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What can I expect if I try to go onto HRT?


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Hello. As you can probably assume by the title, I haven't began my physical transition yet. However, I want to try and begin the process within the next year or so. What I want to know is, if I start to go on HRT, what can I expect? Will there likely be obstacles such as transphobic doctors? Endless amounts of people trying to ask me if this is absolutely for sure what I want?

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Hi @SpongeBobFan, not sure how helpful my answer will be from the U.S. in terms of providers in the U.K., but it's my understanding you would need a referral from your primary care doctor (GP) to one of the handful of NHS gender dysphoria clinics. I'm sure such clinics will create a welcoming environment for transgender people and a safe space to talk about HRT and your goals to support your medical transition. That said, I don't know if transgender-friendly healthcare or HRT prescriptions are available outside of the NHS network.


As far as your transphobia concerns... will you be speaking first with a doctor you know already, or a new one? If it's an established doctor you have a good relationship with, you might say something like: "I'm hoping to speak with someone who has experience working with patients around their gender identity, what's your experience with that?" If you're not sure how accepting a provider will be, sometimes you can also get a sense by the language on their website, the inclusivity actions they take in their office and on registration forms, or even word of mouth.


I'm four months into HRT. So far I've had skin softening, maybe a little slower body and facial hair growth rate, a lot of nipple soreness, and the beginnings of breast growth. I also notice that I'm experiencing my sexuality differently than before. Emotionally, I feel absolutely wonderful, like a fog lifting. People comment I seem much happier, even those who I haven't come out to yet. Honestly, starting HRT was one of the best decisions I ever made!


Hope these thoughts are useful to you. Wishing you the best as you explore the possibilities of HRT!




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I live in an "informed consent" state, so there was not really any delay to start HRT when I was ready.

But my impression is there is more of a process in the UK with the NHS.  I'm thinking I have heard there are private clinics that will work with you though.  Not sure how much gate keeping is involved with them though.

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Hi @SpongeBobFan In the UK it depends on your area. You need to find out your closest Gender Identity clinic and get on their waiting list ASAP. Most wont allow self referrals now as they were getting swamped so you will probably have to ask your GP for a referral but check with the clinic first.

The NHS offers to connect you with a gender therapist, a speech therapist and then a token contribution for electrolysis and wigs if you need. In Scotland they only use E patches. Every person you see has their own waiting list so it does take a long time compared to the US pay to play model, so it can literally take years, but we get HRT and bottom surgery for free.

You will likely be advised to talk to a therapist so that they can confirm your gender dysphoria but I have found the folks very friendly, and okay with whatever pronouns/prsentation you use for the meetings.


Once that is done you are referred to one of the few specialist clinics where you have to chat to a pyschologist before hrt is prescribed. Some of the effects are irreversible so it is not a bad thing to make sure of. Do your research, the NHS guidance is actually a pretty good place to start. You must have socially transitioned for at least a year before they will perform surgery for the same reasons of permanent changes and that was known as the real life test historically.

You can circumvent the waiting times dramatically by going private but that costs a lot of money and the process does not alter with the exception that they wll do shared care with your GP to monitor you.

My advice is get the phonecall out of the way, get electrolysis started when you can and then work out the rest while you are in the system. Hope this helps!

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