HRT with somewhat unsupportive parents

[endofregulation]

Yeah, pretty much what the title says. I turn 18 in less than a week and want to start HRT as soon as possible. The problem (well the biggest one at least) is that I don't know how supportive my parents are of me being trans and know for a fact that they don't want me to start HRT. They hardly use my chosen names or pronouns, and I gave up on correcting them after a month of futility because some combination of autism and anxiety and general social awkwardness makes me really not good at the whole confrontation thing. My parents have also been less-than-perfect about preparing me for real-world things. For HRT reasons, that's relevant because I have no clue what insurance plan I have (I do know the provider) and as such no clue if HRT is covered. In preparation for turning 18, I have tried to do research on various things about HRT that I should know, but I don't know enough about how to actually get it. It seems like the most viable option is to get it through Planned Parenthood, and I've searched around on their website to see what sort of stuff I need to do prior to my first appointment, but it's kinda vague. I haven't yet called my insurance company to see what coverage for HRT looks like and what I need to do on that end (which I intend to do), but beyond that I don't really know what to do beforehand. I know I'll need blood work done at some point before starting, which might also be a challenge because convincing my parents that I should be allowed to leave the house during quarantine and actually interact with other humans is going to be difficult, and I can't exactly pretend to be doing something else because they'll be able to find out through looking through records, and also it would probably be at least 4 hours counting transit so I don't know what I could say anyway. Are there any important things to know or do that I'm not sure about? I'm in Maryland if it matters.

[Jackie C.]

OK. Step one: Breathe. It sounds like you're freaking out a little and that won't help.

 

Now then, here are the steps I had to take to get HRT. Your mileage may vary depending on local laws:

 

First, I needed to get my papers in order. In order to receive HRT in my state I needed a note from a licensed gender therapist that said I had gender dysphoria. To get this note, I went through U of M. They have a program for trans people. So, do you have a medical university handy? I'm not sure where you live in Maryland.

If you don't, look into local LGBT+ resources and centers and see if they can suggest someone. I'm 50/50 on gender therapists taking ANY insurance, let alone mine. It only took me one hour-long session to get my diagnosis. On the plus side, as an adult your diagnosis will be easier to get.

However, if they determine that you have suicidal ideation or are otherwise unstable, they may hold off on the HRT green light until such time as you are deemed stable enough to receive your drugs. HRT messes with your head a little. They like to see that your head is in a reasonably ordered state before HRT pulls the rug out from under you.

Now if Maryland is an informed consent state, you can skip this step and head right to Planned Parenthood IF your local Planned Parenthood has someone on staff who is qualified to prescribe HRT. I looked into this option here and thanks to aggressive defunding, that wasn't an option for me.

 

Second you'll need blood work to prove that you're healthy enough for HRT. They draw blood. It goes to the lab. Easy. If your liver and kidneys are healthy, you're off to the races.

 

Finally, you'll see an endocrinologist. They'll start you on a light dose, then take blood again in 2-3 months. Rinse and repeat until they find a dosage that works for you. During this time, your body will be adjusting to new hormones and you'll see how well it tolerates some combination of Estrogen, Progesterone and T-Blockers. For example, my endo pointed out that not all her patients respond well to progesterone. I love the stuff. We're all different and need different doses of different medications to see results. Another example is a friend of mine who is on a T-blocker that I'd never even heard of.

 

Now then, those are the nuts and bolts. On to the situation with your parents. Assuming that you're not financing all this yourself (you could have a fantastic part time job or really generous grandparents or even a grant, I have no idea), they're going to be paying for this. Presumably with the help of whatever insurance you have. On the plus side, most insurance will cover at least some of it. I get my HRT comped and I didn't pay for the gender therapist visit at U of M. They cover my endo visits too. My insurance sucks so unless your insurance sucks even harder, you should be OK. Even if they don't cover it, estrogen isn't that expensive.

No matter what happens though, you're going to have to talk to your parents.

 

The gender therapist might let you get away with an e-visit because of the pandemic. Then again, they might want to see your body language. In any case, dress as yourself. First impressions matter. The first time I saw my gender therapist at U of M, I was wearing breast forms and a fake butt, a pair of sleek black pants and a nice top. Limited jewelry though because I didn't own any. We had a lovely chat and she drafted my letter of recommendation that afternoon.

I'm thinking that if you can get your parents to let you see the therapist, they'll be more likely to come around to your point of view because the doctor (well, maybe, mine was a LMSW. Three degrees, but none of them are doctorates) says that you need this treatment. Parents often listen to the advice of doctors.

 

If your parents stonewall you, your options are more limited. Basically, you need to get your own money, your own insurance and do it anyway. You can also look for grants online. They can be hard to get, but they exist. Maybe if they see how important it is to you, they'll be more likely to fund all or some of your HRT at least. I'd personally want to take care of my kid but hey, I'm not a transphobic parent.

The takeaway here is that if your parents dig in their heels, you're stuck until you can gain a measure of financial independence and hope they just don't throw you out of the house entirely.

 

I hope that's not too doom and gloomy, but the odds are kind of stacked against us. It's hard to get what we need without support. Luck!

 

Hugs!

[Ivy]

I can't say what's best for you, but PP did blood work on me when I started HRT (I'm with the VA now tho). 

Apparently Maryland is an informed consent state and here is a link to Maryland PP for your info-   

https://www.plannedparenthood.org/planned-parenthood-maryland/gender-affirming-care

 

As for your other issues, I don't have any advice for you.  But it is a big step to take and you should think it through first.