not be giving me an "HRT letter."

What I would get instead is a referral to a gynecologist or endocrinologist who works with the Center. They would counsel me as to the effects

and issues with undergoing HRT, and I would need to sign an "informed consent" form. That's it. I was free to start HRT whenever I felt I was

ready and she would provide the referral!

Shoot, I would ask for it immediately, but I have some big bills to pay between now and the end of the year, so it can wait until late January

or early February, when I was planning to start anyway. I might even wait for my birthday in February, as it seems appropriate to start on

my new "birthday" don't you think?

I wonder if this change in procedure will take hold elsewhere in the G.T. community? I hope so.

Carolyn Marie

Carolyn Marie- My therapist is VERY experienced, and today he just told me the name of a "general physician" to go to, and that he would call the guy to let him know that I'm coming.

Things are being shaken up with the medical community in regards to the Transgender world. It's as if "the Berlin Wall of HIBIGDA is coming down". According to my therapist, the ONLY hard fast rule, anymore, that MUST be carried to the letter without exception is the "real life experience" rule where you MUST live a complete 12 months as your targeted sex before you have SRS. All other rules are fair game for anyone who needs to get around them.

I guess the "American Medical Association" has figured out that they can make more money by opening the doors to their buildings and letting us in. Whatever the case, you can be sure that there's an ulterior motive to this situation. But, I'm cool with it, 'cause I had one 45-minute session, and 2 weeks from now (the earliest that I could get an appointment with the transsexual-friendly doctor), I'll be "becoming who I truly am" with hormone therapy.

Thank Goddess

XX,

Rachel