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Therapist cancelled, devastated

Deanna Celia M

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Was so excited about starting with a great therapist tomorrow. Cost would be $0 out of pocket since it was telemedicine so my spouse was pleased (didn't actually know what it was for though...)

They called this morning. Apparently since I live in PA and they are in NJ, the client confidentiality is not secure or something? The admin. person at the clinic said it's a law. I don't understand, I didn't think the internet was affected by state lines... So they can't see me. 

I live literally 2 miles from the NJ state line. My employer is in NJ and I have a NJ based insurance plan. 

I have been sobbing the last few hours.

Looking for a therapist in my state who does trans issues and telemedicine but there's nothing. Not even any in person in my area (which would mean a fairly hefty copay) taking new patients.

The therapist I had book was fairly far away but it was going to be online so...

My insurance website could be wrong, maybe there's more in my state who work online, but do I call them all to check?

Depressed and want to crawl into a hole... Feel like I was smacked down for having a stupid idea, maybe it is selfish to want to transition... 

There are online options like Folx but my family may not see that as legit and may see the cost as selfish when there are things they want for themselves and I am doing something "crazy." 

Other online counseling services cost even MORE than that and none take insurance of course.

Sorry just... Felt like my journey was started and now I'm on the side of the desolate road with a a smoking engine and no cell phone reception to call for a tow truck :(

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I dont see what living in another state has to do with privacy. they still have to follow hippa which is federal. i would suggest callong

your ins and the Nj state ins dept

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@Deanna Celia M I am sorry - that is a very discouraging experience. It can feel like a personal betrayal because so much was at stake for you, emotionally. Take some time to comfort yourself. Allow yourself to express feeling so upset and deflated. But, make a goal to pick up and carry on because these feelings will pass. Once you've collected yourself, call your insurance company, and speak with someone in behavioral health. Be prepared for a potentially long phone call, especially because insurance companies can leave you on hold for long periods of time sometimes, and they may transfer you to a few different people. Stay on the phone with them until you get answers to your questions. Write the questions down before you call, and keep a pad and pencil nearby when you speak with them. Try not to interpret this setback as any kind of "sign" that you don't deserve help, health and happiness because you definitely do. It's just a bureaucratic obstacle you've encountered, and that is unfortunately not atypical when it comes to dealing with healthcare and insurance. Try to see the effort of seeking out answers to these questions about your insurance as an act of self-care - you are doing it to take care of you and you deserve it. You may feel more frustration in the process of finding the answers, but you will feel accomplished once you do, and even more confident once you have a clearer path to finding a therapist. Just take your time, and wait a little while until you're ready to take on that challenge. Good luck and stay strong!

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@Deanna Celia M I don't know if this would work BUT - I wonder if it's possible for you to open a post office box in NJ and use that address to get around privacy issue. I seems to me that for ever rule made - there is some way to get around it.

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I've heard of similar situations but if I remember correctly it wasn't about privacy, it was about a patient needing to live in a state the professional is licensed in.  I wonder if that was what they were trying to get across.  I may also be misremembering it. :P

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1 hour ago, Kelly2509 said:

I've heard of similar situations but if I remember correctly it wasn't about privacy, it was about a patient needing to live in a state the professional is licensed in.

I think this may be what it was actually about, interstate commerce and crossing borders.  Last year as Covid set in many medical organizations moved to telemedicine and insurance companies paid claims. I got messages early in 2021 that if you lived out of state they would not be able to offer this.  I live in NH, but minutes from MA where all my doctors are.  So I understand your confusion and dismay.  

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That would make sense, my speech therapist only offers telehealth to people who live in the state.

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Oh, that sounds awful. It's happened to me, too.

My Fenway therapist was willing to see me after my first prescription for 12 visits, possibly for a longer term, but she just told me since she's moving out of state, she can't because of some law. That's awful--she turned out to be a great therapist.

I'm not sure of the details in the laws or why they exist at all. Seems it would benefit large health organizations in some way (they hold all the power), but I don't know for sure.

Is there anyone here on TP, who's a lawyer who could check this out?

This could be a far-reaching change for anyone needing help.

Hope this gets fixed.


-- Davie


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to me it sounds like bs. when I lived in nj both me and my wife saw doctors in NYC with no problem. the same for people that go out of state for specialized heart or cancer care

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I don't think it's BS, but it's a new rule. My therapist wouldn't do that. She was upset about it, too. Like to know the real story behind it. I'll look for an answer.


