Question about starting hormones and WPATH etc

[hmillerrr]

Hi guys! so a little while ago I made a post asking about whether or not a therapist that isn't a gender therapist could write me a letter of recommendation. Well I asked her about it and she said it feels "unethical" and that she would have to do some research . I want her to be aware of Informed Consent but I don't know how to take that route and would feel more comfortable with a rec letter. She just needs proof that it's fine to do is there anything in a WPATHS standard of care proving me point, that I could show her? Or is it truly unethical?

[VickySGV]

For informed consent, it is not a therapist that needs strict involvement,  rather it is the Endocrinologist or even Primary Care Physician themselves.  Basically you are agreeing not to hold them liable if you have made a grade A goof up, and that you are over age 18 here in CA.  For them it is matter of what their Malpractice Insurance will tolerate, and they will probably interview you and may do so once or twice before writing the prescription.

 

As for your therapist, it is also a matter of what she feels competent to do.  There is no specific license for a Gender Therapist, or a certificate of competency for doing Gender Therapy.  If your therapist feels she is not competent, then it would be medically unethical to recommend you for HRT, and until she feels competent, which is personal, there is nothing to make her feel differently on the books anywhere.  Here in CA, the LGBT Centers in the major cities do have therapists that feel competent to do it.  Putting her in touch with one of them might be a way since collegial dialogue is the way she will learn.

[Carolyn Marie]

I agree with Vicky.  There are no "rule books" for this, only guidelines in the SoC as far as what therapists and psychologists ought to be looking for when evaluating a client.  The guidelines are not legal or ethical standards.  If she isn't comfortable, you might be well advised to seek your letter elsewhere, unless she is willing to do what's necessary to make herself comfortable with the decision.  Good luck!

 

Carolyn Marie

[hmillerrr]

5 hours ago, Carolyn Marie said:

I agree with Vicky.  There are no "rule books" for this, only guidelines in the SoC as far as what therapists and psychologists ought to be looking for when evaluating a client.  The guidelines are not legal or ethical standards.  If she isn't comfortable, you might be well advised to seek your letter elsewhere, unless she is willing to do what's necessary to make herself comfortable with the decision.  Good luck!

 

Carolyn Marie

Thank you so much for the feedback @Carolyn Marie it means a lot!  As far as making herself comfortable goes.. What does that exactly entail? Talking to a colleague as said above?

[hmillerrr]

9 hours ago, VickySGV said:

For informed consent, it is not a therapist that needs strict involvement,  rather it is the Endocrinologist or even Primary Care Physician themselves.  Basically you are agreeing not to hold them liable if you have made a grade A goof up, and that you are over age 18 here in CA.  For them it is matter of what their Malpractice Insurance will tolerate, and they will probably interview you and may do so once or twice before writing the prescription.

 

As for your therapist, it is also a matter of what she feels competent to do.  There is no specific license for a Gender Therapist, or a certificate of competency for doing Gender Therapy.  If your therapist feels she is not competent, then it would be medically unethical to recommend you for HRT, and until she feels competent, which is personal, there is nothing to make her feel differently on the books anywhere.  Here in CA, the LGBT Centers in the major cities do have therapists that feel competent to do it.  Putting her in touch with one of them might be a way since collegial dialogue is the way she will learn.

It Appreciate this response so much! I'm making these moves forward on my own and I guess I just want to know every step. When you say the endocrinologist needs to get involved, I would basically say I'm transgender and desire hormones how do I go about this? Kind of thing? Idk I apologize for all the questions hahaha. Thank you @VickySGV

[VickySGV]

Find an LGBT Community Center near you.  They will know doctors in their area that are good to deal with.  I do however recommend keeping therapy appointments even if you get the HRT.  There is a lot to this.

[Carolyn Marie]

8 hours ago, hmillerrr said:

Thank you so much for the feedback @Carolyn Marie it means a lot!  As far as making herself comfortable goes.. What does that exactly entail? Talking to a colleague as said above?

 

Yes, that, and reading enough information to allay any fears she has about making the wrong decision.  I also think you have a role to play here.  She should be talking with you about your hopes, plans, and expectations about what HRT will do for you, and mean to you, and your level of understanding about the risks involved.  If your therapist knows that you understand the risks and benefits, that should reduce her apparent anxiety about signing a recommendation letter.

 

Carolyn Marie