Start Transition now or wait?

[Natasha K]

Hiya folks, I used to post on here a little bit, about two years ago maybe.  Fell off, went through several denial fazes along with some purging, and then regretting it later.  You know how it goes.  Anyway, thanks to therapy and a great support network around me with friends and my sister, I fully accepted that I am Trans last year.  

 

I am active duty Air Force and I have roughly Seven months left in my enlistment.  Until a little more recently, like a week or two ago, I didn't know that Biden had reversed Trump's Transgender ban, (I don't really read the AF news ever).  So here is the dilemma, I have been seeing a therapist privately, out of pocket for quite some time now, and I am all set to start HRT like the day after I get out of the Air Force.  I have several semi serious medical issues that I will be getting disability for as well as care through the VA.  After speaking with some people in the VA and looking at their services online, they are actually pretty cool with Trans folks and would be able to help me through my transition.  The place I was going to get HRT from initially was Plume if anybody has heard of them, because I live in a informed consent state they will just write you the prescription for the HRT and you can pick it up at the local pharmacy.  Subscription to their service costs about 90 bucks a month which gets you lab work that they will look over, as well as routine check ups virtually.  Seems like a pretty solid deal, but kind of expensive.  My Therapist has been through Better Help because I started seeing her during the Trump ban and wanted everything solidly off the books. 

 

Basically, my options are A: keep going with what I had initially planned and get HRT through Plume when I get out, or B: Get HRT through the VA which could be significantly cheaper, but I feel like I run the risk of gatekeeping.  I have waited YEARS for this, I am not about to let some doctors stand in my way and gatekeep me.  Additionally, if I do decide to go with the VA would it be smart to start the transition process now, to at least get it on my medical records and maybe start HRT early?  I don't know, and everyone who I have asked, thats safe to ask, doesn't know either.  

 

Thanks for reading.  

[Susan R]

2 hours ago, Natasha K said:

Basically, my options are A: keep going with what I had initially planned and get HRT through Plume when I get out, or B: Get HRT through the VA which could be significantly cheaper, but I feel like I run the risk of gatekeeping.  I have waited YEARS for this, I am not about to let some doctors stand in my way and gatekeep me.  Additionally, if I do decide to go with the VA would it be smart to start the transition process now, to at least get it on my medical records and maybe start HRT early?  I don't know, and everyone who I have asked, thats safe to ask, doesn't know either.  

Ultimately, anything I say means absolutely squat but I can tell you what I’d do…if it’s just a random opinion you’re after.

 

I would go the VA route and start it immediately. For me, life is too short. You’re much younger so you’ll have to put some bias in my corner but if you’ve identified the issue, accepted it, and plan to move forward regardless, I would take the earliest route. I’ve heard nothing but good things overall from the people I know working their transitions through the VA. I’m sure it all depends on the specific medical personnel you’re dealing with but the same holds true just about anywhere to some degree. Save some money, get the care you need and want because as I stated above…life is too short.

 

Best of Luck to you,

Susan R?

[Heather Nicole]

3 hours ago, Natasha K said:

or B: Get HRT through the VA which could be significantly cheaper, but I feel like I run the risk of gatekeeping.  I have waited YEARS for this, I am not about to let some doctors stand in my way and gatekeep me.

 

Hi! Nice to meet you!

 

While I can't offer a direct answer for you, and I don't have any experience with military, VA, or any of the specific details of your situation (and I don't want to pretend to be any trans-expert, I'm pre-HRT too). There is one thing here I'd point out, FWIW, just in case it might be helpful:

 

IIUC, to reiterate, it sounds to me like you're already confident on pursuing HRT and you're mainly just evaluating two different routes to your HRT: "VA now-ish" or "non-VA immediately after discharge". Each seem to have their pros, cons, and maybe also unknowns. Right? (Apologies if I've misunderstood anything.)

 

It sounds like one of your major concerns of the VA route is potential gatekeeping and, I assume, delays as a result of the gatekeeping. If so, I think it's worth also bearing in mind the existence of self-imposed gates and delays. So, if your non-VA option involves voluntarily waiting several months, then, at least as far as the timeline metric of your decision goes, you have a choice between waiting that already-known amount of time, or dealing with some VA gatekeeping hurdles that (IIUC) might wind up getting you to your HRT either faster or slower, for all we know, than your non-VA option.

 

It sounds like there may be other valid considerstions you're evaluating in your decision. But if timeframe is a major factor for you, then I'd recommend not necessarily ruling out the "gatekeeping" option as a nonstarter, but instead comparing it to the time you'd have to wait before finishing your service and going ahead with your "immediate" non-VA option.

 

One other thought: Is it possible to pursue your VA option for the time being, and if the gatekeeping really does drag out past the end if your enlistment, maybe then you could just say "forget it, too late" to the VA route and then fall back to your non-VA "informed consent" option instead?

 

Just my thoughts, FWIW.

[Natasha K]

1 hour ago, Heather Nicole said:

 you have a choice between waiting that already-known amount of time, or dealing with some VA gatekeeping hurdles that (IIUC) might wind up getting you to your HRT either faster or slower, for all we know, than your non-VA option.

 

It sounds like there may be other valid considerstions you're evaluating in your decision. But if timeframe is a major factor for you, then I'd recommend not necessarily ruling out the "gatekeeping" option as a nonstarter, but instead comparing it to the time you'd have to wait before finishing your service and going ahead with your "immediate" non-VA option.

 

One other thought: Is it possible to pursue your VA option for the time being, and if the gatekeeping really does drag out past the end if your enlistment, maybe then you could just say "forget it, too late" to the VA route and then fall back to your non-VA "informed consent" option instead?

 

Just my thoughts, FWIW.