-- Davie

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@Deanna Celia M Chin up girl! I'm sorry you hit a road block. If this journey was easy they'd let anybody do it. It took four months to see my therapist, I didn't know it at the time, but she was dealing with COVID. I'm so glad I waited, she's amazing & has been wonderful for me. She & my doctor blessed HRT two months ago, but the insurance said I needed 90 days seeing a therapist to start, that date was a month ago. I don't know why these delays happened, but they did. I quell the gender dysphoria to tolerable by doing what I can: dressing feminine or androgynous, working on my voice & make-up, a support group & this amazing forum. I'm working through a workbook I really like, titled You & Your Gender Identity by Dara Hoffman Fox.


Once when I was trying to get help for a child I had to politely ask for the specific cause of rejection, then persistently, not always patiently, appeal three times. They finally granted the treatment.


Not sure if it's your issue, but there are some interstate telehealth issues, and some states have entered a Compact to allow easier licensing; it appears neither NJ or PA have passed bills for it yet though. If the issue is on the PA side there was a note about an exception for areas close by in adjacent states.  





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Thanks @Delcina B  . Yes, this complicated because medical licenses are issued  by states and the legal issues of inter-state practices have yet to be fully addressed. It's a legal mess, but it's not just BS. Some states have agreements and some don't. Your doctor or clinic will have more info.

Be persistent, Good luck.


-- Davie

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So this I copied from my health provider about televisits:


"Due to the re-instatement of state and federal restrictions, as of August 31, 2021, Fenway Health will no longer be able to schedule telehealth visits for patients located outside of Massachusetts."


No explanation given.

Thank your own insurance companies and state politicians for this complication.



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1 hour ago, Davie said:

"Due to the re-instatement of state and federal restrictions, as of August 31, 2021, Fenway Health will no longer be able to schedule telehealth visits for patients located outside of Massachusetts."


From talking to my own therapist, it's probably a licensing issue. A lot of that got suspended during the worst of our COVID epidemic because telehealth was so important. Now that things are getting back to a semblance of normal, people are starting to look at what states they're licensed to work in.


If Fenway is only licensed to operate in Massachusetts their hands are kind of tied. I don't see the point either, but licensing requirements vary from state to state.


I hope you can find someone local to you who fits your needs!



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Yes, thank you, Jackie. That all makes sense (not all of it good sense, but mostly some sense "I don't see the point either," LOL). I'm doing fine with what I can get which fills my needs if not my fears and dreams. With my regular Primary Care center I asked for a Gender Therapist and actually got one. So cool. Not sure they've had one before, so maybe this will do other trans folks some good. Asking is good, though we have to follow the rules to get coverage. Grateful for what I have including loving care here on TP.

-- Davie

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Hi all I am sorry to go silent. Thank you for all of your responses. Been really down and stressed with the therapist thing and other issues. Spent a lot of time on my insurance website and on trans resource websites and sending out emails trying to find a new therapist.


After some googling, I believe the therapist cancelled me because the state of PA, which I live in, needs the credentials of providers doing telehealth for PA residents. They have allowed out of state providers to do telemedicine during the pandemic but they must submit credentials to some entity in PA. I doubt this therapist's office wanted to do this for me, I don't blame them.


The good news is I think I have a new therapist, they still have to confirm insurance (fingers crossed). Ironically, they are just down the road from me, even though it is going to be virtual sessions. If everything checks out I should have first session Friday evening. 


It does seem hard to find therapists who deal with trans issues. I was getting desperate, feeling like searching for a needle in a haystack...


I really want to thank everyone for their advice and support, sorry to be such an emotional wreck.  

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@Deanna Celia M -- your perseverance paid off!  That's good news.  If your journey is anything like that of many of us, there will be other detours along the way.  But determination has a way of finding a way forward through the maze 🙂




Best wishes,



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OK update--the new therapist appointment is confirmed for tomorrow evening, he looks like a good therapist, very excited.

I think the therapist may be a trans man based on the picture on their website (I know, kind of impolite to try and clock your therapist, but I'd feel very comfortable with a trans person).

Fingers crossed everything goes well, I am still nervous.

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@Deanna Celia M THAT IS FANTASTIC NEWS - I'm excited for you!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!


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1 hour ago, Deanna Celia M said:

I think the therapist may be a trans man based on the picture on their website (I know, kind of impolite to try and clock your therapist, but I'd feel very comfortable with a trans person).


I hope you're right. That can be a very rewarding experience when your therapist knows EXACTLY what you're going through.



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