Has anyone used Tri-care?

[danats2]

Has anyone used Tri-care for their Therapy and HRT? I have both Tri-Care prime and full V.A. benefits and am wondering which if better / faster / slower/ better? I have been going to a Tri-Care authorized Gender Counselor and really  like her so I will continue even after the Letter thingy, but I figure I can also take the letter to the V.A. to start HRT. I know how slow the V.A. is and just want to start my transition ASAP! I aint getting any younger!

[Jani]

From everything I've read about folks accessing VA care for gender care it is dependent upon the region you are in.   I've heard certain offices in CA and FL are good but can't vouch for others.   I would say your letter would certainly be "transferrable" to be accepted by the VA or any other Endocrinologist.  

I'm sure someone will come along with a better understanding.

Jani

[Jill55]

I use tricare north for my hormone scripts and I've  not had and problem.

[Briana]

If you can stick with TriCare I'd recommend doing it.  There is a lot of variability in the VA system still that can really slow things down.  Most of my patients that have both prefer using the benefits under TriCare if they can vs. the VA.  Honestly, when I have to deal with patients that are using both - going between both, I tend to cringe.  The VA system is not so good at communicating and sharing info with other providers. 

[danats2]

My first experience with the VA on my transition was awful! I scheduled the appointment approx 1 1/2 months ago and told the phone receptionist why I wanted to see both my Primary care Physician and Mental health IAW VA procedures listed on their web site only to find they had no idea why I was there.

Mental health was first and all he said was he no experience with Transgender and had no idea to whom to refer me for help.

In between appointments I found a small bulletin board in an inconspicuous corner in the lobby with three VA poster about the VAs LGBT policy and a phone # to the LBGT coordinator in Dublin, Ga. who is responsible for training VA personnel on LBGT policy and procedures.

Next was the doctor who also had no experience with TGs and also stated at least three time she could no help me because of her Religious beliefs . She also had no Idea to whom I should be referred. I showed her the info on the LBGT coordinator and she wrote down her contact list! Damn!      

When leaving I told the doctor I will be needing a new doctor because of her religious beliefs. She seemed shocked that I would say that. I told her if she had issues helping me with my transition, why in world would she or I want her to be my Doctor after I start HRT and present as women!

I am very upset with the VA! Maybe the LBGT coordinator help? We'll see!

Edited June 10, 2017 by CyndiRae
removed unrelated links copied in text

[Guest LesleyAnne]

danats2.....

Just an FYI,

The VA directives for LGBTQ+ care are in place nationwide, however the directives are subject to regional interpretation. I live close to Houston so my care comes from the Houston region, but I travel to Austin for my transgender mental health issues, and for my endocrinologist who manages my estrogen levels(I'v had surgery thru Medicare...the VA would not do the surgery, but will do follow up care as per the directive) since I require supplemental hormonal treatment. Austin is out of the Temple/Killeen area, and their interpretation of the VA directives are noticeably different. My drive to the Austin VA is a 2 1/2 hour trip, although inconvenient it is worth it for the care, and understanding I receive. 

All of that being said, your Primary doctor should be reported to your regional VA since she is not supposed to provide care based on her religious beliefs. Things may be changing because of the current administration, and the newly appointed Secretary of Veterans Affairs (David Shulkin who has never been a soldier) may have a different approach, but so far they are the same...(crossed fingers in hopes they at least stay the same, and not go backwards!). So I urge you to report her as she has no business giving veterans care, period! My Primary out of the Houston region also told me he could not treat me for transgender issues, not because of religious beliefs but because he felt uncomfortable, and lacked training in that area of medicine. Consequently I am allowed to have two primary physicians, one in Austin who is able to take care of most issues, and she was able to refer me to the endocrinologist, and mental health professionals that are specific to my needs, and the one near Houston treats me for most all other issues. Plus I get my PTSD mental health care out of the Houston region as well. 

So as per our training my dear,......go up the chain of command. 

I wish you the best, and if you have any questions you can PM me, and I'll try my best to answer them. 

LA

[Cindy Truheart]

I haven't gone to the VA, I've heard too many horror stories. Fortunately I have decent insurance and a good job so I don't need to go to them. They need some serious training on LGBTQ+ issues in general from what I hear.

[Briana]

On 6/10/2017 at 8:30 AM, LesleyAnne said:

All of that being said, your Primary doctor should be reported to your regional VA since she is not supposed to provide care based on her religious beliefs.

And then some!  I'd say escalate up the chain but...get ready to bump your head a few times.  The VA can be difficult organization to deal with at times...many times...for some most times.  In my past experience, many times transgressions like that would only get a shoulder shrug unless or until you got to someone that really cared.  But like LesleyAnn said, definitely report it.  That's how change can start.

In healthcare, it's amazing how often personal beliefs come into play when treating/taking care of patients.  The VA is sadly no different.  With physicians it can be particularly problematic.  If they are employed by a provider organization, you can complain etc., but many times there's hesitancy on the organization's part in taking action against physicians.  It's even worse when dealing with private physicians.  They have a lot of latitude on accepting or declining patients.  The smarter ones just claim not enough expertise to handle a specific type of patient.  Or that their practice is too full and they are not accepting new patients.  

Hopefully over time, this can be changed by various payers (insurance, medicare, medicaid etc.) refusing to or withholding payment from providers that discriminate and hide behind their religion or thinly veiled racial prejudices.  While there are some current checks/balances in place, they're pretty weak and usually not enforced unless there's a gross violation. 

But in the end, you have to think, "do you really WANT to go to a physician like that??"

[Guest Hannah Emma]

I am kind of shocked by this as I use the Las Vegas VA and soon we'll be using the Loma Linda VA and I have never heard of such issues. I had very little issues getting on HRT using VA providers.

Because I already had a mental health Team and didn't need a referral from my primary care I didn't even have to tell her right away. I only told her when I finally was ready to start HRT and needed the actual referral to the endocrinologist.

Like everybody here has said please talk to a patient advocate or even escalated up to the director of that hospital because for her to use that excuse is totally unprofessional and goes against all the VA standards of care.

 

[danats2]

Called the regional VA LGBT Coordinator yester day to report and ask for help regarding my disastrous visit with my PCP and Mental health at my home clinic. She was very nice and said she would set me up with immediate appointments with both a VA Mental health that specializes in LGBT for evaluation and Endo for HRT.

She also said she would report the incident to the regional Director for corrective action and to stress the need for more training of regional VA personnel as how to treat and assist LGBT Veterans and the need to expedite evaluation and treatment of Veterans with Dysphoria!

I also asked if she could help me find a new PCP.   We'll see what happens