I Have Several Questions

[Guest Sotha]

I am mildly exhausted from everything that has been happening in my life lately, so I'm not entirely thinking clearly. As such, I apologize if these are stupid common sense questions that I should not have to ask.

Anyway, what exactly are Kaiser in Southern California's policies on HRT and whatnot? I couldn't find them anywhere. I'm on the STEPS Plan by the way. The book for the STEPS Plan merely states (at least as close as I can remember) "Sex change surgery is not covered."

Now, I know almost no doctors will prescribe hormones without a letter of recommendation from a therapist person, but would they still require one for antiandrogens?

On that note, can only GT's / mental health professionals specializing in gender stuff (or just with experience in it) write such letters of recommendation?

And, since psychiatrists can prescribe things, would they be able to prescribe hormones directly?

Thanks for helping clear my confusion.

Kat

[Carolyn Marie]

Kat, anti-androgens are still part of the HRT regimen, and so would likely fall under the SoC. While a letter isn't required by all doctors, most

apparently still do.

A Psychiatrist can prescribe drugs, but usually those involved in treatment of mental illness. I doubt very much that a psychiatrist would

delve into the area of endocrinology, where they are not trained, to prescribe hormones and t-blockers.

Lastly, any registered and trained therapist can write an HRT letter if they have followed the recommendations of the SoC. They don't have to

be a gender specialist.

Hope this helps.

Carolyn Marie

[Guest Sotha]

Kat, anti-androgens are still part of the HRT regimen, and so would likely fall under the SoC. While a letter isn't required by all doctors, most

apparently still do.

Yeah. That is what I thought. I just hoped I would have been able to at least be on antiandrogens while I was going through the therapeutic requirements for hormones, considering that I am still going through puberty (which I really need to stop doing) and that they don't really have any permanent effects like estrogen does.

Lastly, any registered and trained therapist can write an HRT letter if they have followed the recommendations of the SoC. They don't have to

be a gender specialist.

Well, that's a bit of a relief. Might I ask how registered and trained they need to be. Like, any specific certifications or anything like that. (I'm in SoCal if that makes any difference.)

[Guest Sotha]

Yeah. That is what I thought. I just hoped I would have been able to at least be on antiandrogens while I was going through the therapeutic requirements for hormones, considering that I am still going through puberty (which I really need to stop doing) and that they don't really have any permanent effects like estrogen does.

Might I ask how registered and trained they need to be. Like, any specific certifications or anything like that. (I'm in SoCal if that makes any difference.)

Like, how certified would a "Licensed Clinical Social Worker" be?

[Guest Donna Jean]

Good question, Hon....

I think that would be a question that you need to ask anyone that you have in mind to work with...

But, to keep from wasting your time and money...it's best to have a trained gender therapist...

Here....

This is a list on our site here...look it over, ok?

http://www.lauras-playground.com/gender_therapists.htm

Good luck, Honey!

HUGGS!

Donna Jean

[Guest Sotha]

Good question, Hon....

I think that would be a question that you need to ask anyone that you have in mind to work with...

But, to keep from wasting your time and money...it's best to have a trained gender therapist...

Here....

This is a list on our site here...look it over, ok?

http://www.lauras-playground.com/gender_therapists.htm

Yeah... I've seen that list before. I suppose I should just try calling the nearest therapists to me and spiraling out from there.

It's just that I have no way of being able to afford it. That's why I'm trying to do everything through Kaiser.

This is because I have heard that if they're not a part of Kaiser's system, Kaiser will not cover them.

Then again, spending all of my money on a therapist to get to HRT would be better than wasting months with Kaiser, then having to do it anyway.

[Carolyn Marie]

Sotha, my assumption is that any psychologist or therapist practicing within Kaiser's network is qualified to practice individual or family therapy.

What I suggest is, if your policy doesn't specifically prohibit covering gender identity issues, then set up an appointment with any therapist.

Then ask them about gender issues when you see them - whether they know of any gender specialists within the Kaiser network in So. Cal.,

if not, whether they would treat you themselves, particularly if you provided a copy of the SoC and other materials on the subject.

What probably is not a good idea is discussing coverage for GID with a claims specialist or some other bureaucrat in Kaiser's system. If Kaiser

doesn't cover it, they might flag you and keep you from seeing even a general therapist.

I believe I've seen posts from other members who have Kaiser who said they were able see a therapist and even get HRT, but I can't put my finger

on it.

I don't know if this is helpful, but I hope so.

Carolyn Marie

[Guest Sotha]

Sotha, my assumption is that any psychologist or therapist practicing within Kaiser's network is qualified to practice individual or family therapy.

