HRT Questions

[Ryan01]

I am currently in gender thereapy and as I've known for most of my life I am leaning strongly toward going full time. I havent mentioned hormones yet but would really like to start them. What is the process of getting on HRT? Can my therapist recomend them or do I have to see my family doctor? I have been going to therepy for about a month and half and have held my tounge on the subject not wanting to seem like I only go to therepy to get something. Any thoughts, facts or suggestions would be awesome. Have a great day girls.
Ryan

[StaceyJane]

Your therapist can write a letter recommending you for hormone therapy. You would then have to find a doctor who will want to see the letter before beginning.
Most people see an endocrinologist but really any doctor familiar with HRT will do.

[LeaP]

Typically a therapist will want to have had you in therapy for at least three months before writing the letter. That's no longer the ironclad rule it used to be, but it is still a guideline and, in my opinion, it is well advised.

As far as HRT itself goes, doctors will often do bloodwork first, both for a baseline on serum testosterone and estradiol as well as to look at any potential problem areas like prolactin, potassium, and liver enzyme levels. A common start is a low dose of anti-androgens for a period of time, followed a month or so later by a low-dose of estradiol. The latter may be oral, injectable, creams, or patches. The doctor may or may not include progestogens. Any ramp up in dosages after start would be something you would want to discuss with your therapist as well as your doctor. The doctor may want additional blood work before ramping up dosages – some do, some don't. And when your regimen is fully established, you can expect to have a check in with the doctor and blood drawn every six months or so for the time being.

If you haven't done so already, start reading everything you can get your hands on about HRT. Hormones manage and change the body in very fundamental ways, and it pays to know what you are doing to yourself.

[Tammy V]

I was like you and did not want to mention hormones to my gender therapist even though I did want to transition and essestially that's why I was there. In our third meeting (about a month and a half in) she asked me what I thought the next step was and I responded that I did not know. Then she asked me if I wanted to "try" hormones. I tried not to be too quick with my response of yes but it was a few more sessions (3 months as Lea stated) before she actually had the letter ready and was sending it to the doctor. She is probably progressing toward a point of talking to you about HRT or she may be waiting for you to ask about it. If you get to the three month point and it hasn't been brought up, ask her about hormones. Actually, she is working for you so you can ask about that treatment at any time you want to, and what her plans or policies are about recomending you for HRT.

[Kathryn Martin]

You should be in counseling for a period of at least three months. It's part of the Standards of Care by WPath which is used by most doctors and therapists.

[Ryan01]

Thank you everyone for the advice. I was aware of the three month time period for the Dr. and the patient to both evaluate the situation but was not sure if I had to see secondary medical professional as well.
Could anybody suggest a tg friendly Dr. in the state of FLorida? Preferably somehwere between Orlando and Jacksonville. I am not oppossed to traveling I want to get out of this town as it is anyways.