Can't find an endocrinologist !

[Suzanne F]

I was elated last month to find out that my health insurance now covers HRT and SRS. I went to my primary doctor and he agreed to refer me to the endocrinologist at the same facility that is in my network. I couldn't wait to have my initial consultation.
After a few weeks with no call I decided to check on things myself. I called the office for the endocrinologist. The nurse put me on hold and then came back. She said she was sorry but I had been denied coverage. I explained that I had a letter from my insurance authorizing coverage for HRT. She said no the doctor was turning me down because she had no experience " treating transgender issues.,

Ok I almost cried but I pressed on. I called my insurance company and they said ok we will refer you to UC Davis. Ok great that will work! A week later I was told no we don't have any room for new patients. I did cry when I was told that. I pressed on and called back. They tried to refer me to Mercy in Sacaramento. Guess what? The doctor said no she didn't have experience treating transgender patients. Cried again! Now insurance company tries to refer me to UCSF in San Francisco. Apparently this may not work because the doctor there is considered primary care and I can't see their primary care doctor only a specialist. Plus it has to be approved by upper management at insurance company because way out of network. I haven't heard back and it has been another week!

I will prevail! However, it has been so difficult. Thanks for listening.
Suzanne

[PretzelGirl]

I am sorry it is turning into such a stressful chore Suzanne. But you are in a major city, so there are likely many that can help you, it sound like you are just getting the bad luck of the draw. Are there any local groups or centers you can poll to quicken the process?

[CostaRicaRachel]

I'm so sorry for you. It must be very difficult. I hope things work out for you. If you ever get down, just remember there are people like me, on your side rooting for you.

[Barati]

That is the downside of living in the USA. No national healthcare program, no anything.

However, my country has healthare protection for all citizens, but I still had to fork up thousands of euros for my SRS.

[Melissa Rose]

Suzanne, sorry to hear about the difficulties in finding a suitable doctor.

Try contacting the Gender Health Center in Sacramento. They have a small packet of information you can give to your doctor concerning health care for transgender patients. It is a good starting point for a doctor with little experience in HRT. Also, it has contact information for the main doctor who oversees the GHC hormone clinic.* I recent changed to a new primary care physician and she had no problem with taking me on as a patient and was very interested and willing to learn more about my treatment protocols. I had a fantastic first visit with her which is a whole story in itself.

*The Gender Health Center has a free hormone clinic on Friday evenings two times a month. The cost of the visit and lab work is free, but you have to pay for your own meds. The waiting list is 3-4 months to get your first appointment.

[Annaliese]

Suzanne I would send a letter to the first doctor, and just ask if it's no experience with transgender issues, or an issue with transgender. If it no experience there not time like present to learn.

[Eryn]

Perhaps you should seek out an endo who isn't transphobic and then see if that doctor will take your insurance. Seems a lot more direct than letting your insurance shoot in the dark.

[celeste26]

Virtually every health plan includes options for going "out of the plan". Usually the costs are a little higher but in general they will cover most of those costs. Since it seems you are in San Francisco there has to be some endo somewhere to help out since the city offers to cover SRS in their own health insurance. I find it hard to believe that some of those professional medical people cannot offer you a referral since they probably meet regularly with groups of endos in their region on a regular basis. Dont lose hope there are some professionals within that area who can help you, just haven't found them yet.

[Kate T]

Wow, Suzanne, I'm really sorry you are getting stonewalled like this. On the flip side though I think it is best that you are treated by a specialist who has had experience with TS.

The American Association of Clinical of Endocrinologists has a website with a "find an endocrinologist" thingy. Unfortunately whilst TS is not listed as a special interest one would assume that any specialist interested in Reproduction would be most likely to have the knowledge and experience to deal with transition hormone programs.

Good luck

[DebbieL]

I had the same experience here in New Jersey. Nearly all of the endocrinologists were more interested in fertility treatments - it would have been trivial to get MORE testosterone, but trying to get LESS - anathema. One secretary was rather blunt; "Most our customers are Christian couples trying to have a baby, you would drive them away".