Thats a great point.  I definitely had not thought of it like that before.  I think I was thinking about things in a really (binary) kind of way; either or.  Maybe I also know that I want to try to get HRT while in service, but I am scared to do so.  It involves coming out to the commander...and that seems super scary. :3  But I think I will muster up the courage to give it a go.  Thank you for encouraging words. 

[MirandaB]

As someone who regrets not started sooner every dang day the option of starting now and using the other plan as a backup is the way to go!

[Charlize]

I have a trans friend near Reno who is very pleased with the VA care she receives both virtually and in person.  You may well want to explore that option.

 

Hugs,

 

Charlize

[KymmieL]

@Natasha K  While I realized that I was trans well after I got out of the war. The VA has been a goddess send. Even before transition. since coming out to my VA therapist. they have evaluated me, confirming the trans diagnosis.  ultimately on HRT. VA has been great I would defiantly go that route. and depending on a few factors, you could be like me and cost nothing out of pocket. 

 

As far as while still in. this is my opinion only. If you feel comfortable with your PCP. I would start there. legally I believe they cannot disclose information unless it affects your job and the AF. ( that I am unsure of.) Ask them to start seeing a counselor. Regardless, make sure make the records from your current therapist available to the VA that may save you some steps in the VA HRT process. 

 

Any other questions you have I am happy to help another flap lady, LOL.

 

Kymmie

[Aylamac]

Hi! I know this is almost a month old, but I wanted to offer some insight. I am also Active Duty Air Force, however have a family and so am still trying to work through how to come out to my wife and such before I take any steps towards transition. So I have no experience with the process in practice.

 

However, I have made sure to read up on all of the pertinent regulations. Between those and a friend I have at medical, it seems like the system outlined in the regs is working. So it may be worth starting your transition before you get out. I don't have the documents available to post here, but the relavent ones for us in the Air Force are DoDI 1300.28 and DAFPM 2021-36-01. The first document outlines what is required by the DoD. The second is the process the Air Force uses to meet the requirements set out in the DoDI. Both are very detailed and I was honestly left with very few questions. Hopefully this was helpful and good luck!!

[Marcie Jensen]

Hi Natasha. I realize this was originally started last month, but, this is the first time I've seen it. Here are some thoughts form a retired soldier. I admit that I'm biased about the VA system, as both my grandfathers and my father passed away in VA hospitals; this makes it kinda hard to view them objectively. That said, free prescriptions are good and you should take advantage of them. Also, both the VA and military pharmacies will fill prescriptions from providers outside the military medical system.

 

So, there is nothing to prevent anyone from starting HRT and using an outside provider such as Plume. I've been using Plume for a couple of years and am satisfied with it. In fact, I like the service so much that I'm not using TRICARE for this. Instead, I'm paying a copay and getting reimbursed for "out of net provider." So, that is also an option.

 

I've also discovered that military pharmacies don't always have the meds I use available, so that requires some advance planning. No real issue there--it just requires thinking ahead... Also, it's better to start HRT earlier rather than later. And keep in mind that while the VA now covers GCS, TRICARE does not. As Aylamac advises get the documentation. When dealing with any DoD issue, the correct manuals/regulations/other documents are always a help.

 

Good luck with your journey!

[Desi]

I have been very happy with my VA care where I live, even though there are government restraints on what they are allowed to do. They have always been welcoming at the VA. I would say the one benefit of starting on Active that is is in your records and have a better chance of getting a VA rating for it and having VA to continue the care after you get off Active Duty. 

 

Desi

[Cover Girl]

On 8/26/2021 at 7:20 PM, Natasha K said:

Hiya folks, I used to post on here a little bit, about two years ago maybe.  Fell off, went through several denial fazes along with some purging, and then regretting it later.  You know how it goes.  Anyway, thanks to therapy and a great support network around me with friends and my sister, I fully accepted that I am Trans last year.  

 

I am active duty Air Force and I have roughly Seven months left in my enlistment.  Until a little more recently, like a week or two ago, I didn't know that Biden had reversed Trump's Transgender ban, (I don't really read the AF news ever).  So here is the dilemma, I have been seeing a therapist privately, out of pocket for quite some time now, and I am all set to start HRT like the day after I get out of the Air Force.  I have several semi serious medical issues that I will be getting disability for as well as care through the VA.  After speaking with some people in the VA and looking at their services online, they are actually pretty cool with Trans folks and would be able to help me through my transition.  The place I was going to get HRT from initially was Plume if anybody has heard of them, because I live in a informed consent state they will just write you the prescription for the HRT and you can pick it up at the local pharmacy.  Subscription to their service costs about 90 bucks a month which gets you lab work that they will look over, as well as routine check ups virtually.  Seems like a pretty solid deal, but kind of expensive.  My Therapist has been through Better Help because I started seeing her during the Trump ban and wanted everything solidly off the books. 

 

Basically, my options are A: keep going with what I had initially planned and get HRT through Plume when I get out, or B: Get HRT through the VA which could be significantly cheaper, but I feel like I run the risk of gatekeeping.  I have waited YEARS for this, I am not about to let some doctors stand in my way and gatekeep me.  Additionally, if I do decide to go with the VA would it be smart to start the transition process now, to at least get it on my medical records and maybe start HRT early?  I don't know, and everyone who I have asked, thats safe to ask, doesn't know either.  

 

Thanks for reading.  

When I came out three years ago, I called the V.A.’s LGBTQ+ coordinator three days later. That was the end of April, 2020. By the end of June, I had hormones in hand.

i can’t say you’ll have the same experience because the pushback against us has increased since then. But they didn’t gate-keep me.

[Heather Shay]

I'm late to the thread but I wanted you to know WELCOME and I'm glad you are back and wish only for the best for you.

Hugs,

Heather