What I suggest is, if your policy doesn't specifically prohibit covering gender identity issues, then set up an appointment with any therapist.

Then ask them about gender issues when you see them - whether they know of any gender specialists within the Kaiser network in So. Cal.,

if not, whether they would treat you themselves, particularly if you provided a copy of the SoC and other materials on the subject.

Well, the Licensed Clinical Social Worker lady said she would try to help me after we talked about it. I am scheduled to meet her on April 1st. (It's no joke!) I plan to give her a copy of the SOC then because, even though she said she would look it over, I do not trust that she will have had sufficient time to. I will also ask about her qualifications/certifications and her ability to actually write a letter of recommendation for HRT, as well as if she would be able to look up and see if there are any gender specialists (like therapists and doctors) in the Southern Californian Kaiser network.

The main problem with her (assuming that she will be able to help me) is just the frequency of our meetings. As she is new to this process, I imagine she would adhere to the SOC rather strictly (even though I could attempt to persuade her that they're more guidelines than anything else ). I would like to be able to fulfill the semi-requisite twelve therapy sessions before diagnosis within the seemingly standard three months. We would thus be required to meet every week or so. She is so busy (My mother's work schedule also has a lot to do with it, considering she only has Wednesdays and Thursdays off.) that I can only get in every three weeks or so. That is not good.

I believe I've seen posts from other members who have Kaiser who said they were able see a therapist and even get HRT, but I can't put my finger

on it.

Well, that's because you have. I think I've seen three different people post threads about it working for them.

[Guest Sotha]

But, to keep from wasting your time and money...it's best to have a trained gender therapist...

This is a list on our site here...look it over, ok?

http://www.lauras-playground.com/gender_therapists.htm

After looking over the list and putting everyone on it in google.maps, I have concluded that these people are the closest to where I live at 34.3 miles and 38.6 miles respectively. Not too far, I guess.

Joseph M. Amico, M.Div., CAS, LISAC

2526 Hyperion Avenue, Suite 4

Los Angeles, CA. 90027

Phone : (818) 502-2271

Email : [email protected]

Sliding fee scale.

Christine Milrod, MA, MFT

519 North La Cienega Blvd., Suite 209

West Hollywood, CA 90048

Phone : (310) 281-9658

Anyone else is at least 40 miles away. The LA Gender Center (LAGC) is 42.5 miles from me.

I also found an electrologist that is hopefully still practicing only 10.5 miles away!

Yvette A. Becerra, L.E., C.P.E.

President, E.A.C., So. Chapter

22603 Birds Eye Drive

Diamond Bar, CA. 91765

Phone : (909) 860-3264

Email : [email protected]

"I do treat transgender clients."

I will have to do some looking and make some calls some time soonish...

Has anyone heard anything about any of these people?

I've heard the LAGC is good, but I'd prefer not to have to travel another 10 miles if I don't have to...

[Carolyn Marie]

I only have experience with the LAGC, and they are excellent. If all else fails, its a good choice.

Carolyn Marie

[Guest Sotha]

I only have experience with the LAGC, and they are excellent. If all else fails, its a good choice.

Carolyn Marie

How are their prices?

[Carolyn Marie]

How are their prices?

Mine charges $100 per hour if you pay cash, $150 an hour if you use insurance. I guess that explains why we need Obamacare!

I can provide her name if you PM me. She is excellent.

Carolyn Marie

[Guest Sotha]

Mine charges $100 per hour if you pay cash, $150 an hour if you use insurance.

Yeah.. probably not, unless I am able to find work before then.

[Guest Sotha]

I went to the directory of private practice therapists on the LAGLC site, and found two specializing in "transgender issues", both 25 miles from me.

Evelyn Novello Ph.D.

Mary Nalick LCSW

Mary Nalick charges $60, $10 less than Evelyn. If the Kaiser therapy route doesn't work, which it doesn't seem likely to, I am going to attempt to convince my mom to pay for it, and I will pay her back when I get a part time job (this summer). I mean, it's only $960 for 12 hours.

[Guest Sotha]

Well, I called the LGBT center where my youth group is at, thirty miles away in Orange County, and they sent me to the OCTC site, where there is a huge list of therapists and other transition resources in Orange County.

I am going to see their distance from me, as well as prices (if I can find them), and my mom wants me to search their names at the Kaiser site, but I still don't think this is going to narrow it down nearly enough for me to just pick one. How would you decide? Phone consultations with all the top choices?

[Guest Sunshine]

Just a thought. If you are seen for depression. The GID might be a secondary condition. Depression is covered.