I ended up going to Mazzoni center - a 2 hour train ride on Amtrack - where I was not only able to get treatment, but I was also able to get the appropriate letters needed for legal name change and gender change.

Check the local LGBT center in San Francisco. I can PM some other options. Usually there are doctors who may not specialize in endo, but they have the qualifications to prescribe and monitor the appropriate levels and to monitor progress.

Ironically, once I did get start treatment at Mazzoni, my heart doctor offered to prescribe the spiro if I needed him to do so, and my GP offered to write the estrogen scripts. She also told me that I needed to get a mammogram next year, and an annual breast exam, she also showed me how to check myself for lumps and explained that as my breasts grew, they would be lumpy at times and then smooth out, but if one of the lumps started growing or getting harder, I should see her right away. So far, so good.

One of the problems for many doctors is that they have hospital privileges in hospitals that are funded and managed by religious institutions. Diagnosing a patient as transsexual and providing transition assistance puts those hospital privileges at risk.

Recent research of larger and larger groups of transgender and transsexual populations has shown that treatment is critical to survival as well as the health and well-being of the patient. In fact, the American Psychology Association and American Psychiatric Association have now made it UNETHICAL to try and convince a confirmed transsexual to accept their birth gender. The American Medical Association has now declared gender dysphoria a medical disease, which is treatable, and is pushing to have treatment, including HRT and SRS covered by all insurance plans.

They have also discovered that the transgender population is much larger than originally thought. Including the full range, they have revised their estimate from 1 in 300 men to 1 in 30 - when they got over 9 million respondents to a recent survey. When observing children in kindergarten and first grade, there are indications that 1 in 10 boys exhibit transgender behavior and 1 in 7 girls.

[grace7777]

Suzanne, sorry to hear about the hard times you are having. Hopefully everything ends up working out.

[Heather25]

Hi Suzanne,

Sorry to hear about your troubles. I didn't think I'd have much to add but I just thought of a partial work around maybe? As I understand it, the problem is mostly finding an endo on your insurance right? I would assume in the SF area a endo experienced in HRT would be otherwise available.

So would it be useful or helpful to at least mitigate the cost by having your GP order the necessary tests (as indicated by the endo you would eventually see) so that those tests would be covered by the insurance. Then you could come out of pocket for only the endo's fee. Take the prescriptions and have them filled using your insurance. I know it may not be optimal but would it help? Remove some of the costs?

Hope you meet with success soon.

Heather

[Kris Avery]

Suzanne,

This medical practitioner, insurance, and referral process is total rubbish.
I have come to realize in my own case that you can't even find someone to talk to in some areas...least wise a physician.

Perhaps it's another sanity test?

[Suzanne F]

I called my insurance company on Thursday. They were surprised that the doctor from UCSF has not called me yet. They had agreed to see me according to the coordinating nurse. She gave me the number of the nurse in the office at UCSF and I called and left a message. That was on Thursday. I did not hear back yet. So I think some progress has been made but I am still waiting for the appointment.
Suzanne

[Suzanne F]

Success!
UCSF Women's clinic will see me! There is a Dr Deustch that treats trans women. I have initial appointment on 12-12. Thanks for all of the support. I can't believe I am at this point. If I hadn't found this site I would have never taken the first steps.
Suzanne

[Annaliese]

That is so good to here, good luck girl, First step of many. Hugs

[StephanieJ]

Glad to hear you had success my friend. If you had trouble finding someone in the big city, I'm worried how I ever would here in small town Utah. I don't have insurance though so maybe that will make things less complicated. Good luck on the 12th. You will be in my thoughts.

[MaudeB]

I don't post on this site very often but I followed this thread with much interest. I'm in Canada and my company has offices both in the USA and Europe. I worked in the US previously and had planned to be back there one day. Since I have coverage from my public health system, I would be most curious as to what kind of coverage my company offers for HRT/SRS in the US. I'm not completely out yet but have been on HRT for 10 months. I'm working on electrolysis first before being fulltime. It'll take another six months at least to get beard free and able to be out fulltime... tn

I'm very happy for you that you finally found coverage !

Maude

[MarieTS]

Maude, did your insurance cover electrolysis or are you paying for that out-of-pocket?