[Guest Sotha]

Just a thought. If you are seen for depression. The GID might be a secondary condition. Depression is covered.

You mean to get me covered for every therapy session rather than the standard eight my plan covers?

And I think I may have found something on a site my mom found...

Kaiser Permanente Fontana Medical Center

Hospital and Main Campus

9961 Sierra Ave.

Fontana, CA 92335

Start with the Mental Health Center seeking

a therapist.

Therapy: Christine L. Smith,

Psychiatry: Jasvinder K. Dhingra.

Endocrinology: Matthew L. McCauley

I'm just worried I wouldn't be able to see them because I'm a minor.

[Guest Sunshine]

I don't know the specifics of your plan, but a lot of plan start with a fixed number of sessions which can be extended at the discretion of the therapist. So, yeah.

[Guest tori319]

You mean to get me covered for every therapy session rather than the standard eight my plan covers?

And I think I may have found something on a site my mom found...

I'm just worried I wouldn't be able to see them because I'm a minor.

Did you find anymore stuff out?

[Guest Sotha]

Did you find anymore stuff out?

Oh. I'm sorry.

I have forgotten that I have not told anyone here about what's been going on in my life lately. Okay. Let me bring you guys back up to speed.

Although she was unqualified to really work with me, the LCSW lady was very nice and helpful. She sent a message out to the directors of several mental health facilities in my area asking about therapists who have experience with GID. One about thirty minutes away from me responded recommending a Michael Stample, who has worked with several. Despite the fact that he is an adult therapist, he was willing to see me. He was, and I have seen him several times (like three) over the past two months.

As he is the only Kaiser therapist I have actually seen, I cannot verify what he has told me or anything like that, but what he has essentially said is this: 'Kaiser doesn't follow the SOC. It just doesn't work out like that. Just work with your PCP (if they're supporting; if not, find another one who is) to find an endocrinologist or the like who will work with you to get you want you want. No letters or anything like that.' As I said, I do not know if Kaiser is actually like this, but it's what I have been working off of.

As it seems you are still looking for a therapist, I can offer you a little advice.

People in Kaiser are there for you. Most of them want to help you.

Ask around. Ask for lists of trans-friendly doctors (as ReginaRenea suggested, though I personally have no experience) if there are any. Ask your PCP (or someone else if you have someone better to ask) to try to find a therapist for you with experience or to refer you to an endocrinologist or whoever. Ask them to ask around themselves, send letters out or whatever to try to find someone with experience if you can't.

There are always people who do. Or at least people who know of people who do.

Squeaky wheel gets the grease.

Or should I say, annoying patient gets the help they want.

[Guest tori319]

Oh. I'm sorry.

I have forgotten that I have not told anyone here about what's been going on in my life lately. Okay. Let me bring you guys back up to speed.

Although she was unqualified to really work with me, the LCSW lady was very nice and helpful. She sent a message out to the directors of several mental health facilities in my area asking about therapists who have experience with GID. One about thirty minutes away from me responded recommending a Michael Stample, who has worked with several. Despite the fact that he is an adult therapist, he was willing to see me. He was, and I have seen him several times (like three) over the past two months.

As he is the only Kaiser therapist I have actually seen, I cannot verify what he has told me or anything like that, but what he has essentially said is this: 'Kaiser doesn't follow the SOC. It just doesn't work out like that. Just work with your PCP (if they're supporting; if not, find another one who is) to find an endocrinologist or the like who will work with you to get you want you want. No letters or anything like that.' As I said, I do not know if Kaiser is actually like this, but it's what I have been working off of.

As it seems you are still looking for a therapist, I can offer you a little advice.

People in Kaiser are there for you. Most of them want to help you.

Ask around. Ask for lists of trans-friendly doctors (as ReginaRenea suggested, though I personally have no experience) if there are any. Ask your PCP (or someone else if you have someone better to ask) to try to find a therapist for you with experience or to refer you to an endocrinologist or whoever. Ask them to ask around themselves, send letters out or whatever to try to find someone with experience if you can't.

There are always people who do. Or at least people who know of people who do.

Squeaky wheel gets the grease.

Or should I say, annoying patient gets the help they want.

So the doctor that your seeing now is with kaiser?

[Guest Sotha]

So the doctor that your seeing now is with kaiser?

Yes. I am working entirely within the Kaiser network. Actually, I saw an endocrinologist (also in Kaiser) for the first time yesterday, and I should be posting a topic on what happened during the appointment sometime soon.

If I forget to post a link here, keep an eye out for it.